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P r o f i l e
Services and Facilities
Pay reform agenda for all staff within the NHS has
Aims 
The Royal Liverpool and Broadgreen University
equalised pay rates across the NHS. These
We will ensure that high quality services are
Hospitals NHS Trust is one of the largest and
reforms have been implemented with significant
designed and delivered in collaboration with all our
busiest hospital trusts in the North of England
additional investment from the Department of
major partners in the local health and social care
employing over 5000 staff and providing services to
Health and there is an expectation that all
system, to promote and improve the health of the
almost 1 million patients each year.  As well as
organisations will benefit from improvements in
population, reduce health inequalities and to promote
providing general hospital services and emergency
efficiency arising from lower sickness absence,
the early diagnosis and management of major disease
services to local Merseyside communities, the Trust
turnover of staff and redefined roles.
areas, and specialist services. 
offers high quality specialist care including
renal services, cancer services, cardiovascular,
The introduction of the tariff system ‘Payment by
The services within our hospitals will be organised
gastroenterology, haematology, orthopaedics,
Results’ will change the way the Trust is paid for
so that patients receive services promptly, have
ophthalmology and dental services to the wider
the services it provides and will lead to service
choice in access to services and treatments that
population of North West England and North Wales. 
redesign to ensure that expenditure is within the
are delivered to assured standards of clinical care.  
income received.
As one of a small number of teaching hospitals
Care will be provided in an environment that promotes
across the country, the Royal and Broadgreen are
patient and staff well being; respects patients’
The White Paper, ‘Our health, our care, our say:
closely linked with Liverpool and John Moores
privacy, needs, and preferences and is provided
a new direction for community services’, has
Universities and  the Trust provides a large number
through modern facilities which are able to support
identified clear intent to move services out of
of placements for student doctors, dentists and
twenty first century service standards.
Hospital care. The Trust embraces this objective
nurses all of whom benefit from the expertise and
and is working in partnership with the PCTs to
We will continue with our strategic alliance with the
experience of some of the most skilled and respected
develop clinical pathways and diagnostic services,
University of Liverpool and other partners to be a
medical and nursing staff in the country. 
which will result in patients obtaining their care in
recognised centre of excellence in biomedical, clinical
the most appropriate setting.  
Activity for 2005/2006 includes 474,724 Outpatients
and health service research ensuring that patient
appointments, 125,591 patients attending our
individual needs are based on what assessed
Emergency Services Departments and 83,353
research evidence has shown provides effective
in-patients who have been treated.
clinical outcomes.
Our budget this year was £294million.
Our aim is to provide quality undergraduate,
postgraduate and continuing education and
External Environment
development in all disciplines, promoting the
The NHS is undergoing a significant period of
organisation’s culture and working practices, and
reform and it is within this environment that the
ensuring that quality improvement and patient safety
Trust must operate:
are core values within the Trust.
The development of Independent Sector
We will deliver healthcare in partnership with
Healthcare Centres, allowing patients choice in
patients, their carers and relatives, respecting their
the selection of the hospital where they have
diversity whilst ensuring that their changing health
their treatment, will impact on the demand for
care needs are met. 
services at the Royal and Broadgreen hospitals.
The Trust was awarded a maximum three stars
The Trust Board places significant importance
by the Independent Healthcare Commission,
As a Trust we wish to be regarded as an effective,
on the issues which will ensure that our Hospitals
in July 2005 for its improvements in clinical
well run organisation, meeting financial duties,
continue to be the places where patients choose
services
providing a supportive environment for staff and
to have their treatment. 
ensuring that activities are planned in a way to
deliver NHS performance targets.

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Looking ahead I believe 2006/07 is going to be a watershed as the NHS continues
to implement the NHS Plan which was written in 2000. The patient-led NHS is
becoming a reality with patient choice of where they will be treated, online booking of
appointments and the greater use of independent sector facilities paid for by the
NHS. It will be a challenge to meet these objectives and remain in financial balance.
This challenge will only be partially mine since I retire from the “Royal and
Broadgreen” after 10 years as Chairman on 30th November 2006.
Before leaving I would like to pay tribute to all our staff who over these ten years have
worked tirelessly for the NHS. I genuinely believe that the NHS has improved greatly
with waiting times being reduced dramatically. I believe competition will drive us to
greater efficiencies and I am sure the management team and my successor will strive
to make this Trust the hospital of choice for those on Merseyside by continuing to provide
excellent medical and surgical care within an improving  environment.
Finally a big thank you, once again, to my Board colleagues for their support and
commitment over the last year. In December we welcomed Colin Duncan to the
Board who replaced Christine Johnson who had been a Board member for the
previous 8 years.
Roger James
These are very challenging times for the Trust and I am delighted that we have come
Chairman
through them to date in such good shape. For this achievement we must thank our
staff for their enormous cooperation in overcoming the difficulties that faced us during
the year.
These difficulties were both financial and operational.
Financially we overcame the shortfall in funding for the new Consultant Contracts as
well as Agenda for Change. We overcame the initial introduction of Payment by
Results although the amount of money we will receive on a like for like basis will be
reduced by some £4.3 million in 2006/07. We will therefore not be immune from
difficulties that are affecting so many other Trusts up and down the country.
However, it gives me pleasure to write that we ended this year  in financial balance.
Operationally we treated 3% more patients in A&E and 4% more inpatients and 6%
more out patients than the previous year.
2

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Profile
inside front cover
Our Patients
16
Services and facilities
Patient and Public Involvement Strategy
External environment
Our Future
17
Aims
Royal Redevelopment
Foreword – Chairman
2
Resources and Performance
18
Welcome – Chief Executive
3
Performance and Activity
Making an Impact
4
Complaints
Collaborative Healthcare
6
Managing the Hospitals
Faster, more convenient Services
9
Summary of Financial Statements
BGH Urology treatment centre
Remuneration Report
Research and Development
10
Audit Services
Modern Facilities 21st Century Standards 11
Photographs
Broadgreen Hospital New Development
The new Radiopharmacy Department, RLUH
5
Clinical Chemistry - Royal Visit
Patient Rehabilitation - Broadgreen Day Hospital
7
Our Workforce
13
Ultrasonographers - Radiology Department, RLUH
8
Effective People Management
The Vascular Unit, RLUH
9
Becoming a Model Employer
HRH Duchess of Cornwall - 
12
Valuing Our Staff
Department of Clinical Biochemistry
Delivering Major Projects
The winning Team of the Year 2006
14
Mainstreaming Equality & Diversity
Christine Atkinson (centre) - Employee of the Year
15
1

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I am grateful for the valuable contribution of our staff throughout the year particularly in respect of the
major NHS reform projects like Agenda for Change, the introduction of the Picture Archiving
Communication System (PACS) and service re-design of Services for Older People, including the
development of a new Stroke Pathway.  All Trust staff have worked extremely hard throughout the year
in order to make improvements to so many of our services. This year 15 teams again submitted entries
for the Trust’s “Team of the Year” competition and I wish to offer my congratulations to all those teams
who submitted entries and to recognise the achievement of the prize winning Renal Conservative
Management Team.  I am delighted to report that the Trust at the end of March 2006 achieved
Improving Working Lives Practice Plus status.
The Trust has updated its assurance framework, which assists in the management of the critical risks
facing the organisation. 
As a 3-Star Trust we are eligible to consider an application for NHS Foundation Trust Status. A
Foundation Trust Diagnostic Study last year supported the conclusion that the Trust would be fit for
purpose to apply for Foundation Trust Status in 12-24 months time. The Trust Board has yet to make
a decision on the timing for Foundation Trust Status application.  At the appropriate time, such an
application would involve preparatory work and a period of consultation with our local community. 
The Trust has collaborated closely with the Primary Care Trusts in developing Clinical Pathways in
order to ensure that patients are treated in the appropriate location.  To that end, the Trust has worked
with the Primary Care Trusts to ensure that patients come to hospital only when they need to.  
Work has continued throughout the year on planning for the replacement of the Royal Liverpool
University Hospital for which we are currently developing an Outline Business Case.  The work to date
has focused on determining the size and scale of a new hospital and the development of the Service
Delivery Model which will help to describe how clinical services will be delivered in the future. Following
discussions with the Primary Care Trusts projected future activity levels for the new hospital have been
I am pleased to introduce my 3rd Annual Report as Trust Chief Executive, incorporating the Operating
agreed.   
and Financial Review. I am delighted to continue my association with the Trust and to be involved in
the ongoing improvement of services to our patients.
The Trust has been in discussion throughout the year with Liverpool City Council with regard to the
Council’s proposed Hall Lane Relief Road Scheme.  Following those discussions, the City Council has
The Trust continues to treat more patients to higher standards.  Once again we have delivered a
agreed to withdraw the current Hall Lane Road Scheme, allowing the hospital to identify a site of suitable
balanced budget and I wish to commend all Trust staff for their efforts in achieving this. The Trust has
size to redevelop the Royal in its current location. The Trust regrets that it was not possible to enable
also achieved all the financial and key targets set by the Department of Health whilst at the same time
the road and the hospital to proceed in tandem. It recognises the leadership of the Council Leader in
delivering high quality services.  The achievements throughout the year were again particularly
reaching the decision to give precedence to the hospital which the Trust and City Council believe to
impressive having regard to the background of increased activity and demand on our services, as
be in the best long term interests of the population of Liverpool. The Trust will work together with the City
mentioned in the Chairman’s Foreword to this Report.
Council to ensure a suitable road solution in the long term. The Trust is developing a Patient and
Public Involvement process for the new hospital project and the Trust looks forward to achieving a
There have been major capital projects completed during the year. These include a new Radio Pharmacy
world-class hospital in the City Centre co-located with the University of Liverpool by 2014.   
Department and Interventional Radiology Suite at the Royal Liverpool University Hospital. In the
Liverpool University Dental Hospital a new Oral Health Suite and a new Operative Skills Suite have
I wish again to commend all our staff, our contractors’ staff, and all of our volunteers for their achievements,
been installed together with an innovative Endontic Suite. On the Broadgreen site the new major
for their teamwork and effort, which has led to the improvement in the range and quality of the services
Treatment Centre development at Broadgreen Hospital, in partnership with the Cardio Thoracic
we have provided to our patients. I look forward to the next 5 years and to the challenge of the further
Centre, is on schedule, a new 750-space car park in partnership with Vinci Park UK Ltd has opened, we
work on the development of the new Royal and to the sustained improvement in services on both the
have continued with the refurbishment of the four staff residence blocks and have completed a new
Royal and Broadgreen Hospital sites.
Energy Centre. All represent significant investment in 21st Century facilities.
Maggie Boyle (Miss)
Chief Executive
3

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Sustained Improvement
There is continuous improvement with reducing
Emergency Preparedness
The Trust is part way through the NHS Plan reforms.
the number of Delayed Discharges (bed blocking)
The Trust’s Major Incident Plan has been revised to
This is the sixth year since 2000 of sustained
and also bed days lost. 
reflect the requirements of the NHS Emergency
improvement. The innovations and reforms introduced
Planning Guidance 2005 and of the Civil Contingencies
over this period are making an impact and we are
Cleaner Hospitals
Act 2004.
delighted to set out in this report how we have made
In 2005/06 the Trust continued to invest time and
tremendous strides in the delivery of services for
resource into cleaning. We consider that cleanliness
The Major Incident Plan is supplemented by
our patients.
is a high priority. Detailed below are some positive
Directorate/Departmental Major Incident and Business
steps taken that highlight this:-
Continuity Plans and by topic specific emergency plans.
Some of our main achievements are:-
A revised Trust Pandemic Influenza Plan has also
A big improvement in the speed and convenience
The Trust introduced a computerised package
been prepared, which is also supplemented by
of services.
for recording cleaning standards which allows
Directorate/Departmental Pandemic Influenza Plans.
information regarding cleanliness to be distributed
Patients on planned surgical waiting lists at the
to Matrons much more effectively.
The Deputy Chief Executive has been designated to
end of March:-
take responsibility for emergency preparedness on
2002 no patients waited more than 17 months
ISS Mediclean, the Trust’s current provider of Hotel
behalf of the Trust and is supported in that role by
2003 no patients waited more than 14 months
Services including cleaning, took a decision
a nominated Non-Executive Director. The Head of
2004 no patients waited more than 11 months
supported by the Trust to separate out catering
Corporate Affairs is the Emergency Planning
2005 no patients waited more than 9 months
and cleaning services at ward level; this facilitated
Liaison Officer.
2006 no patients waited more than 6 months
greater defintion around the cleaning role.
The Trust Board receives regular reports, at least
98.2% of all patients attending A&E are seen,
The Trust has continued to work toward achieving
annually, on emergency preparedness exercises,
admitted or treated within four hours.
the frequencies laid down within the National
training and testing undertaken by the Trust.
Standards and Trust representatives are actively
Emergency attendances have increased over
involved in the national working group responsible
Information Governance
the last five years and this year was just over
for those standards.
Information is critical to the Trust’s ability to implement
125,000, an increase of 3% on last year.
change. Data quality and accuracy are extremely
The Trust has invested in a dedicated Janitor role
important and a set of standards has been published
The waiting list for patients requiring surgery is
for its public areas to ensure that our visitors have
to assist Trusts in assessing their arrangements
5,176, a significant reduction of 33% since 2002.
improved services in what are very busy areas.
around information. The Information Governance
Toolkit comprises of 8 initiatives and 121 standards.
Although outpatient attendances were up from
The Trust has invested in housekeeper roles to
A recent audit gave significant assurance of
449,441 in March 2005 to 474,724 in March
improve cleaning for barrier nursing rooms and
Information Governance Standards within the Trust.
2006 (6%), no patients waited over 13 weeks
the quality of ‘deep clean’ in certain critical areas.
as at 31st March 2006.
The Self-Assessment carried out during March
Patient and Public Involvement Forum (PPIF)
2006 against the standards revealed a new overall
The Trust has successfully introduced an
visits to both sites of the Trust have been, largely,
score of 90%, with a rating of Green in all initiatives.
electronic booking system which enables GPs
complementary regarding cleanliness within the
This continued improvement reflects the Trust’s
to directly book outpatient appointments onto
Trust.
commitment to best practice in the use and security
our Patient Administration System.
of information.
4

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Infection Prevention and Control
Completion of the final phase of the 2 year
MRSA Actual Against Profile 2005-06
The year 2005-06 has been a challenging year for
National CHART study assessing whether
80
the infection control team who welcomed a nurse
regular feedback of data on MRSA acquisition
70
consultant in December 2005. During the year the
to specific ward areas contributes to reducing
60
infection control nurses moved office accommodation
acquisition.
50
and incorporated the use of a new database into the
40
clinical advisory service. 
The Trust met its target for MRSA bacteraemia
30
reduction for 2005-06.
20
Notable achievements included:-
10
The Trust has signed up to the Department of
0 Apr MayJun Jul Aug Sep Oct Nov Dec Jan Feb Mar
The introduction of a peripheral cannulation
Health ‘Saving Lives’ Programme which focuses
Pro
file o finfec
tions
in p
eriod
Act
ual oTDa
te
pack  into most clinical areas during 2005. 
on embedding knowledge and responsibility for
infection control throughout the organisation
Two successful  promotional days focussing on
and adoption of simple high impact 
aseptic technique at the Royal and Broadgreen
interventions in clinical areas to
Hospitals.
reduce the risk of hospital
acquired infection.   
Leading participation in the national Clean
Your Hands Campaign, auditing hand hygiene
compliance and improving performance by
regular review.
Working with matrons & infection control link
nurses undertaking additional comprehensive
infection control audits of their areas, the results
of which have been reviewed by the Infection
Control Sub Group.
Participating in the 3rd National Prevalence
Survey of Hospital Acquired Infection. Results
to be published in October 2006.
Participated in enhanced MRSA bacteraemia
s u r v e i l l a n c e   i n   a d d i t i o n   t o   m a n d a t o r y
Staphylococcus aureus bacteraemia surveillance,
clostridium difficile diarrhoea surveillance,
glycopeptide resistant enterococcal bacteraemia
surveillance and orthopaedic surgical site
surveillance.
5

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Nephrology 
With this in mind the role of senior nurses within the
include the Medical Research Council, Wellcome
The Nephrology Directorate at the Royal Liverpool
Directorates are currently under review, in terms of
Trust, and the North West Cancer Research Fund.
University in collaboration with Aintree Hospital’s
which professional (whether hospital based or in the
NHS Research and Development support the
Nephrology Unit has recently launched a new website
community) is best placed to provide specific
research and members of the directorate staff have
called  <www.merseyrenalunits.nhs.uk>
aspects of care.  
had several recent publications in well respected
journals such as ‘Gastroenterology’. 
The website has been produced as a tool to inform
The Directorate has worked with the I V Therapy at
and educate GPs across the Strategic Health
Home Team which has enabled patients to have
Three Nursing staff are undertaking Masters
Authority (SHA) around referral criteria for patients
intravenous iron in their home rather than to have to
Degrees, and several have undertaken advanced
being referred into the Nephrology directorates.
make the journey to hospital.  
courses in Advanced Life Support, Prescribing,
Physical Examinations Course and Clinical
The basis of all Nephrology referrals is now around
Gastroenterology 
Diagnostics.  This education will enhance their practice
the patient’s estimated Glomerular Filtration Rate
The Directorate has performed well during this year.
and develop further nurse led clinics that are already
(eGFR). It was necessary to highlight this new referral
We have managed further decreases in our waiting
in evidence. Specialist Nurse in Inflammatory Bowel
pattern to GPs and a website was considered the
times for Endoscopy and Outpatients despite increase
Disease Belle Gregg was awarded a £1,000 prize
best option.
in referrals. There remain significant challenges in
for being voted by patients of the National Crohn’s
maintaining and improving on this performance.
and Colitis Society as Nurse of the Year for her work
There was close liaison with the laboratories at both
in improving patient care.
hospitals and eGFR is now reported to GPs.
The Gastroenterology Directorate has benefited
from increased funding support to improve and
The Directorate is particularly proud of the appointment
The Chronic Kidney Disease Nurse Practitioner  has
re-design services to patients attending the outpatient
of Professor Tony Morris as President of the British
worked closely with the GPs in the SHA to highlight the
clinics particularly around the increasing demand
Society of Gastroenterology and Professor Ian
new GP Quality Outcome Framework for Renal
for Liver Services.  The Trust has further agreed to
Gilmore as President of the Royal College of
Services which came into effect on 1st April 2006
fund  a Nurse Consultant in Hepatology (Liver
Physicians in London.
and a number of educational sessions have been
Medicine) with clerical support.
organised for GPs. The Directorate saw this as an
Specialist Services for Older People
opportunity to engage the GPs whilst controlling the
Trust support was also given to the Nurse
The Model of Care
flow of referrals into the hospital. 
Consultant in Gastroenterology to implement an
The Trust was asked to develop an extended stroke
Iron Deficiency Anaemia Clinic.  This has improved the
model of care, which would address an identified
The aim was to get appropriate referrals, with quality
patient pathway considerably by patients undergoing
gap in service provision following discharge from
information, to aid a speedy referral process.
appropriate investigations in a timely way.
hospital care. Clinical guidelines advise that acute
Dr GM Bell and Dr H Anijeet have been the lead
stroke care specialists should support ongoing
clinicians at the RLBUHT on this initiative with Dr B
Both of these initiatives have been successful in
rehabilitation to improve care outcomes and the
Pandya at Aintree Hospitals NHS Trust. 
seeing patients more quickly. 
model was developed on the following assumptions:
The Nephrology & Renal Transplant Directorates
Achievements in the field of Gastroenterology research
Those who have experienced a stroke should
recognise that in order to effectively manage
continue under the direction of the Academic
be treated in a dedicated specialist acute stroke
patients with chronic illness it is imperative that
Gastroenterologists with the focus continuing on
unit.
close working relationships need to be established
cancers of the stomach and colon and inflammatory
Inpatient rehabilitation should be available.
with colleagues in the community.
bowel disease. Funding from various sources
6

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Dedicated multi-disciplinary rehabilitation support
A comprehensive rationalisation of all
A Reference Group has been meeting alongside the
(Early Supported Discharge) to be provided by
documentation within a dedicated Stroke Care
implementation process as a constant check and
the extended specialist service in a community
Pathway as determined by clinical guidelines.
balance to the model being developed. The Group
setting for up to six months post stroke.
includes service users, carers representatives,
A Transfer of Care Summary document as
academic representatives and other related
Co-ordinate disparate stroke services across all
determined by clinical guidelines.
Voluntary Sector services. This has been a helpful
care sectors in a virtual multi-disciplinary team
The development of a dedicated data base to
and informative process of ongoing external
framework to pool resource and provide a
inform the National Stroke Sentinel Audit and
consultation, which has advised subtle amendments
programme of care that is based on individual
the National Stroke Register.
enhancing the model.
need.
The standardisation of patient information
The Trust has worked closely with Aintree Hospital
Internal Development
made available at all points of service contact in
NHS Trust throughout the development of
Dr Shankar Loharuka and Dr Glyn Scott were
the first six months.
this model to ensure equity of service
appointed in 2005 as Consultant Geriatricians with
provision throughout the North Mersey
an interest in stroke care and have been heavily
External Development
area. 
involved in the development of the service. Since
An initial wave of additional posts have been advertised
their arrival the following critical components of
to include a Stroke Specialist Nurse, Speech and
stroke care provision are now available:
Language Therapy, Dietetics, Occupational Therapy
and Physiotherapy. The second wave  is anticipated
Transient Ischaemic Attack clinics take place
to include dedicated Clinical Psychology, additional
twice weekly with access to the Vascular
Speech and Language Therapy and Dietetic support
Laboratory for immediate Doppler investigation. 
and Social Work input.
The introduction of thrombolytic therapy, which
although not suitable for all patients who have
The Stroke Specialist Nurses will lead the provision
experienced an ischaemic stroke, improves the
of weekly virtual multi-disciplinary team meetings
care outcomes significantly for those who do
that will be based at Venmore Resource Centre
meet the criteria. This treatment has to be given
and the Broadgreen Day Hospital. With a community
within 3 hours of stroke onset which poses
orientated focus these facilities will provide access
challenges for Accident and Emergency,  Acute
to a comprehensive range of dedicated stroke
Medical Unit, the Acute Stroke Unit and the
support resources to include  therapists, social
Radiology Department as a CT scan is critical
care, employment advice, user support,
for accurate diagnosis.
Stroke Association, Local Solutions Carers
Support and Crossroads. The virtual
Additional Telemetry equipment and training for
multi-disciplinary team will have formal
staff in the Acute Stroke Unit.
links to the Consultants Stroke Review
Review of inpatient rehabilitation service provision
Clinic through the role of the Stroke
following the publication of a recent rehabilitation
Specialist Nurse.
research project undertaken in partnership with
the University of Central Lancashire.
Both facilities will be equipped to
Secondary prevention by undertaking one, three
provide comprehensive rehabilitation
and six monthly review in the Stroke Review Clinic.
programmes closer to home. 
7

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Evaluation
A formal launch of the extended stroke pathway is
In October 2005 two advanced Nurse Practitioners
The extended stroke pathway will be fully operational
anticipated and will include collaboration with The
were appointed to the department to support the
in August 2006. Those who use the service will be
Stroke Association using their FAST campaign
junior doctors’ workload. Educated to Masters
asked for their views on a systematic basis and
(Facial weakness, Arm weakness, Speech problems,
Degree level, they work in the ‘Majors’ part of the
questions will be based on the standards that have
Test all three) to raise the awareness of the general
department assessing and treating patients. 
been developed within a mission statement for the
public in treating stroke as a medical emergency. 
extended pathway which include the following: 
Money, gained by the department in recognition of
Emergency Services
achieving national targets, has been used to install
The extended stroke pathway has agreed a target
The Emergency Department has had an eventful
new cardiac monitors in the resuscitation room,
of a reduced length of stay in a hospital setting from
year. The two Australian Consultants who came to
linked to the central nurses station and to replace the
30 days (performance based on the National
Liverpool to work with us for 2 years returned
aging ventilators.  
Sentinel Audit 2004) to 18 days. The National
to Australia at the end of  the year. One
Sentinel Audit will be completed again in October
of these, Dr James Rippey, developed
During the year the Acute Medical Unit (AMU)
2006 and significant improvement is anticipated.
his own expertise in ultrasound
has  successfully set up a new Deep Vein
and established an Ultrasound
Thrombosis (DVT) service with the Old Swan Walk-In
Course as part of the ongoing
Centre. GPs now refer patients directly to the Walk-In
programme of education for
Centre where blood tests and a clinical assessment
Emergency Department Senior
are performed. This has lead to a 70% reduction in
Doctors. All senior doctors in the
DVTs presenting in the AMU. Those patients who
department have undergone
test positive for a DVT are then referred from the
this training and the course
Walk-In Centre to the  AMU for treatment.
is established on a regional
(soon to be national) basis. 
The departure of our
Australian colleagues has
seen new appointments
to the consultant team of
Dr Jay Rathore and Dr
Jane McVicar as locum
Consultant. All consultant
posts in the Emergency
Department are now filled.  
8

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“The One Stop Shop”
a laparoscopic donor nephrectomy (kidney removal)
Vascular Surgery Unit at the RLBUHT for EVLT of
The opening of the new Urology Treatment Centre
programme and blood group incompatible renal
varicose veins. Thirty-six patients have attended for
at Broadgreen Hospital in the Autumn of 2005 was
transplant programme. The introduction of these
duplex ultrasound follow-up. In all of these patients
as a result of a Directorate Team effort including
programmes will not only increase the number of
the procedure has been successful. Patients are
medical staff, nurses, secretaries, clerical staff and
kidney transplants but will allow hope for some
now considered for EVLT as a first option and only
help from other Departments including Operating
patients for whom transplantation has in the past not
if duplex ultrasound indicates that they are not
Theatres, Medical Records and the Radiology
been an option.
suitable are they then listed for conventional surgery. 
Directorate.  
EVLT Development at RLBUHT
Patients who were previously referred by their GP
Endovenous Laser Ablation (EVLT) of varicose
with haematuria would make at least three visits to
veins is a minimally invasive procedure, which is
the hospital before a diagnosis could be made. Now
replacing surgery and is now the ‘gold standard’
these patients attend the Treatment Centre in the
method of treatment. Unlike conventional surgery
morning and, following consultation, they set off on
this treatment only uses local anaesthetic. There is
their journey through the Treatment Centre which
no need for hospitalisation and there are lower risks
includes the venepuncture room, the flexible
of complications. Patients can return to their normal
cystoscopy suite and the ultrasound room. Results
activities much sooner than having conventional
are gathered prior to a final consultation when the
surgery. It is reported to have a
diagnosis will be discussed and a treatment plan
high success rate (93-98%).
agreed the same day.  Similarly, patients with many
Conventional surgery has a
other urological conditions can be seen and treatment
longer recovery time, requires
started on the same day. Many patients are referred
hospitalisation and a general
back to Primary Care for their management/follow up. 
anaesthetic with two large
incisions. It is associated with a
Renal Services
recurrence rate of 10-15%.
A home haemodialysis programme has been
re-established across Merseyside and Cheshire. A
The surgeon, using ultrasound
formalised training programme has been devised
to guide him, will insert a very
and all suitable patients opting for home haemodialysis
small catheter into the affected
will be supported by a specialist team of nurses both
vein at knee level and advance
within the hospital setting and in their own home.
it up towards the groin. A laser
fibre is inserted through the
A haemodiafiltration (HDF) programme has been set
catheter and is activated to
up at the Royal site. This renal replacement therapy
cause damage to the internal
treatment option offers a form of dialysis for those
vein wall, causing it to seal
patients who are unstable on the more conventional
down on itself. The body will
haemodialysis, e.g. patients with cardiac problems.
eventually absorb this vein.
The Renal Transplant Directorate is in the process
Up to  the end of March 2006
of putting together business cases to support both
128 patients have attended the
9

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Research in the Trust & University of Liverpool
Improving research quality through education,
The Trust in collaboration with its main academic
training, effective research governance and
The University 
partner, the University of Liverpool, is active in a
collaborative working practices.
variety of research areas including cancer, circulatory
of Liverpool
Further information on Research & Development in
disease, gastroenterology, ophthalmology, infectious
Faculty of Medicine
the Trust can be found on the Trust’s website or by
diseases, metabolic disorders, pharmacology and
contacting the R&D Manager in the Trust via the
care of the elderly. The Trust has an annual funding
R&D office on 0151-706-3771.   
allocation from the NHS Research & Development
The relationship between the Faculty of Medicine
Levy of approximately £3.9 million supporting
Department of Health Strategy “Best Research
at the University of Liverpool and the Trust is a
external grant funding in excess of £10million. The
for Best Health-2006”
very close one.  Many of the clinical academic
Trust   currently has approximately over 350 research
Research underpins everything we do in the
staff of the Medical School provide clinical services
projects active within the organisation. 
National Health Service. In January 2006 the
to patients attending the Trust Hospitals and
Department of Health launched a new strategy for
much of the laboratory service work is provided
The Research & Development (R&D) Department is
Research & Development (R&D) for the United
from the University. In return, NHS staff are
based on the 4th floor of the Linda McCartney
Kingdom. The implementation of this strategy will
involved in teaching medical, dental, nursing and
Centre on the Royal Liverpool site. The R&D team
provide a number of exciting challenges & opportunities
many other healthcare students, on courses at
is a multidisciplinary team led by the Trust’s R&D
for the Trust and its research staff. This Trust is
the University.
Director Professor J Rhodes.  The Trust employs
committed to working with its NHS, academic partners
over 20 research nurses who work across a number
and patients / public to provide the best possible
The Faculty aims to provide excellence in the
of disease specialities providing an important service
research based care for our patients. The Trust has
education of all healthcare professionals in medicine,
to patients attending the hospital. The overall aims
recently submitted a number of outline bids to the
dentistry, nursing and the allied health professions.
of the R&D Directorate and Principal Researchers
Department of Health to strengthen its current
The Faculty and its associated NHS Trusts are
in the Trust are to support and facilitate clinical
research portfolio across a number of disease
internationally recognised for the quality and
research and researchers within the Trust and
areas. The Trust has developed strong links with
innovation of its teaching in medicine and other
University. They do this by:
our partners across the R&D  community including
subjects and significant numbers of its graduates
Manchester and beyond. 
move on to take up posts in the Royal Liverpool
Providing guidance & support to all those involved
and Broadgreen University Hospitals NHS Trust. 
in NHS Research & Development.
Artificial Intelligence
Assisting researchers to continuously improve
The work of Drs Azzam Taktak , Christian Setzkorn
Our partnership with the Trust is also built upon
the quality of patient care through evidence
and Tony Fisher of the Department of Clinical
a shared strategy for identifying research areas in
based practice.  
Engineering in the application of artificial intelligence
which we are internationally competitive and
Ensuring effective research governance &
(AI) and mathematical modelling to solve problems
focussing on these to provide the basis of innovative
management of research across the Trust in
in medicine has been recognised by membership of
clinical practice and to train future generations of
partnership with the University of Liverpool.
the Network of Excellence under the EU Biopattern
research-aware healthcare professionals.  
Promoting an active research culture and a
FP6 Programme. Their recent work has led to the
commitment to research in the NHS.
development and implementation of  novel expert
Professor John Caldwell
Striving for best research practice.
systems, including outcomes prediction in ocular
Dean
Disseminating research findings through
cancer, generalisable models for differential diagnosis
Faculty of Medicine
publications in high quality journals as well as
and automated reporting of electrophysiological
The University of Liverpool
giving presentations on research findings at
recordings. World wide web access to these
National and International meetings.
applications is at www.liverpooleye.org
10

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Broadgreen Hospital New Development: 
We were fortunate to secure funding for the new
Cardiology 
The final section of the new build element of the
main entrance (£2m). This has also been handed
This year has seen Cardiology successfully bid for
Broadgreen / Cardio Thoracic Centre Development
over in this section. The new main entrance
funding to build a new dedicated cardiac catheter
at Broadgreen Hospital reached practical completion
includes a purpose-built Outpatients Ambulance
suite which will contain state of the art equipment
on 1 May 2006.
Lounge. We are now in the process of securing
and will be the most modern in the North West. This
tenants for the retail area.
will replace the present old and unreliable catheter
This section comprises
laboratory shared with the interventional radiologists.
Four new wards
In addition, the new car park has opened and there
The new facility will allow us to upgrade and improve
Eight operating theatres
is now no longer any difficulty parking on the site.
our capacity to perform cardiac catheterisation and
Orthopaedic outpatient department
We have incorporated additional foundations and
permit us to start a new pacing service for the first
Pre-operative assessment 
enhanced the structure of the car park so that
time at RLBUHT. It is envisaged that permanent
Musculo-Skeletal Therapies
additional decks can be added later with minimal
pacing will start in June 2006 and the full time on-site
Cardiac Rehabilitation
disruption if this proves necessary
catheter laboratory available in September 2006.
Radiology
A new 6th consultant Cardiology post has also been
National Endoscopy Training Centre 
approved in order to support these new developments.
This was completed on time with two of the wards
The National Endoscopy Modernisation Team have
A locum consultant started in June 2006. These
completed ahead of time. 
devised a toolkit, the Global Rating Scale (GRS), to
services will also be supported by the expansion
measure Quality & Safety and Customer Care for
of new physiologist appointments in the Cardio-
The Project Office team is now working hard with
Endoscopy Practice. The Gastroenterology Unit
Respiratory Department.  
the commissioning leads from the various departments
Staff have worked hard throughout the year to
on getting these departments ready for their opening.
achieve a good score on the GRS.  The unit underwent
Drs Patel and Fisher have also been successful in
This includes all the final tests and checks, staff
a vigorous assessment of all Endoscopy Training,
winning a Cordis Interventional Cardiology Fellowship
training and installing the considerable amount of
documentation, procedures, risk management,
award. This national competition, judged by an
equipment involved.
education, levels of quality and standards of care
eminent committee, awarded £60,000 to Dr Patel and
and practice.  We were complimented on all aspects
Dr Fisher for their work on “The role of inflammatory
This last year has been a busy one at the
and were awarded accreditation as a Training Centre
state in downstream vascular injury post PCI”.
Broadgreen project with Sections 2 to 5 opening,
in accordance with JAG (Joint Advisory Group,
including the new Urology Centre and Refractory
Academy of Royal Colleges).
The heart failure service has become fully integrated
Angina, plus the shared Pharmacy, Pathology and
in Cardiology with links to the cardiac rehabilitation
Radiology Departments. The Radiology Department
Both the GRS and the JAG Accreditation are essential
service and the expanded heart failure service in the
has some of the very latest technology including the
components in order to meet the criteria of the
community. Cardiac rehabilitation has also developed
first 64 slice CT scanner in the country plus an MR
Government’s Bowel Cancer Screening Programme.
to encompass a broader range of patients. This
scanner, both of which have additional capability of
The Unit was succesful in its bid to become one of
expansion will be supported by the new facilities in
undertaking specialised cardiac work. In addition, a
the first wave Colon Cancer Screening Centres to
the new cardiac rehabilitation facility at Broadgreen
Picture Archiving Communication System (PACS)
be rolled out during 2006.
Hospital.
was introduced and also went live on the day of the
The Audit Commission have also undertaken a
department’s opening. The Radiology Department
review of Endosocopy services and, in comparison
is planned to accommodate further diagnostic
with other University Hospitals outside London, we
equipment in the future.
have performed very well with above average
performance in most indicators.
11

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Radiology
services that support the clinical activity. She
Ultrasound - The Ultrasound Department opened
commented that this was the first occasion, despite
in November 2005 and we have provided four new
many visits to densitometry units, that she had been
ultrasound rooms within the department. These
given the opportunity to see the vital service that
ultrasound rooms have been designed to have
laboratories provide in the management of a wide
access for patients in wheelchairs and beds and to
variety of clinical conditions. 
provide a service for the whole hospital, outpatients
and for G.P. patients.
A plaque was unveiled in the laboratory to mark its
formal opening. This state of the art automated facility
Interventional Scheme - The first phase of the new
processes in excess of 3000 samples per day
interventional theatre scheme opens in October 2006.
generating a massive 6 million test results each
It will provide three new theatre style interventional
year. The Duchess was keen to speak to as many
x-ray rooms including a dedicated cardiology x-ray
staff and patients as possible and her friendly,
room and the second phase will be completed in
interested and knowledgeable approach was greatly
March 2007. This will provide a dedicated patient
appreciated. This was certainly a very special day
waiting area and day case trolley area for patients.
that acknowledges the prestigious work done in this
field.
Picture Archiving Communication System
(PACS) - This digital imaging system removes the
need for x-ray films.  It is expected that installation
of the  system in the Royal Liverpool University
Hospital will be complete by Autumn 2006. The
first phase of the system, within the Radiology
Department, will be complete by July 2006.
When the system is complete, a patient’s x-ray
image will be able to be viewed on computer monitors
in wards and clinics.
Royal Visit to the Bone Densitometry Unit
As the President of the National Osteoporosis
Society, HRH the Duchess of Cornwall made a special
visit to the Royal on Friday 18th November 2005.
The Duchess toured the Bone Densitometry Unit,
the Metabolic Bone Disease Unit based on Ward 2C
and the Department of Clinical Biochemistry. The
regional bone disease service based on these units
has developed an excellent reputation and a great
deal of positive feedback from service users. The
Duchess showed a particular interest in the laboratory
12

---

To deliver the best possible levels of care and
Trust Board in November 2005 following a period of
The information and guidance given by the WFAS
achieve its objectives the Trust needs to recruit,
detailed consultation with key stakeholders. The
aims to reflect a balance between individual
develop and retain the highest calibre of staff to an
strategic objective is to provide “a service focused
aspirations, and organisational and legislative
environment that is well managed and supports
Human Resources Strategy that actively supports
requirements. 
individual and service needs. We are working to
progressive people management practices and
achieve this in collaboration with staff, managers,
informs the direction,  priorities and processes of
Valuing Our Staff
trade union organisations and local community
the Human Resources service for the Trust between
Staff Involvement & Consultation
partners. 
2005 – 2008”
The Trust remains committed to both formal and
Effective People Management
informal involvement and engagement of staff in
Work continues on the development of supporting
decision-making. With support from the TUC
Model of HR Service
Delivery Plans at local level in line with service
Partnership Institute, work with Staff Side organisations
The Trust continues to work in collaboration with
priorities and the implementation of the Workforce
is progressing with the aim of establishing formal
North, Central and South Liverpool Primary Care
Balanced Scorecard.
partnership working and infrastructures to support
Trusts to provide an integrated model of HR Services
positive employee relations. Wider staff involvement
led by a jointly appointed Director of Human Resources.
Becoming a Model Employer
activities formed the basis of the Improving Working
The service is designed around the delivery of
Achieving IWL Practice Plus
Lives Self Assessment exercise and the establishment
customer facing support for staff and managers,
Improving Working Lives (IWL) recognises that
of Staff Forums across the Trust.
transactional services, specialist services and project
the best services for patients can only be delivered
management support. With the introduction of the
from a well-managed, flexible working environment
Staff Survey 2005
new Electronic Staff Record 2006/07 we will see
that supports staff, promotes their welfare and
The National Staff Opinion Survey is conducted
further developments and streamlining of HR Services
development and provides a productive balance
annually by the Healthcare Commission.  The overall
to improve provision for our customers.
between work and life outside work. Since the
aim is to gather information relating to the working
achievement of IWL Practice Status the Trust has
lives of staff and to inform improvements in working
HR Governance Arrangements
worked, in partnership with Staff Side colleagues,
conditions and practices. The response rate for
In line with the Trust’s reporting structures a new HR
to reach the IWL Practice Plus standard. Following
2005 was 53%, in line with the National average for
Governance framework has been introduced. The
a thorough internal self-assessment process and an
Acute Trusts.  Key themes and recommendations
Human Resources Committee (Sub Committee of the
external Validation Visit the Trust was awarded IWL
from the 2005 Staff Survey were reported to the
Trust Board) oversees the development of strategic
Practice Plus accreditation in March 2006. We will
Trust Board, Executive Management Team and via
HR issues, the effective delivery of HR projects
continue to monitor progress and activities to fully
an Open Forum session with plans in place to
against targets and the implementation of the HR
embed IWL principles and practices as the Trust
address improvement areas.  
Strategy across the organisation. This Committee is
continues its journey towards becoming a Model
supported by Sub Committees in the areas of Policy
Employer.  
Delivering Major Projects
Development, Learning & Organisational Development
and Equality & Diversity. This formal structure is
Agenda for Change
Working Families Advisory Service
complemented by Project Groups to oversee the
Agenda for Change has been the biggest change to
The Working Families Advisory Service (WFAS) is a
implementation of  initiatives including Agenda for
the pay structure of NHS staff for over 50 years. It
key part of Human Resources. The service supports
Change, Electronic Staff Record and Improving
has been a huge project to manage and implement
parents and carers through the provision of both
Working Lives.
involving nearly all staff in the Trust and has
childcare and carers’ advice, support and advocacy.
been delivered in partnership with the trade union
It also provides a service to staff and managers
Implementing the HR Strategy  – 2005/08
organisations. The first stages of implementation, to
around flexible working and work life balance solutions.
The Human Resources Strategy was approved by the
introduce new terms and conditions and to assess
13

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every post with transition to an Agenda for Change
Mainstreaming Equality & Diversity
patients not only had a short life duration on dialysis
pay banding, is now reaching completion. The
but also had a poor quality of life in that much of it
Equality & Diversity Strategic Overview
longer-term element of implementation, the
was spent in hospital.  
During 2005/06 the Trust continued to progress
Knowledge and Skills Framework, is now being
and embed Equality & Diversity (E&D) principles
rolled out. This supports personal development and
The team decided to offer these patients the
into mainstream activities. We have made good
career progression through the comprehensive
opportunity of  treatment without dialysis in the
progress in relation to effective policy making,
process of annual development reviews and personal
hope that this would provide them with a better
strategy development and review of the Race
development plans. The framework is intended to
quality of life.
Equality Scheme. The Trust has developed or
help staff develop their skills to the full. 
updated policies in relation to Equality & Diversity,
Over 70 patients have now undergone this treatment
Reasonable Adjustments and Parking for Disabled
ESR
with a large number of patients being treated at
Patients, Visitors and Staff. The Trust also
Electronic Staff Record (ESR) is a new computer
home by a Community Nephrology Nurse with the
strengthened the provision of E & D training through
system that will manage all staff records for the
input from the team’s Social Worker.
Induction & Mandatory provision and Managers
NHS. It is a national system, sponsored by the
Sessions. Progress will be monitored and assessed
Department of Health and integrates Payroll and
The team have audited their results, which show
by the Equality & Diversity Sub Committee.
HR information together into one IT system. The
that 60% of patients who have opted for this type of
Royal Liverpool and Broadgreen University
management have had no admissions to hospital
Equality & Diversity Leadership
Hospitals Trust is part of the 4th wave of the national
and the survival rate is considerably better than the
The Trust is working in partnership with the Liverpool
rollout of the system, with implementation scheduled
team expected.
PCTs and has developed an integrated model of E&D
for September 2006. 
Leadership across the Health Community. This is
Not only have the patients benefited from this model
underpinned by the establishment of 3 senior level
of care but all members of the multidisciplinary team
posts working collaboratively in the
feel they have benefited from this way of working
areas of Service Delivery, Employment
and wish to extend it into other areas of their practice.  
and Disability. 
Three other short-listed teams shared in the excitement
Team of the Year 2006
of the evening:
At the Trust’s annual premier
award night held in the Marriott
The Lower Limb DVT Proforma Team, who work
Hotel on Wednesday 7th June
with Primary Care to improve the diagnostic
2006, Roger Phillips from
service given to patients with suspected DVT.
Radio Merseyside once again
opened the golden envelope to
The Haematology Patient Support Group who
present the Renal Conservative
offer emotional, practical and educational
Management Team with the
information to patients in an informal and neutral
prize for Team of the Year 2006.  
setting.
The service was set up when it
The Falls Assessment Service. This new service
was identified that a small group
offers a comprehensive assessment and practical
of patients often did not benefit
advice, support and treatment to older patients
greatly from dialysis. These
who attend the Emergency Department after a fall.  
14

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Employee of the Year
is also heading up the newly formed Mersey School
more varied clinical programme together with a
Christine Atkinson is a Foot and Ankle Nurse
of Medicine which forms part of the MMC agenda
weekly programme of associated lunchtime lectures.
Specialist working with the Orthopaedic Team.
and will set the standards for post Foundation Training.
Further to this we devised and introduced a log
Since joining this team Chris has been instrumental
book for 2nd year students to record and evaluate
A rolling programme of clinical competenices based
in totally revamping the service and working tirelessly
their experience. Dr Kennedy intends this information
on the individual training needs of nursing staff and
on improvements.  
be used to further improve the quality of the clinical
clinicians has been developed. A drop-in facility has
attachments we provide.
also been established which enables all clinicians
She places great importance on being there for the
and health care professionals to develop and practice
patients through the whole of their journey right
skills.
through to discharge. The Orthopaedic directorate
regularly receives formal thank you letters from
patients each month praising Chris. One of these
Undergraduate developments 
letters said "what you have in Chris is a combination
In addition to the usual complement of 3rd, 4th & 5th
of qualities you don't often find in one person. She
year and Graduate students on clinical attachments
is very kind, caring and professional, a typical
from Liverpool University Medical
example of what a nurse should be.  It is a credit to
School we welcomed 120 2nd
your hospital that such a unique and special person
year students for a 28
is caring for patients."
week attachment. Under
the leadership of newly
Education Service
appointed Clinical Sub
Dean, Dr Tom Kennedy,
Modernising Medical Careers (MMC) is a government
we introduced a new,
initiative which represents the greatest ever change
to post-graduate medical training. Its aim is to provide
‘fit for purpose’ training to enable doctors to deliver
the future healthcare needs of a modern society.
The Education Service has met the enormous
challenge of implementing this by rolling out a 2
year nationally identified curriculum of clinical skills
and competency training together with a robust
system of continual assessment for all newly qualified
doctors appointed to the Trust. The new programme
is known as Foundation training, and provides highly
supervised and more focused training for junior
doctors while the rigorous and regular appraisal will
help us to identify and remedy any problem areas
junior doctors may encounter.
Dr Philip Weston, Director of Postgraduate Medical
Education, has become MMC lead for the Trust and
15

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Patient and Public Involvement Strategy
Brother type “Diary Room” in which patients were
involved in monitoring the cleaning within the hospital
To ensure that patients’ voices are heard at every
able to voice their opinion and have them recorded
(“Bug Watch”) and are represented at the following
level of the organisation a 3-year Patient and Public
on camera.  The feedback from the video was mostly
Trust work groups:
Involvement strategy has been developed. This has
positive. The day was repeated in June 2006.
Patient Experience Group
been influenced by research undertaken by the
Stakeholder Workstream Group
Department of Health with patients and the public
The Trust continues to forge links with partner
which identified five key dimensions for achieving a
organisations and local volunteer groups. The Trust
Carers Desk
good patient experience. The 5 key dimensions are:
had representation at a number of events in the
The Carers Information Desk is an innovative project
community. These include a Yemeni celebration day
developed as a result of a successful partnership
1. Safe, high quality, co-ordinated care.
at which the Ambassador to the Yemen was present
between the Trust and Local Solutions. This service
2. Building closer relationships.
and the annual Carers event held at Liverpool Football
continues to be used extensively and responds to
3. Clean, comfortable, friendly place to be.
Club. 
the specific needs identified by carers.  
4. Improving access and waiting times.
5. Better information, more choice.  
The National Inpatient Survey was undertaken in
This project is funded by the Trust but the volunteers
2005.  Statistical analysis of the results is generally
are recruited and trained by Local Solutions. The
This Strategy aims to ensure that there is ongoing
positive but some negative comments relating to
Carers Desk is now in operation five days per week
improvement in patient centered care and that
cleanliness and provision of food were received. An
at peak times on the Royal Site and offers an outreach
Patient and Public Involvement is embedded in the
Action Plan has been developed to demonstrate
service on the Broadgreen Site.
organisation and delivers real measurable benefits. 
how the Trust proposes to address outstanding
issues highlighted from the survey. 
Volunteers
Patients’ Feedback
The “Lend A Hand” Volunteers Scheme was
The Trust continues to undertake patient satisfaction
Patients’ Council
launched in October 1998. The busy and dedicated
surveys at national and local level, analyse results
The Patients’ Council has continued to grow and
Volunteers will not only guide you to where you
and use patient and carers’ views to evaluate and
develop throughout 2005/2006. To ensure that
need to be, they will shop for patients and staff, take
improve our services wherever possible. 
members focus on what they consider high priority
patients home from hospital, visit lonely patients,
they have   produced a yearly work plan, which will
visit with the Library trolley / Provisions trolley and
New suggestion leaflets have been developed
focus on the following issues. 
generally “Lend A Hand” to busy staff.
and are now available throughout the hospitals.
Feedback from the leaflets is used to develop and
Nutrition
Fundraising
influence service improvement.
Recruitment of Council members
During the year an increasing number of people and
Improving the patients’ journey through outpatients
groups have supported fundraising activities within
In April 2005 the Trust hosted a Patient and Public
Environment
the Trust. Many departments have benefited from
Involvement Awareness Day in the main reception
the funds raised which have helped staff to develop
of the Royal Hospital. The event was a huge
Patient and Public Involvement Forum
and improve services to our patients. The Trust
success and helped to develop closer relationships
The statutory Patient and Public Involvement
wishes to thank all of our fundraisers for their valuable
between staff and patients, improve partnership
Forums (PPIF) have been in place since December
work  The two main fundraising appeals are the
understanding/working with local health related
2003 and are part of a national network to promote
Linda McCartney Centre ‘Forget-Me-Not’ Appeal
groups and demonstrate how information, provided by
patient and public involvement in health services.
and the Foundation for the Prevention of Blindness.
patients, helps us to make improvements to our
Over the year the Trust has further strengthened its
These appeals raised £134,700 and £181,500,
services. The highlight of the day was the Big
links with the Forum and its local provider, Age
respectively, during the year.
Concern. This year Forum members have been
16

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Royal Redevelopment
process of ensuring we get good patient and
is equipped to a very high specification with operating
Work on our plans for a new hospital to replace the
community input into the process. 
microscopes and digital radiography linked to on-chair
Royal has been gathering momentum. We are
screens and, via a seminar room within the clinical
currently developing the outline business case.
Dental Hospital
area, the Operative Skills suite. 
Once this has been approved by the Department of
The new Oral Health Suite, based at the Liverpool
Health, next year, we will be able to advertise for a
University Dental Hospital, includes three new
Challenges for 2006/07
private sector partner to develop, construct and
surgeries with facilities for 'conscious sedation'
NHS Targets for Patient Access
maintain the new hospital building under a private
which is particularly suited to children. This is
In 2006/07 patients will have more choice in selecting
finance initiative (PFI).
specifically designed as an alternative to general
the hospital where they receive care and will be able
anaesthetic to relax young patients with 'dental
to book appointments to suit their own circumstances
In June 2006 the City Council agreed to set aside its
anxiety' and improve their response to treatment.
from the GP surgery. There will also be shorter waiting
proposals for the Hall Lane road scheme. This
times for out patients and inpatients as progress is
allows the Trust to proceed with its plans to rebuild
The facility will also accommodate a diverse range
gradually made to reducing waiting times from GP
the Royal next to the existing hospital within the
of specialist clinics including orthodontics for the
referral to start of in patient treatment down to 18
city centre and retaining its close links with the
treatment of children born with cleft lip and palate.  
weeks by the end of 2008. The Trust focus at this
University of Liverpool. The Trust will continue to
time is to improve the patient experience at our
work with the City Council to find a solution to the
As well as specialist treatment and teaching the unit
hospitals, such that the Trust remains the first
road congestion in the area.
will provide a focus for two important international
choice for our patients. To do this we will act on the
research programmes that will benefit the wider
feedback we receive from all of our service users,
The skills and resources needed to deliver such a
community. Liverpool is already a leading centre
and make improvements in the areas which have
major project are considerable. We are building a
for state-of-the-art diagnostic techniques such as
the longest waiting times. 
strong internal project team, and appointing
Quantitative Light-Induced Fluorescence (QLF),
experienced external specialist advisers to assist
which is a method for the early detection and
Efficiency, Productivity and Financial Balance
us. The project structure is established, with a number
monitoring of the loss of minerals in teeth.
There is a drive for greater efficiency across the
of workstreams overseeing key areas.
NHS and in 2006/07 all organisations are expected
The expansion in dental undergraduate training in
to deliver efficiency savings of 2.5%. The introduction
The Clinical Workstream Group, which includes
Liverpool has been given a "head start" with the
of the new tariff for treatments at hospital means
medical staff, nurses, therapists, pharmacists and
installation of a new cutting-edge Operative Skills
that the Trust will no longer receive income at the
representatives from primary care, has developed
suite  in the Dental Hospital and School. Liverpool
same level as in previous years. As a result of both
the Service Delivery Model to guide our planning.
is the first Dental School in England to build a
of these changes, the Trust will need to save some
This is founded on the North Mersey Model of Care
new facility to accommodate the increase in dental
£13.4m in order to achieve financial balance in year. 
and describes how clinical services will operate
undergraduate numbers announced in late 2004.
within the new Royal and the expected developments
46 patient simulators allow students to acquire and
Workforce
in out of hospital care. Over the coming months, we
perfect their operative skills. In a unique departure
One of the Trust’s great strengths is its well trained
will be working with colleagues across the Trust on
from traditional phantom head facilities there are
and committed staff. The NHS is changing rapidly
the future shape of their services in line with this
also two-way audio-visual links between the
and owing to changes in technology, research
model and how that will translate into the new
Operative Skills suite and a newly refurbished clinical
advances, European legislation and productivity
hospital, in a way that is affordable and deliverable.  
area in the Department of Restorative Dentistry,
improvements there will be a need to redefine roles
also within the Dental Hospital. 
and find new ways of working. 2006/07 will be a
The next stage of the project will involve option
time for considerable organisational change across
development and appraisal with the preferred
The clinical refurbishment of 15 dental chairs includes
the Trust and communication with and participation
option identified by the end of the year. The
an innovative 5-chair "Endodontic suite". The only
by staff during this period is essential to the continued
Stakeholder Workstream Group is leading the
facility of its sort in the North West, each of the units
success of the organisation.
17

---

Performance and Activity
In-Patient & Day Case Activity
Elective Waiting List
by Method of Admission
Waiting Times Appointments
Elective Admission  % of patients pre-booked
60
0-2 mo
100
NHS targetActu
50
3-5 mo
40
90
30
20
80
10
70
0
2001/02
2002/03
2003/04
2004/05
2005/06
60
Emergencies
Elective - in-patient
Elective - d
Total in-patient and day case activity was 83,353, an
As at 31 March 2006 the number of patients awaiting
As at March 2006 the Trust pre-booked 99% of elective
increase 3,362 (4%) on previous year. This increase was
elective admission was 5,176. Over the same period
admission compared to 83% as at March 2005. The NHS
mainly due to a rise in Emergency admissions. The
the number of patients waiting over 6 months was
target was 100% for March 2006.
decrease in day case activity from 2001/02 to 2002/03
reduced to 0.
was due to reclassification of activity to outpatient
attendance.
Total Waiting Lists
Patients Awaiting Surgery
Cancelled Operations  on day of surgery for non 
medical reason
7000
2500
350
3-5 Mths
6-8 Mt
6000
9-11
Mths
12-14 
300
Cancelled O
2000
5000
250
1500
200
4000
150
1000
3000
100
2000
500
50
NHS Target
Actual total
1000
0
0
March 02
March 03
March 04
March 05
March 
At 31 March 2006 there were 5,176 patients waiting,
By March 2006 patients waiting on planned surgical lists
In total 412 of the 28,067 planned operations (1%) were
better than the agreed target of 5,241 (-1%).
were being admitted within 6 months - a major achievement
cancelled on day of surgery for non medical reasons.
from 2001.
18

---

Accident & Emergency
Complaints
Total Attendances
% Admitted, Transferred or Discharged
within 4 hours
150
100
600
Royal
St Pauls
HEC
Dental
AMAU
90
500
100
400
80
300
70
50
200
60
NHS Target
Actual
100
50
0
0
2001/02
2002/03
2003/04
2004/05
2005/06
2001/02
2002/03
200
3/04 200
4/05 200
5/06
Total attendances through Emergency Departments were
In 2005/06 96% of patients attending Emergency
322 Complaints were received by the Trust in the
125,59,  an increase of 3,364 (3%) on previous year.
Departments were admitted, transferred or discharged
year to the end of March 2006, of which 88% were
within 4 hours.
responded to within 20 days.  The top 5 subjects of
complaints related to:
All aspects of clinical treatment
Outpatient Clinics
Outpatients Activity
Waiting Times
Appointments delay/cancellation (Outpatients)
500
3500
Attitude of staff
attendances
13+
26+
3000
400
2500
Admission, discharge and transfer arrangements
2000
300
Communication/information to patients (written
1500
and oral)
200
1000
500
The Trust has prepared action plans to address
100
0
these areas.
0
2001/02
2002/03
2003/04
2004/05
2005/06
If a complainant is dissatisfied with the Trust’s
response to a complaint the complainant may
request an Independent Review of the complaint.
Total outpatient attendances were 474,724, an increase
The Trust reduced waiting time from GP referral to 1st
In the year to the end of March 2006 26 requests
of 25,353 (6%) on previous year.
outpatient appointment to 13 weeks.
for Independent Review were received.
19

---

Trust Board and Committees
The Trust Board and its sub-committees monitor standards within the Trust. They are responsible for formulating  policies and ensuring that Clinical Excellence is maintained. 
The Board Members listed between 1st April 2005 to 31st March 2006 were:
Committee Membership
Chairman
Mr R L James
*
*
*
*
Chief Executive
Miss M Boyle
Non Executive
Mr G Hollick
*
Directors
Mr M Carr
*
Mrs A Bebb 
Ms J Mawer 
*
Ms C Johnson
until November 2005
Mr C Duncan
from December 2005
Other Directors
Mr A J Wilks  
Deputy Chief Executive
Miss C Lyons 
Director of Finance
Dr F E White 
Medical Director
Mrs D Carroll
Acting Director of Nursing & Quality (Feb 05-Sept 05)
Mr T Yaseen
Director of Nursing & Quality  (from October 2005)
Ms J Green 
Director of Human Resources 
Key:  (* Chair)
Human Resources Committee
Finance Committee
Clinical Governance Committee
Audit Committee
Remuneration Committee
Charitable Funds Committee
Charitable Investments Committee
Clinical Governance 
Clinical Risk Management 
2005/06 was a year of significant development in the Clinical Governance framework for the Trust.
The focus for managing risk in 2005/06 has been in three key areas; falls, medicines management and
The Board revised the committee structures and reporting arrangements for Clinical Governance
violence and abuse to staff and patients. A multidisciplinary task group has been established for each
and the Healthcare Commission (HCC) published new core ‘Standards for Better Health’ against
area to identify the key issues and to make recommendations to improve systems in order to reduce
which the Trust measured its own performance. We received a positive visit from the HCC in
the number of incidents. Detailed work has also been done in the Surgical, Medical and Clinical
December 2005, when our draft declaration against the standards was tested by the HCC team.
Support Service Divisions to identify the key risks in each area. 
In March 2006, using the experience gained, the  Trust was able to confirm compliance with all 7
of the core standards in the Declaration:  Safety, Clinical and Cost Effectiveness, Governance,
The Trust updated its assurance framework, which assists in the management of the critical risks facing
Patient Focus, Accessible and Responsive Care, Care Environment and Amenities and Public
the organisation.
Health. Copies of the declaration are available from www.rlbuht.nhs.uk. Work is ongoing to make
an assessment of compliance with the new development standards which will be introduced in
2006/07.
20

---

The Trust has had a successful year meeting all of its key
Income and Expenditure Account
Statement of total recognised gains and losses 
financial targets during a year of transition in the finance
for the year ended 31 March 2006
for the year ended 31 March 2006
regime of the NHS. 2005/06 reforms included the introduction
2005-06
2004-05
2005-06
2004-05
of the ‘Payment by Results’ funding mechanism for in-patients
attending for planned procedures and the continuation of
£000
£000
£000
£000
NHS Pay reform in which all staff were transferred to a
Income from activities:
new pay spine under a programme called ‘Agenda for
Restated
Continuing operations 
242,069
234,746
Change’. Against this background of change, the Trust
Surplus (deficit) for the financial 
achieved a significant savings programme, reducing the
Other operating income 
year before dividend payments
7,390
6,464
cost of running the Trust in order to live within its budget.
Continuing operations
52,102
49,490
Operating expenses:
During the year, the income for certain renal services
Continuing operations 
(286,757)
(278,023)
Fixed asset impairment losses
0
0
transferred to Specialist Commissioners and the wheelchair
service transferred to the Liverpool Primary Care Service.
OPERATING SURPLUS (DEFICIT)
As a result, income and expenditure of £7.4m was no
Continuing operations
7,414
6,213
Unrealised surplus (deficit) 
longer recorded at this Trust. The remaining Income
on fixed asset 
earned by the Trust increased by 6%, which was used for
Cost of fundamental 
revaluations/indexation
3,396
19,390
additional activity, a reduction to waiting times for inpatients
reorganisation / restructuring
0
0
and outpatients, inflation, pay reform and the development
Profit (loss) on disposal of
costs of the scheme to rebuild the Royal Liverpool
fixed assets
0
0
Increase in the donated asset 
Hospital.
and government grant reserve 
SURPLUS (DEFICIT) 
due to receipt of donated and 
Specific Perfomance on the Trust’s key Financial Targets
BEFORE INTEREST
7,414
6,213
government grant financed 
is set out below:
assets
117
534
Interest receivable 
375
350
Break-even Performance
A surplus of £18k was achieved on Income over
Defined benefit scheme 
Interest payable 
0
0
Expenditure in 2005/06. On a cumulative basis
actuarail gains / (losses)
0
0
over the last nine years, the Trust now has a surplus
Other finance costs - 
of £205k.
Additions/(reductions) in 
unwinding of discounts
(75)
(99)
“other reserves”
0
0
Capital Cost Absorption Rate
Other finance costs - 
The Trust is required to make a return on capital at
change in discount rate
a target of 3.5%. The rate is calculated as the
Total recognised gains and 
on previsions
(324)
0
percentage that dividends paid bears to average
losses for the financial year
10,903
26,388
relevant net assets. The actual rate achieved for
SURPLUS FOR THE 
the year was 3.4% and was within the permitted
FINANCIAL YEAR
7,390
6,464
Prior period adjustment
0
0
range of 3.0% to 4.0%. 
Public Dividend Capital 
External Financing Limit
dividends payable
(7,372)
(6,464)
Total gains and losses 
The Trust met its External Financing Limit.
recognised in the 
10,903
26,388
RETAINED SURPLUS
18
0
financial year 
(DEFICIT) FOR THE YEAR
Maggie Boyle
Cathy Lyons
Chief Executive
Director of Finance
During 2005/06 £1,052,000 was received as planned in
year support.
21

---

Cash flow statement
Balance Sheet
for the year ended 31 March 2006
as at 31 March 2006
2005-06
2004-05
2005-06
2004-05
£000
£000
£000
£000
OPERATING ACTIVITIES
FIXED ASSETS
Intangible assets 
0
0
Net cash inflow from operating activities
14,136
22,383
Tangible assets 
238,917
218,809
RETURNS ON INVESTMENTS AND SERVICING OF FINANCE:
Investments
0
0
Interest received
372
353
238,917
218,809
CURRENT ASSETS
Interest paid
0
0
Stocks and work in progress 
5,586
5,692
Interest element of finance leases
0
0
Debtors
18,187
18,263
Net cash inflow (outflow) from returns on investments and servicing of finance
372
353
Investments
0
0
Cash at bank and in hand
867
659
CAPITAL EXPENDITURE
Payments to acquire tangible fixed assets
(24,535)
(19,458)
24,640
24,614
Receipts from sale of tangible fixed assets
42
33
(Payments to acquire)/receipts from sale of intangible assets
0
0
CREDITORS: Amounts falling 
(Payments to acquire)/receipts from sale of fixed asset investments
0
0
due within one year
(25,002)
(25,694)
Net cash inflow (outflow) from capital expenditure
(24,493)
(19,425)
NET CURRENT ASSETS 
(LIABILITIES)
(362)
(1,080)
DIVIDENDS PAID
(7,372)
(6,464)
TOTAL ASSETS LESS 
Net cash inflow (outflow) before management of liquid resources and financing
(17,357)
(3,153)
CURRENT LIABILITIES
238,555
217,729
MANAGEMENT OF LIQUID RESOURCES
CREDITORS: Amounts falling 
Purchase of investments
0
0
due after more than one year 
0
0
Sale of investments
0
0
Net cash inflow (outflow) from management of liquid resources
0
0
PROVISIONS FOR 
LIABILITIES AND CHARGES
(7,099)
(7,029)
Net cash inflow (outflow) before financing
(17,357)
(3,153)
TOTAL ASSETS EMPLOYED
231,456
210,700
FINANCING
Public dividend capital received 
17,737
5,255
FINANCED BY:
Public dividend capital repaid (not previously accrued)
0
0
Public dividend capital repaid (accrued in prior period)
(172)
(2,097)
TAXPAYERS’ EQUITY
Loans received
0
0
Public dividend capital 
151,602
133,865
Loans repaid
0
0
Revaluation reserve 
71,292
68,035
Other capital receipts
0
0
Donated asset reserve 
7,083
7,332
Capital element of finance leases rental payments
0
0
Government grant reserve 
61
68
Cash transferred from / to other NHS bodies
0
0
Other reserves 
0
0
Income and expenditure reserve 
1,418
1,400
Net cash inflow (outflow) from financing
17,565
3,158
Increase (decrease) in cash
208
5
TOTAL TAXPAYERS’ EQUITY
231,456
210,700
22

---

Better Payment Practice Code -
Capital Developments
The Trust is required to declare the pensions
measure of compliance
In 2005/06 we invested £27m in buildings and
benefits for certain senior managers. 
The NHS Executive target is to pay non NHS trade
equipment to improve the facilities on our Hospital
Information is declared for all members of
creditors within 30 days of receipt of goods or a
sites. The most significant investment was £14.4m
the Trust Board.
valid invoice (whichever is the later) unless other
for the Diagnostic and Treatment Centre on the
payment terms have been agreed with the supplier.
Broadgreen site, providing a state of the art theatre
A Cash Equivalent Transfer Value (CETV) is the
suite, new in patient beds, a Radiology Department,
actuarially assessed capital value of the pension
equipped with latest digital imaging facilities and
scheme benefits accrued by a member at a
2005/06
2004/05
out patient clinics. This scheme will in total cost
particular point in time.  The benefits valued are
£79m as part of a shared development programme
the member's accrued benefits and any contingent
Number
£000
Number
£000
with the Cardio Thoracic Centre, and the total
spouse's pension payable from the scheme. A
Total Non-NHS trade
88,323 140,568
97,272 120,209
investment made by this Trust for the scheme will
CETV is a payment made by a pension scheme,
invoices paid in the year 
be £38m. The final phase will be completed in
or arrangement to secure pension benefits in
Total Non-NHS trade
70,450 123,773
78,733 104,664
2006/07.
another pension scheme or arrangement when
the member leaves a scheme and chooses to
invoices within target
Two other schemes, which have modernised the
transfer the benefits accrued in their former
Percentage of Non NHS
80%
88%
81%
87%
scheme.  The pension figures shown relate to the
trade invoices paid within
services on the Royal site, are investments in year
benefits that the individual has accrued as a
target  
of £1.7m on the Radiopharmacy Department, which
consequence of their total membership of the
provides a specialist regional service and £1m
Total NHS trade invoices 
3,787
19,513
pension scheme, not just their service in a senior
on the Radiology Interventional Suite, providing
paid in the year
capacity to which the disclosure applies. The
new equipment and significantly upgrading the
CETV figures include the value of any pension
Total NHS trade invoices 
2,184
16,258
environment for patients. Both schemes have been
paid within target
benefits in another scheme or arrangement which
in progress over more than one year and total
the individual has transferred to the NHS pension
Percentage of NHS trade 
58%
83%
expenditure on each scheme was £1.8m and £3.2m
scheme. They also include any additional pension
invoices paid within target
respectively.
benefit accrued to the member as a result of
their purchasing additional years of pension
£2.1m was spent on new medical equipment, which
service in the scheme at their own cost. CETVs
Management Costs
is a continuous process of renewal and replacement
are calculated within the guidelines and framework
aiming to provide equipment to support 21st Century
prescribed by the Institute and Faculty of
2005/06
2004/05
healthcare standards.
£000
£000
Actuaries.
Management costs
10,199
9,341
Looking to the future, the Trust purchased the
Income 
288,967
278,621
Real Increase in CETV - This reflects the increase
Costs as percentage of income
3.35%
3.35%
Blood Transfusion Centre site in 2005/06. The £2m
in CETV effectively funded by the employer. It
acquisition will provide flexibility in the redevelopment
takes account of the increase in accrued pension
of the Royal Liverpool Hospital.  In addition, as part
due to inflation, contributions paid by the employee
NHS Managers Pay Compliance
of the National programme to invest in modernising
(including the value of any benefits transferred
The Trust complied with the Secretary of State's
the IT capability within the NHS, the Trust invested
from another pension scheme or arrangement)
request that pay awards for Board Members and
£2.4m implementing a digital imaging system
and uses common market valuation factors for
Senior Managers be limited to a maximum of
(PACS) which replaces the need for X Ray films.
the start and end of the period.
3.35% in year.
23

---

Elements of this remuneration report are subject to audit; the salary and pension entitlements of the Board, the membership of the Remuneration Committee, the Trust policy on remuneration of senior
managers including employment contracts, early terminations and any significant awards made.
Salary and Pension entitlements of Trust Board : Table 1
Remuneration Committee
To succeed in delivering an excellent service to patients and to be at the
Name and Title
2005/06
2004/05 
forefront of teaching and research, we must have the best people in place.
A
B
C
A
B
C
The Board has established a Remuneration Committee, comprising the
Executive Directors
£000
£000
£
£000
£000
£
Chairman and all Non Executive Directors of the Trust, whose role is to
M Boyle 
-
Chief Executive
140-145
145-150
determine, on behalf of the Board, appropriate remuneration and terms and
A J Wilks 
-
Deputy Chief Executive
95-100
90-95
conditions for the Chief Executive, Executive Directors, Senior Managers
C Lyons
-
Director of Finance (from April.05)
90-95
on Trust Contracts and all other staff employed on Trust terms and conditions.
J Green
-
Director of Human Resources*
100-105
95-100
The Policy on Remuneration
M Carroll 
-  Director of Nursing  (to April 04)
0
0-5
Inflation: Committee has resolved to uplift pay in line with general NHS
J Galvani 
-
Acting Director of Nursing (to Feb 05)
0
60-65
inflationary uplift. 
D Carroll
-
Acting Director of Nursing (to Sept 05)
25.30
TH Yaseen -
Director of Nursing & Quality (from Oct 05)
45-50
Performance: The Trust has been through a period of reorganisation of
F E White  -  Medical Director
45-50
110-115
50-55
110-115
the management and committee structure, which has strengthened the
operational Divisional Teams, established an effective HR structure and
Chairman & Non Executive Directors
established the role of Deputy Chief Executive. A performance framework
R L James - 
Chairman
20-25
1,700
20-25
1,100
for assessment and development of Directors and Senior Managers is planned,
M Carr 
-  Non Executive Director
5-10
5-10
but not in place, therefore at this point there have been no performance
A M Bebb 
-
Non Executive Director
5-10
5-10
related pay awards.
J Mawer 
-  Non Executive Director
5-10
5-10
Contracts: Directors and Senior Managers are appointed on permanent
C Johnson  -
Non Executive Director (to Nov 05)
0-5
5-10
contracts with generally a three month termination period. The Committee
G Hollick 
-
Non Executive Director (from March 05)
5-10
0-5
may, if appropriate, consider fixed term appointments for specific time limited
G Parker 
-  Non Executive Director (to Nov 04)
0
0-5
schemes. There were no payments for early termination for Directors or
C Duncan
-
Non Executive Director (from Dec 05)
0-5
n/a
Senior Managers in the year.  
* The Director of HR provides a shared HR service to North,
A - Salary (bands of £5000)
Directors’ Remuneration
South and Central Liverpool PCTs. The Trust receives
B - Other Remuneration (bands of £5000)
Table 1 records the total Remuneration, pay and benefits in kind of Trust
income for this service.
C - Benefits in kind (rounded to the nearest £100)
Directors for the year 2005/06
Pension Benefits
Name and Title
Real increase in
Increase in lump sum
Total accrued 
Lump sum at age 60
Cash Equivalent
Cash Equivalent
Real increase in
Employer’s
pension at age 60
at aged 60 related to
pension at age 60
related to accrued
Transfer Value
Transfer Value
Cash Equivalent
Contribution  to
(bands of £2,500)
real increase in pension
at 31 March 2006
pension at 31 March
at March 2006
at March 2005
Transfer Value
stakeholder pension
(bands of £2,500)
(bands of £2,500)
2006 (bands of £2,500)
£000
£000
£000
£000
£000
£000
£000
£000
M Boyle 
- 
Chief Executive #
40-42.5
120-122.5
40-45
130-135
671
64
605
0
A J Wilks 
- 
Deputy Chief Executive
0-2.5
2.5-5
45-50
140-145
869
804
45
0
C Lyons
-
Director of Finance
0-2.5
2.5-5
25-30
85-90
420
375
36
0
D Carroll 
- 
Acting Director of Nursing  
7.5-10
0.2.5
20-25
60-65
271
247
8
0
TH Yaseen
-
Director of Nursing & Quality
0-2.5
2.5-5
20-25
70-75
307
268
9
0
J Green
-
Director of Human Resources
0-2.5
5-7.5
0-5
5-10
42
21
21
0
F E White 
- 
Medical Director
2.5-5
7.5-10
55-60
165-170
969
912
34
0
# These figures are provided by the NHS Pensions Agency. The increase in pension benefits is due to the transfer of benefits in 2005/06 from a scheme outside of the English NHS scheme.
As Non Executive members do not receive pensionable remuneration, there will be no entries in respect of pensions for Non Executive members
24

---

The Audit Commission provides external Audit services to
Financial Aspects of Corporate Governance – 
Independent auditor’s report to the Directors of the
the Trust.
in particular, examining
Board of the Royal Liverpool and Broadgreen
University Hospitals NHS Trust
Systems of internal financial control
The main objective of the Audit Commission is to plan
I have examined the summary financial statements set
and carry out an audit that meets the requirements of
Standards of financial conduct, fraud and 
out on pages 21 to 24.
the Code of Audit Practice as revised on 1 April 2005.
corruption
This report is made solely to the Board of the Royal
Legality of financial transactions
Audit work is focused on the Trust’s significant financial
Liverpool and Broadgreen University Hospitals
and operational risks that reflect the risks for the NHS as
Financial standing
NHS Trust in accordance with Part II of the Audit
a whole and for 2005/06 were identified as:
Commission Act 1998 and for no other purpose, as set out
Accounts
in paragraph 36 of the Statement of Responsibilities of
The Trust’s arrangements for ensuring value 
Examination of the Trust’s annual accounts 
Auditors and of Audited Bodies prepared by the Audit
for money in its use of resources
and provision of an audit opinion as to their 
Commission.
The impact of Payment by Results on activity, 
accuracy and robustness
casemix and budget management
Respective responsibilities of Directors and Auditors
Review of the effectiveness of the Trust’s 
The Directors are responsible for preparing the Annual
Performance management arrangements
closedown procedures and QA process
Report.  My responsibility is to report to you my opinion
Data quality in the management of key targets
The cost of these audit services in 2005/06 was £178,000
on the consistency of the summary financial statements
within the Annual Report with the statutory financial
Annual accounts production process
In addition, the Audit Commission audited the Funds
statements.  I also read the other information contained
Held on Trust accounts for 2005/06. The fee for this
in the Annual Report and consider the implications for
Areas examined included:
was £12,000.
my report if I become aware of any misstatements or
Performance management
All services provided by the Audit Commission were of
material inconsistencies with the summary financial
a statutory nature.
statements.
Acute hospitals portfolio. The three main 
topics covered in 2005/06 were:
The Non Executive Directors who were members of
Basis of opinion
Diagnostic services (including pathology, 
the Audit Committee during 2005/06 were Mr M Carr,
I conducted my work in accordance with Bulletin
radiology and endoscopy)
Mrs A Bebb, Mr G. Hollick and Ms C Johnson.
1999/6 ‘The auditors’ statement on the summary financial
Medicines management
statement’ issued by the Auditing Practices Board. 
Hospital admissions
The Annual Accounts were approved by the Trust Board
Opinion
Review of Data Quality
at their meeting held on Tuesday 4th July 2006 and
In my opinion the summary financial statements are
Review of arrangements to improve 
signed by the Chief Executive
consistent with the statutory financial statements of the
data quality
The information contained within this report is a summary
Trust for the year ended 31 March 2006. 
of the annual accounts.
Use of resources:
Mark Heap
IM&T governance
The Trust is also required to make a statement on
Audit Commission
internal control which forms part of the annual
E-booking
Aspinall Close
accounts. A copy of this statement, or a full set of
Organisational capacity
Enterprise Park 3
accounts is available on request from:
Project management
Middlebrook
Effectiveness of management of human 
The Director of Finance, Royal Liverpool &
Bolton BL6 6QQ
Broadgreen University Hospitals NHS Trust, Prescot
resources
Street, Liverpool L7 8XP.
Date: 6th July 2006
25

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Royal Liverpool University Hospital
Broadgreen Hospital
Liverpool University Dental Hospital
Prescot Street Liverpool L7 8XP
Thomas Drive Liverpool L14 3LB
Pembroke Place Liverpool L3 5PS
Tel: 0151 706 2000
Tel: 0151 282 6000
Tel: 0151 706 2000
Fax: 0151 706 5806
Fax: 0151 282 6798
Fax: 0151 706 5807

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