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QEH accounts cover Artwork 2008  31/8/08  16:04  Page 1
Queen Elizabeth Hospital NHS Trust
Ranken House
Stadium Road
Woolwich
London SE18 4QH
Tel: 020 8836 6000
www.queenelizabeth.nhs.uk

QUEEN ELIZABETH HOSPITAL NHS TRUST
ANNUAL REPORT & ACCOUNTS 2007/08
Queen Elizabeth Hospital 
Queen Elizabeth Hospital 
NHS Trust
NHS Trust

CONTENTS
Page
1.
Message from the Chairman
2
2.
Chief Executive’s Summary
4
3.
Operating & Financial Review
• History and background to the Trust
7
• The services we provide
8
• The environment in which we operate
9
• How we are governed and managed
10
• How we performed in 2007/08
13
• Our priorities for 2008/09
22
• Our longer term strategy
23
• Financial report
24
• How we are addressing our environmental, social and
30
community responsibilities
• Our emergency planning arrangements
31
4.
Staffing Report
32
5.
Remuneration Report 
38
6.  Appendices to the annual report
• Services provided at Queen Elizabeth Hospital
41
• Director biographies
42
• Committee structure 
45
• Clinical directorate structure
46
7.
Annual Accounts
47
1

MESSAGE FROM THE CHAIRMAN
Welcome to our Annual Report and Accounts for 2007/08. As with last year’s publication, we
have produced a document which incorporates a wide range of mandatory information which
meets the requirements of the Manual for Accounts and the Department of Health.  However,
as promised in the last full Report, and due to popular demand, we did produce a second
copy of Life magazine as a review of the year for patients and staff. 
I should say here that we were all delighted that the first edition of Life was not only a great suc-
cess but also won an award and plaudits on the national scene too.
The past 12 months have again been extremely challenging for all of us, not least because we
still have some way to go to achieve a sounder financial position.  However, we have still man-
aged to achieve much to be proud of during the year and many of these achievements are high-
lighted in this document. 
During the year we have seen ever more patients coming through our doors for treatment
whilst we have continued to deliver our stated financial objectives, achieved most of the Gov-
ernment’s targets and significantly improved access to many of our services.
These achievements reflect exceptionally well on the dedication and hard work of the manage-
ment and staff of the hospital, as well as those who provide services to or support the hospital
in other ways. The Board’s thanks go to all our staff and supporters, in particular to the League
of Friends and our army of 250 or more volunteers, so capably led by Diane Hudson, Voluntary
Services Co-ordinator, who all work so hard and do so much to improve the experiences of our
patients. A special mention also goes to the Mammography Unit Appeal which raised £146,000
toward a new mammography scanner.  
As part of our Getting it Right for Patients strategy we have also sought to develop our services
in response to what patients think and say. The national Patients’ Survey this year was still
slightly disappointing and was actually carried out before we began work on our strategy in
earnest. There were, however, some encouraging signs that we were moving in the right direc-
tion.  We are confident that once Getting it Right for Patients becomes embedded in our or-
ganisation we shall see real improvements next year.
This year we have contributed to A Picture of Health - a programme which has been working
to change local health care for the future.  Public consultation on the proposals completed on
7 April 2008.  We are in no doubt that changes are needed, for both clinical and financial rea-
sons and I would thank those individuals in the Trust, including a number of senior clinicians
such as our new Chief Executive, David Robson and new Medical Director, David Sulch, who
have taken their own time to attend events and presentations in the local community as well
as here at QEH to explain the options. I think it is fair to say that we go forward as an organi-
sation with a great deal of confidence in our future as a major health service provider in South
East (SE) London. 
Now thanking those who have left.  I start with expressing the Board’s gratitude to our Chief
Executive for the past four years, John Pelly, who left us at the end of the year to take up a new
position as Chief Executive of Moorfields Hospital NHS Foundation Trust. Despite our difficult
2

financial position, John leaves us in good shape to play our part in A Picture of Health as it un-
folds in SE London. The fact we are in such good shape owes much to his excellent steward-
ship over the last four years. I am sure that the whole organisation will wish him well for the
future.
We also said goodbye to two of our Non-executive Directors, Daphne Barnett and Allan Mc-
Naught, both of whom gave sterling service – Daphne for a full eight year term.
I would also like to make special mention of the members of our Patient and Public Forum, ably
led by William Bruce, who have contributed so much during the Forum’s existence to improving
the experience of patients in the hospital.
And finally, a special word for Ron White, the Vice Chairman of the Greenwich Pensioners’
Forum, who sadly passed away recently. Ron was a marvellous character and great champion
for older people’s services at QEH. He will be sadly missed by us all.
I commend this report to you.
Colin Campbell
Chairman
3

CHIEF EXECUTIVE’S SUMMARY
2007/08 has been another eventful year of steady progress for Queen Elizabeth Hospital in
which we have continued to achieve most of our important short term objectives whilst at the
same time, working closely with colleagues in other NHS Trusts supporting PCTs in outer SE
London to draw up and consult on plans for the future shape of local health care. 
Our two highest priorities have been to remain on course to achieve financial stability whilst at
the same time we have focused on improving the experience of our patients during their stay
in hospital in our Getting it Right for Patients strategy.
I am delighted to be able to report that we have again met almost all of the national perform-
ance targets that now exist. In particular, I must highlight the Trust’s achievement in meeting
the Government’s 18 weeks referral to treatment milestones by 31 March, indeed we were one
of just 37 Trusts nationally to hit early the targets set for December 2008.  The achievement of
this challenging target has required a huge effort on the part of a wide range of clinical, pro-
fessional, administrative and managerial staff to whom my own thanks and those of the whole
Board are extended.
Unfortunately, for the second year we failed to achieve the trajectory laid down by the Depart-
ment of Health for the reduction in cases of MRSA bloodstream infections. Having had 41
cases in 2004/05, we managed to reduce this to 23 cases in 2005/06 and 17 in 2006/07 and
for this year we had 19 cases, although at least five of these patients arrived at the hospital al-
ready infected.  So although we have failed the target of just 12 MRSA bloodstream infections
for the year, we have still seen a considerable reduction in the number of infections since
2004/05. 
Our efforts to reduce Clostridium Difficile (C. Diff) on the other hand, have been dramatic and
have won praise from the SHA and Department of Health.  Our rates of infection for C. Diff have
continued to reduce significantly and we are continuing to improve in this area. 
The Trust was able to complete the Government’s deep cleaning programme on schedule by
the end of March 2008 and we have been working closely with the Department of Health’s Re-
ducing MRSA Improvement Team.
I would like to make special mention of our Matrons and senior nursing team who, with the sup-
port of their colleagues and our partners in ISS Mediclean, have done so much over the past
year to ensure that the environment of the hospital has improved. 
My clinical colleagues continue to impress with the introduction of innovative procedures which
benefit our patients and it is gratifying to see services expanding in diagnostics and cardiology.
Many of these achievements are highlighted in our Annual Review Magazine, Life, which gained
international recognition by being awarded the 2007 PR Week Corporate Publication of the
year.  
We received the results of two national surveys conducted during 2007. The national inpatient
survey has shown some improvements in key areas in the hospital such as giving patients in-
formation about their condition or treatment in A&E and on discharge, reducing delays on dis-
charge, explaining test results and explaining anaesthetics and pain control.   We have got
4

better but still have some improvements to make in keeping patients waiting a long time before
they get to a bed, giving help to families on discharge, treating people with respect and dignity,
doctors washing their hands, cleanliness and food.
We have unfortunately also got worse in patients’ eyes in terms of keeping them waiting more
than four hours in A&E, the noise they experience at night, and not being available to answer
patients’ or families’ concerns.
These areas will now come under close scrutiny by our action teams as part of the Getting it
Right for Patients strategy, along with the work our senior nurses and matrons are doing in im-
proving cleanliness and hand hygiene.
Some of the solutions will involve relatively simple measures that can be introduced quite
quickly and at little cost. Others will require a longer-term programme of individual and organ-
isational performance improvement which will include setting standards for, and monitoring
compliance with, the competences, attitudes and behaviours of our staff. 
In our staff survey, I am pleased to note that we scored better than average for Acute Trusts in
England in a number of indicators including the extent of positive feeling within the organisation
and managers committed to helping staff achieve work/life balance. However we scored worse
than average in indicators such as staff being regularly appraised and having to work extra
hours, and I know we have more work to do to restore high levels of appraisals.
By the end of the year we had succeeded in reducing our costs as we had planned and con-
cluded the year with a deficit of £3.1M (compared to the end of year deficit of £7.3M in
2006/07). Whilst we have been able to achieve this position without the kind of actions nec-
essary the previous year, which had included some staff redundancies, we nevertheless have
continued to place tight controls on expenditure throughout the organisation. These controls
remain in place and, indeed, we face further challenges in the coming 12 months. We expect
a considerable reduction in commissioners’ funding as they seek to provide alternative services
in the community in line with national policy. The result of this shift in service and funding means
that our agreed deficit for 2008/09 will be £5.5M.
Although a number of independent studies and publications have identified that a significant
cause of our financial difficulties stem directly from the high costs of our PFI scheme, we are
nonetheless obliged to work as efficiently as we can do to offset these ‘excess’ costs. I believe
it is important to point out that our in-year stringency in controlling costs saw 5% efficiency sav-
ings equal to £9M.  Achieving these kind of savings, on top of the annual £9M excess PFI
costs we have to meet, is a clear indication that QEH has become an efficient and effectively
run organisation. Much credit for this should go to my predecessor, John Pelly, and our Finan-
cial Director, David Wragg and his team.  
Looking ahead, whilst we have another year in which substantial further financial savings are
required, we are also working within the context of a change programme as set out by A Picture
of Health (APOH).  We have been working closely with our neighbouring Trusts in SE London
5

and our PCT colleagues to draw up models of care and options for the future shape of services
which will enable us to maintain our high clinical standards, deliver positive patient experiences
and balance our books in a sustainable way in the longer term. 
This has involved a full three month PCT led consultation exercise in which QEH, and in par-
ticular several senior consultant colleagues, have taken an active part.  This Trust has now re-
sponded in full to the consultation.  As I write we await final decisions from the Joint Committee
of the PCTs but it is fair to say that we have supported the direction of travel of the consultation
and – with the exception of one or two concerns on detail – support the options as laid down
by APOH. 
In the pages that follow, we describe more about the hospital and the way we work, as well as
some of our achievements and challenges, looking both back over the past year and forward.
I hope you find the report interesting. If you have any comments to make please email me at
xxxx.xxxxxxxxxxxxxx@xxx.xxx or write to me, addressing your correspondence to the Chief
Executive, Queen Elizabeth Hospital NHS Trust, Ranken House, Stadium Road, London SE18
4QH.
David Robson
Chief Executive
6

OPERATING & FINANCIAL REVIEW
History and background to the Trust
Location
Queen Elizabeth Hospital NHS Trust (QEH) was formed in March 2001 when services relocated
to a new hospital in Woolwich in the London Borough of Greenwich.  QEH was developed via
the government’s Private Finance Initiative (PFI) and is located on the site previously occupied
by the Queen Elizabeth Military Hospital. The new 500 bed hospital was created partly by re-
building and partly by refurbishing the military hospital, and now provides a range of acute
hospital services mainly to the residents of Greenwich as well as to a natural catchment from
our neighbouring borough of Bexley and, increasingly, from further afield. 
The hospital is well located in the centre of the borough with excellent road transport and bus
service links. A total of seven bus routes serve the hospital and also link the hospital to London
and into Kent via rail services from Woolwich Arsenal and Woolwich Dockyard stations, and via
the excellent Jubilee line underground service into London from North Greenwich station. 
Population
Greenwich is one of 12 inner London boroughs. It has a population of 232,700, which is ex-
pected to rise by approximately 40,000 over the next 10 years – a rise of some 17%. This rise
is principally the result of the Thames Gateway development – the largest housing development
in Europe. Whilst a major tourist destination with World Heritage status, the borough also has
pockets of extreme deprivation with more than half the borough (10 of the 17 wards) in the most
deprived 10% of wards in England.
More than 100 different languages are spoken in the borough and approximately 23% of the
borough’s population are from minority ethnic groups, compared with 13% of the population
of England as a whole. Increasingly, the highest proportion of the population in Greenwich is
in the 30 to 34 age group. This is reflected in the increased birth rate, which has risen from 14.9
per 1,000 head of population in 2001/02, when QEH first opened, to 18.6 per 1,000 head of
population in 2006.  In fact, Greenwich now has a birth rate that is 14% higher than the average
for England and Wales.
While the proportion of older people in the borough is decreasing, the number of very elderly
people (85+ years of age) is rising, creating its own demands on the hospital and support serv-
ices. Although older people account for 12% of the general population, about 37% of all elec-
tive and non-elective admissions (with the exception of obstetrics) to QEH during 2007/08
were people aged over 65 years.   
The new housing developments, which form part of the Thames Gateway, will impact on the
age profile of the borough, with residents in the new developments expected to be mainly of
working age and proportionately fewer older people among the borough’s new entrants.
QEH is also the local healthcare provider to HM Prison at Belmarsh, a maximum security jail.
The prison has an operational capacity of 915 inmates and is soon to be expanded by a further
480 places.  In addition, planning permission has been sought for a new prison development
in Woolwich for a further 600 places.  The prison population uses a range of our services but
makes a particularly high demand on the Trust’s genito-urinary services.  Telemedicine tech-
7

nology has been developed to provide some services to this section of the population, which
enables consultation and often treatment to be given without the need for prisoners to leave
the prison.  
The services we provide
A full range of clinical services is provided at Queen Elizabeth Hospital, providing both emer-
gency and elective (planned) care to patients. The majority of these services are provided by
staff employed by QEH; however some specialties, including ophthalmology, oral surgery and
ENT (ear, nose and throat) are provided on an outpatient basis only by staff from neighbouring
trusts. QEH also provides some services, such as urology and dermatology, to other local
trusts. The full list of services available at QEH is set out in Appendix 1
Activity Review
Since it opened in 2001, demand for services at QEH has grown significantly. This demon-
strates that we have strong backing from the community we serve and confirms our credibility
as the local provider of choice. 
The tables below show that in 2007/08 the hospital remains as busy as ever and that, in the
six years since we opened, A&E attendances have increased by 32%; non-elective admissions
by 33%; elective admissions by 27%; outpatient attendances by 25% and births by 41%. 
A&E Attendances
2001/02
2002/03
2003/04
2004/05
2005/06
2006/07
2007/08
Increase over 2001/02
75,149
73,638
85,223
94,298 100,831 99,700
99,534
24,551     32%
Note:  These are first attendances only.  Previous Annual Reports have reported total A&E at-
tendances

Non-Elective Admissions (spells)
(excluding obstetrics)
2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 Increase over 2001/02
13,355
14,854
16,584
16,879
16,882
17,669
17,757
4,402     33%
Elective Admissions (spells)
2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 Increase over 2001/02
18,586
20,946
21,116
21,155
23,497
24,622
23,648
5,062     27%
Outpatient Attendances
2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 Increase over 2001/02
155,000 169,808 168,234 158,221 169,560 190,077 193,502
38,502     25%
Births
2001/02 2002/03 2003/04 2004/05 2005/06 2006/07 2007/08 Increase over 2001/02
3,021
3,264
3,487
3,753
3,950
4,182
4,263
1,242     41%
8

The environment in which we operate
Along with all NHS trusts, QEH operates within a financial, competitive and regulatory environ-
ment determined by government. This environment has changed and developed significantly
in recent years, most notably following the publication of the NHS Plan in 2000 and the NHS
Improvement Plan in 2004. Particular features of the current regime that are most relevant to
acute hospitals include:
• a requirement to comply with a range of targets and healthcare standards, compliance
with which is assessed each year by the Healthcare Commission, which publishes the
results of an annual health check for every organisation it has responsibility for assess-
ing (see below for further details);
• a system of funding hospitals known as Payment by Results by which hospitals are
paid (at present mainly by commissioning primary care trusts) for the work they do,
based on a centrally determined national price tariff;
• the development of practice based commissioning, a system by which GP practices,
or groups of practices, are given responsibility by their PCTs for commissioning
services from hospitals;
• the introduction of patient choice - and a computer system known as Choose & Book
- providing patients with a free choice of hospitals to go to for consultations and opera-
tions, including private hospitals (see below);
• the introduction of the independent (private) sector into the provision of healthcare to
NHS patients through the issue of a number of central government contracts; and
• moves to enable a much greater share of healthcare provision to take place in settings
outside hospital.
The Healthcare Commission’s Annual Health Check assesses hospitals on the basis of a range
of performance measures, which come together to produce two ratings, one for quality of serv-
ices and the other for use of resources. QEH was rated as ‘Good’ for quality of services and
‘Weak’ for use of resources based on performance during 2006/07.  We had anticipated a poor
use of resources rating because of the financial challenges we face, and we were pleased to
have been assessed as ‘Good’ for the quality of our services.  We were particularly pleased to
have been assessed as ‘Excellent’ for the new national targets and were the only hospital in
outer south east London to have been awarded an ‘Excellent’ score.  We expect to have an-
other strong score for our performance in 2007/08. 
Aside from the Healthcare Commission, NHS trusts are also subject to inspections and accred-
itations from a very wide range of interested bodies including the medical royal colleges,
deaneries, peer review teams (most notably those concerned with cancer care), specialty-spe-
cific bodies such as Clinical Pathology Accreditation (CPA), the Health & Safety Executive
(HSE), the NHS Litigation Authority, Patient Environment Action Teams (PEAT) and many others.
These are all designed to ensure that hospitals operate to the highest standards and, where
problems are identified, that they are addressed.
9

How we are governed and managed
The Trust Board and its committees
Governance of the Trust is exercised by the Trust Board and a small number of non-executive
led Board committees, supported by a comprehensive framework of executive management.
The Board comprises a non-executive Chairman, five other non-executive directors (NEDs)
and eight executive directors (EDs), including the Chief Executive.  The Chairman of the Pa-
tients’ Forum during 2007/08 has also been made an honorary member of the Board and reg-
ularly attends its meetings.  With the Department of Health shift away from Patients’ Forum he
has now joined the Board as a Non Executive Associate Director to ensure continued patient
representation on the Board.  The names and short biographies of Board members are set out
in Appendix 2.
The Chief Executive is the Trust’s Accountable Officer, accountable via the NHS Chief Executive
to Parliament.
The Board meets monthly in public to oversee the management of the entirety of the Trust’s
business. Where confidential matters need to be discussed, the Board also meets in closed
session, immediately following the open meeting.  Detailed minutes of all meetings are
recorded and the minutes of public meetings are published.
The Board has established four non-executive led committees to oversee particular areas of
Trust business that the Board considers require more detailed scrutiny than the full Board can
provide. These are:
• Audit & Assurance Committee
• Clinical Governance & Risk Management Committee
• Finance Committee
• Remuneration & Terms of Service Committee
Minutes are taken and reported to the Board following each committee’s meeting.
Outer South East London (OSEL) Joint Committee 
We have made reference later in this document to the challenging strategic agenda faced by
acute trusts in outer south east London.  We have recognised the need to work collectively to
provide the best care and services to local people and better meet the requirements of the
south east London Primary Care Trusts.   As a result all four acute trusts - Queen Elizabeth,
Queen Mary’s, Princess Royal and Lewisham Hospitals - have recognised the need for new in-
terim management arrangements to enable a faster more transparent solution to developments
aimed at improving the financial position of the trusts as well as to prepare for the outcome of
consultation on the future configuration of services.   During the year, a Joint Committee has,
therefore, been established and a Transitional Chief Officer appointed, initially for a period of
12 months.  The Joint Committee will ensure that collectively each Trust is supported so that
business continuity and patient safety are maintained.  
10

Trust Executive Committee
The QEH Board has also established a Trust Executive Committee (TEC), chaired by the Chief
Executive, as the principal decision-making body of the Trust.  TEC comprises the executive
directors, clinical directors and the general managers of the clinical directorates. TEC meets
twice each month and, as with the Board, detailed minutes are taken of each meeting’s dis-
cussions and decisions, which are subsequently reported to the Board.
A number of management committees and groups have been established to support the work
of, and report to, TEC. These include the following, some of which have their own sub-com-
mittees:
• Clinical Governance Executive
• Control of Infection Committee
• Cancer Board
• Operations Executive
• Risk Management & NHS Standards Committee
• Capital Planning Group
• Estate & Facilities Management Group
• ICT Strategy Programme Board
• Information Governance Steering Group
The Trust’s committee structure can be seen in diagrammatic form at Appendix 3.
Clinical management structure
The Trust has five clinical directorates, each led by a part-time clinical director (CD) and sup-
ported by a full-time general manager (GM), with responsibility for all aspects of the manage-
ment of a significant part of the Trust’s business. Following a review of the effectiveness of this
structure in early 2007, a number of changes were introduced which took effect from June
2007. The new clinical directorates manage the following services:
• Acute Medicine – acute medical specialties, elderly care, accident and emergency and
therapies;
• Specialist Medicine – a range of medical specialties including cardiology, rheumato-
logy, dermatology, as well as cancer services, critical care, genito-urinary services, im-
aging and outpatients;
• Surgery – general surgery, urology, trauma and orthopaedics, anaesthetics and theatres;
• Women and Children – maternity services, gynaecology and paediatrics; and
• Pathology – covering all the pathology disciplines.
The clinical directorates have a considerable amount of autonomy, operating within a structured
performance management framework.  Each of the clinical directorates has established its
own management structures and arrangements to enable it to manage its affairs effectively and
each is supported by a member of the Finance and HR departments.
The clinical directorate structure can be seen in diagrammatic form at Appendix 4.
11

Business planning and performance management 
The Trust has a well established planning process that commences in the autumn of each year
with the development and agreement by TEC and the Board of the coming year’s corporate
objectives. These are developed by reference to the Trust’s longer-term strategic direction, the
Department of Health’s priorities and targets, and the Trust’s own immediate priorities. Once
agreed, these form the basis of detailed planning guidance which is provided to the clinical and
corporate directorates and departments, together with a template and timetable for the sub-
mission of their plans for the year ahead. These are reviewed and refined at meetings between
the directorates and the executive team prior to final sign-off in the spring.
Performance management operates at three levels: within clinical directorates; at formal per-
formance review meetings of the directorates; and by the Board. These arrangements work
well, as evidenced by the operational and financial performance of the directorates, and the
Trust as a whole, in recent years where the great majority of Trust and directorate plans and
targets have been met. The Trust has achieved extensive savings plans in recent years of
£7.8M in 2007/08, £10.8M in 2006/07 and £4.5M in 2005/06.
In parallel with these internal performance management arrangements, regular meetings be-
tween senior Trust personnel and the local Commissioning Consortium, led by Greenwich
Teaching Primary Care Trust, also take place to review performance against the respective
Service Level Agreements, including local priorities and performance targets, and to consider
and agree on any matters requiring action.  
Risk management
The Trust has comprehensive and robust risk management arrangements in place that enable
the Board to be made aware of, and scrutinise the Trust’s arrangements for managing, the
risks facing the organisation. These include regular consideration of the content of the Assur-
ance Framework (which has received a Category A rating by the Trust’s internal auditors con-
firming that it meets the criteria laid down by the Department of Health), appropriate risk
management policies, procedures and systems, an extensive structure of Board and executive
committees concerned with clinical and non-clinical risk management, as well as sound anti-
fraud arrangements and expertise.
Complaints and Principles for Remedy
The Trust has a formal complaints policy in place, and staff allocated to handling complaints.
In dealing with both formal and informal complaints the Trust takes into account the six Prin-
ciples for Remedy as defined by the Parliamentary and Health Service Ombudsman.  The Trust
plans to update the Complaints Policy in 2008/2009 specifically to include the Principles for
Remedy.
The Trust aims to respond to all complainants within 25 working days.  When this is not possible
the complainant will be contacted and advised of the reason for delay. 
12

How we performed in 2007/08 
2007/08 National Targets
QEH has achieved another good year of performance against the national performance targets,
as summarised in the following table.
Trust

Indicator
Measure
Target
Position
or
2007/08
x
A&E - 4 hour target
% of patients waiting 4 hours or less
98%
98.0%

in A&E from arrival to admission, 
transfer or discharge
18 Week  Referral to
Data completeness of the referral to 
No
100%

Treatment Target (RTT)
treatment data
threshold
By March 2008, 
85% of admitted patients to be
85%
91%

treated within 18 weeks
By March 2008, 
90% of non-admitted patients to be
90%
96%

treated within 18 weeks
Diagnostic Tests
Proportion of patients receiving
100%
94.2%
x
specific diagnostic test in 6 weeks or
less
Cancer – 2 week rule 
Proportion of patients seen within 2
98%
100.0%

weeks of urgent GP referral for 
suspected cancer to first outpatient 
appointment
All Cancers – 1 month 
Proportion of patients treated within 31 
98%
100.0%

days of diagnosis
All Cancers – 2 months 
Proportion of patients treated within
95%
98.8%

two months of urgent GP referral 
Cancelled Operations
Part 1 - % of elective admissions
0.8%
0.36%

cancelled on the day of, or after, 
admission for non-clinical reasons
Part 2 - % of elective admissions 
0%
0%

cancelled on the day of, or after 
admission for non-clinical reasons, 
where that patient is not offered a 
date within 28 days
MRSA Bacteraemia
To achieve the target trajectory
12
19
x
reduction in the number of incidents 
of MRSA bacteraemia (see below)
13

Trust

Indicator
Measure
Target
Position
or
2007/08
x
Clostridium difficile
Local target for Clostridium difficile
Yes
Yes

infections agreed with PCTs and in 
place by March 2008
Convenience and
Availability of slots within 13 weeks 
No 
87.4%

Choice
as shown on Choose and Book slot 
threshold
utilisation reports
Convenience and
Provider inpatient information in place 
Yes
Yes

Choice
to support choice
Delayed transfers of
% of patients whose transfer of care
3.5%
3.3%

patients
was delayed care
Number of inpatients 
% of patients waiting 26 weeks or more 
0%
0%

or day cases waiting
for an elective admission 
longer than the
standard
Number of outpatients
% of patients waiting 13 weeks or more 
0%
0%

waiting longer than the
for a first outpatient appointment 
standard
following a GP referral standard
Waiting times for Rapid
% of patients to RACP clinics seen 
98%
100.0%

Access Chest Pain
within 14 days (where referral received 
from GP within 24 hours)
Waiting times for 
GUM Improvement in access to GUM 
100%
97.8%
x
clinic
clinics within 48 hours
Data quality on ethnic
% of patient admissions for whom a 
90%
94.8%

group
valid 2001 census coding for ethnic 
category is recorded
Reduce emergency
Achieve % reduction of bed days by  
5%
4.6%
x
bed days in hospital for
2008 from 2003/04 baseline.  Measure 
by 2008 increase over  
people with long term
is year on year reduction. 
2006/07
conditions
Smoke free NHS
Part 1 – demonstrating a smoke free 
achieve
achieved

trust
Part 2 – Recording the smoking status 

of adult patients
Part 3 - Reducing smoking in adult 

patients through advice and onward 
referral 
14

Trust

Indicator
Measure
Target
Position
or
2007/08
x
Participation of
Provision of information, existence of 
Yes
Yes

problem drug users in
clear screening and referral  
drug treatment
processes
programmes
Infant mortality and life
Part 1 - reduction in the number of 
No
0.4%
x
expectancy at birth
women known to be smokers at the
threshold
increase 
time of delivery compared to 2006/07 
Part 2 - Number of mothers known to
No
2%

have initiated breastfeeding within 48
threshold
increase 
hours compared to 2005/06
Reduce mortality rates
Ensure compliance with NICE 
Yes
Yes

by 2010 from suicide
guidelines on the treatment and 
and undetermined
management of self harm in the 
injury
emergency department 
Reducing healthcare acquired infection
Whilst we have been very pleased with our overall performance against the national targets,
we were disappointed not to have achieved our target to reduce the number of MRSA (methi-
cillin-resistant staphylococcus aureus) bacteraemia (bloodstream infections) to a maximum of
12 in 2007/08 – the very challenging target set for our organisation and much lower than many
other London hospitals.  We know that the public see cleanliness as one of the most important
priorities in their hospitals, with MRSA infection rates viewed as a key indicator of this.  Although
we missed our target, with 19 cases for the year, we have continued to invest considerable ef-
fort into improving infection control and have secured a reduction in MRSA bacteraemia of
some 14% over last year, which follows a 46% reduction over the previous two years.   
Infection control continues to have an extremely high profile within QEH and this view was
supported by the Healthcare Commission in their feedback to us following their unannounced
spot-check visit in August 2007.   In addition, we have taken part in the Department of Health
Reduction in MRSA Improvement Review Programme and the advisory team has been com-
plimentary about areas of best practice at QEH that they have identified to share with other hos-
pitals across the country.
Our work during the year has also focused on reducing other healthcare acquired infections
and, in particular, on reducing the incidents of Clostridium Difficile (C. Diff), which has demon-
strated a marked reduction in cases during 2007/08 and ensured that the incidents of C. Diff
at our hospital were less than half the maximum target set by our host commissioner.
We have implemented and maintained a number of measures across the hospital to help re-
duce infection rates, including:
• continued participation in the ‘Clean your Hands’ campaign;
15

• the availability of alcohol hand rub dispensers in all areas; the introduction of a Hand
Hygiene Compliance Policy and regular hand hygiene audits, which have demonstrated
an overall improvement in compliance;
• regular audits using both the Saving Lives HII audit tools and the ICNA (Infection Con-
trol Nurses Association) audit tools;
• analysis of each MRSA bacteraemia to ensure that we understand the cause, and,
where necessary, policies and procedures are reviewed;   
• QEH completed the deep clean of all wards by the end of March 2008, in line with the
national initiative;
• enhanced chlorine cleaning was introduced in 2007/08;
• the antibiotic protocols were reviewed and re-issued, with every junior doctor receiving
a pocket guide.
In addition, during 2007/08 QEH successfully bid for resources from the national infection con-
trol improvement funding and as a result achieved the following:
• implementation of screening for MRSA of all admissions from October 2007;
• appointment of an infection control pharmacist to audit and drive best practice anti-
biotic prescribing;
• commenced a one-year trial in the use of probiotic drinks for all patients on antibiotics;
and
• purchase of closed system computer keyboards for high risk areas such as A&E and
ITU.
Other achievements
As well as performing well against the national targets, Queen Elizabeth Hospital is constantly
striving to improve the quality of services delivered to our patients. Summarised below are
some examples of how we have successfully improved services for patients during the last
year.
Shorter Waits - Achievement of Access targets
Key access targets have been achieved, which means that our patients have waited less time
for their treatment.  Achievement of these targets has required organisation-wide focus, co-op-
eration and effort.  Our success has meant that:
16

• 98% of the 100,000 patients who attended our A&E department during the year were
seen, treated, and admitted or discharged within four hours of arriving at the depart
ment;
• all patients who were referred by their GP with a suspected cancer were seen in our
outpatient department within two weeks;
• all cancer patients had started their treatment within 31 days of having been diag-
nosed; and
• nearly all cancer patients (99.1%) had started their treatment within 62 days of an
urgent referral from their GP.
A key target for 2007/08 has been the introduction of the first stage of the 18 Week Referral to
Treatment target (RTT).  This target aims to reduce waiting times to ensure that patients start
their treatment within 18 weeks of being referred by their GP.   To achieve this challenging
target we have had to review systems and processes across the whole organisation to improve
patient pathways, minimise delays and ensure that our patients receive high quality, effective
and timely care.  The measurement of this target in March 2008 demonstrated that 91% of ad-
mitted patients in that month received their treatment within 18 weeks and 96% of non-admit-
ted patients received their care within 18 weeks.  We were delighted to have achieved this
target in March, considerably reducing the time that our patients wait for their treatment, but
we know that we have a lot more work to do during 2008/09 to sustain this success.
Cardiology
Our Annual Report for 2006/07 identified the considerable improvements to our cardiology
services during that year, including significant reductions to wait times for all cardiac diagnostic
tests and the introduction of a ‘one stop’ cardiology clinic.  These improvements led to the QEH
becoming one of only seven national innovator sites for cardiology for the Department of Health
(DH), who were keen that QEH shared its excellent practices with other hospitals nation-wide
so that they could benefit from our work.  The DH identified the QEH cardiac diagnostic service
as ‘an example of what good diagnostic services look like’ and described the Trust’s cardiac
team as ‘innovative, high flyers’ who could help nationally in the drive to bring down waits for
diagnostic tests.
During 2007/08, we built on our success with the introduction of a new service at the beginning
of this financial year – an elective percutaneous coronary intervention (PCI or coronary angio-
plasty) service.  Approval to start the service was obtained from the British Cardiac Intervention
Society (BCIS) in March 2008 and the first patients were treated in April.  This has been an ex-
cellent development for QEH and for our patients, many of whom will no longer have to travel
into central London for these procedures.                                                                                                                       
Cancer
As highlighted in the performance summary above, we have maintained our success in achiev-
ing all three cancer targets during 2007/08.  In the previous year, the Peer Review process for
17

cancer services – a system of review which assesses cancer services in a standardised way
across a considerable number of measures – had confirmed QEH as a provider of high quality
cancer services with over 80% of all measures achieved.   During 2007/08 our Haemato-on-
cology and Chemotherapy services were assessed by the Peer Review Team against the na-
tional standards set for staffing, facilities and support services involved in delivering high-dose,
complex chemotherapy.  The service achieved 100% compliance with the measures and re-
cent benchmarking across London has confirmed that QEH was one of only two hospitals in
London to achieve 100%.   The Peer Review Team commended the multi-disciplinary team
providing these services on a number of aspects of the service provided.  
During the year we also achieved successful reviews for our Colorectal, Urology and Thyroid
cancer services.
In addition, this year has seen the introduction of video-conferencing for specialist multi-dis-
ciplinary team meetings, hosted at the Joint Cancer Centre, for Urological cancers, Anal can-
cers and Upper Gastro-Intestinal cancers.
Care for patients with lung disease
During this year, we have continued to work closely with our partners Greenwich TPCT and
local GPs to develop even further the integrated clinical service for patients suffering from
Chronic Obstructive Pulmonary Disease (COPD), which was introduced in 2006/07.  COPD is
a chronic lung disease, which is traditionally a leading cause of emergency hospital admission.
This service improves the quality of life for these patients by supporting them to manage their
condition at home and at the same time facilitates the shift of activity from secondary to primary
care, thereby reducing hospital admissions.  Dr Jonathan Webb, QEH Consultant in Respiratory
Medicine, has been the driving force for change in this service.  Specific initiatives include: 
° the introduction of community matrons specialising in COPD, who visit patients in their
own homes; 
° a nurse-led oxygen clinic; 
° specialist physiotherapists to help patients improve their lung function; 
° a pulmonary rehabilitation service, which is largely based around exercise, but also
looks at medication and diet; and 
° support for  patients in giving up smoking.  
Investments in Imaging
We are in the sixth year of our innovative PFI contract with Toshiba Medical Services Ltd for
the management of medical equipment.  This 15 year contract provides for the maintenance,
repair and replacement of our medical equipment.  During 2007/08 we have made additional
investment under the contract to improve access and facilitate timely diagnosis and treatment
18

for patients by upgrading from a single slice CT scanner to a 64-slice model.  The introduction
of this new equipment provides significant benefits:
• improved patient comfort during the procedure and a shortened duration of procedure;
• shorter examination times results in increased throughput and, therefore, more patients
can be scanned each day, reducing wait times;
• the diagnostic capability of the CT is extended, which results in earlier diagnosis and
treatment and improving patients’ long-term prognosis.
In addition, the Toshiba contract was due to replace the existing traditional mammography
equipment during 2007/08.  This equipment takes x-rays of the breast and plays a key role in
the detection of breast cancer.   Our staff were keen to enhance this replacement with a digital
camera and set about fund raising to achieve that.  Their significant efforts raised £146,000,
which has meant that the mammography equipment has been replaced with a state of the art
Full Field Digital mammography unit, which has the following benefits:
• significantly improved the image quality, whilst reducing the patient’s radiation
exposure by 50%;
• shorter examination times will reduce waiting times for mammograms;
• the digital unit now means that the images are available on the hospital’s Picture
Archiving Communications (PACS) system almost immediately and ensures that results
are discussed with the patient on the same day in the one-stop breast clinic.
End of life care
During 2007/08 we consulted on a proposal to merge the management of Specialist Palliative
care under the umbrella of Greenwich and Bexley Cottage Hospice (GBCH).   Following con-
sultation, this service merged in April 2008 and will ensure the service delivery changes nec-
essary to meet NICE guidance on supportive and palliative care for adults with cancer.  Uniting
the separately managed services under one management structure will result in a seamless
service for patients as well as economic efficiency.  The combined service will also allow for
service developments and provide a more comprehensive range of services to meet national
recommendations for Greenwich palliative care patients. 
In summary the merged management of the service includes development of a “hub and
spoke” model under the management of GBCH to include:
° one Community services department to allow for improved in and out of hours cover;
° an in-reach service for QEH patients; 
° development of additional therapies;
19

° co-ordination of psychological, spiritual and social work services working across the
Hospice, Hospital and Community; and
° review of senior clinical posts to develop education input that is tailored to the require-
ments of specific groups.
New Substance Misuse Service for A&E
In July 2007 we introduced the Substance Misuse Liaison Team into the A&E Department.  The
service is joint funded by the Greenwich Drug and Alcohol Action Team (DAAT) and Greenwich
TPCT and was set up to improve access to treatment in the community for patients who have
a drug or alcohol problem.  The team of experienced nurses support the doctors and nurses
in the A&E department in managing this difficult patient group.  The team works closely with
A&E staff and in our wards to provide assessment and referral to community services for pa-
tients who have a drug or alcohol problem.
Communications
During this year the Trust's Annual Review for 2006 – ‘Life at QEH’ - gained international recog-
nition in the world of public relations and advertising by scooping the PR Week magazine's Cor-
porate Publication of the year.  The judges praised Life magazine and commented that it was
"very impressive - good, clean and well presented".  The magazine pipped The Prince's Trust
and the trade magazine of the World Jewellery Confederation to win the coveted award.  QEH
was the only NHS organisation to be recognised in these international awards this year. 
Arts Programme
The QEH Arts programme, Elixir Arts, developed several new strands during 2007/08. The pro-
gramme was fortunate to be awarded a grant from the Leverhulme Trust towards the hospital’s
first artist in residence scheme and was pleased to welcome Rachel Wingfield and Mathias
Gmachl of Loop.pH, a London-based design studio.  In December, Loop installed a temporary
window feature of spectrum-coloured gels; passers-by were consulted to find which colours
were considered to be more calming and relaxing. Rachel and Mathias also spent time con-
sulting with different departments before coming up with proposals.
In March 2008 the artists submitted a proposal to create lightweight garden features and win-
dow panels, to transform a section of the first floor in the hospital and existing gardens.  As
well as proposing attractive architectural features, the artists have sought to address issues of
energy conservation through this project. The Residency will culminate in June 2008.
The children’s arts programme, which is funded by Capital Radio’s Help A London Child, con-
tinued until early 2008 and has been working in partnership with the schoolroom and playroom,
providing workshops in decorative flag-making, lantern-making to celebrate autumn festivals,
a Chinese New Year celebration and a visiting theatre company performance.
To launch Black History Month celebrations in October 2007, Elixir Arts commissioned pho-
tographer Laura Mtungwazi to spend a day on site photographing patients, visitors and staff
20

with the plants of their choice. This resulted in some stunning portraits which have been framed
and hung near the outpatients’ department. 
Tesco Charity Trust provided an award to Elixir Arts to offer a new programme specifically for
older patients – ‘Creative Days’ – throughout 2008. This will include monthly performances of
music for patients on Ward 4 and the Stroke Unit.  In the summer, patients will be encouraged
to take part in crafts and other creative activities in the ward gardens. As well as providing a
stimulating and inspiring break in the afternoons, music and singing has been found to help
the recovery of stroke patients.
Patient Experience
The Trust’s annual Inpatient Survey is undertaken by the Picker Institute, which enables us to
benchmark ourselves against other Trusts.  Given our comparatively poor results in previous
years, the Trust Board decided that tackling the issues giving rise to patient dissatisfaction at
QEH would be our top priority for 2007/08.  Consequently we launched a major and detailed
programme of action called ‘Getting it Right for Patients’.  The Director of HR & OD is leading
the programme and each strand of work is led by an Executive Director, with a rigorous per-
formance monitoring process in place involving our full Trust Executive Committee. 
The vision of the programme is to remove the obstacles to providing high quality care and high
quality interaction with our patients and their carers.  It concentrates on those areas where pa-
tient feedback in the survey was poor and through that aims to ensure the delivery of first class
communications and behaviours towards our patients in support of first class healthcare.  In
so doing it also focuses on relationships between our staff, between departments within the
hospital and between us and our partners in care outside the Trust so that these relationships
work well for our patients.  The programme also includes workstreams, which focus on our
processes for admission and discharge, on the training, development and supervision of our
staff and on the environment within which we provide patient care and where our staff work.
The preliminary annual Inpatient Survey results for 2007 show that the overall scores for the
hospital’s care, and the extent to which patients would recommend the hospital to others,
have shown a significant improvement, bringing us closer to, though still slightly below, the
Picker average for these two overall indicators.
Our score is at or above the Picker average on 12 out of 81 indicators (seven out of 80 in 2006),
but below average on 46 out of 81 indicators (71 out of 80 in 2006).  Of these, our scores have
shown improvement in 19, 12 have worsened, and 11 have remained the same.   
We can be pleased with our progress in giving patients information about their condition or
treatment in A&E and on discharge, reducing delays on discharge, explaining test results and
explaining anaesthetics and pain control.  We have got better but still have improvements to
make in keeping patients waiting a long time before they get to a bed, giving help to families
on discharge, treating people with respect and dignity, doctors washing hands, cleanliness
and food.
21

We have unfortunately got worse in patients’ eyes in terms of keeping them waiting more than
four hours in A&E, the noise they experience at night, and not being available to answer pa-
tients’ or families’ concerns.  There are also some new questions, about feeling unsafe, and
respect for religious beliefs, in which we also do not do well.
We know that Trusts in similar situations to ours fare worse than average in national surveys,
and that we have to work extra hard to improve patients’ satisfaction.  The Getting it Right for
Patients strategy, launched in July 2007, just before this survey was conducted, is aimed at
tackling all these areas.
The Board has decided that improving patient satisfaction will continue to be the Trust’s highest
priority in 2008/09, and the comprehensive programme of activity is being extended to support
this. 
Our priorities for 2008/09
The Trust’s plans for 2008/09 are centred around six core objectives:
• improving patients’ experience of our services through the delivery of the ‘Getting it 
Right for Patients’ strategy and improved arrangements for involving patients and the
public in the work of the Trust;
• delivering safe, high quality clinical care through the application of best clinical practice
and by ensuring that the principles of clinical governance underpin our organisation’s
culture, our systems and the working practices of our clinical teams and clinical services;
• securing the future service and financial viability of acute healthcare across south east
London in conjunction with partner organisations;
• demonstrating that QEH is providing high quality, cost effective services through the
performance measures included within the Annual Health Check;
• developing a workforce that is increasingly sensitive to the needs of patients, exploits
every opportunity to improve its productivity without sacrificing quality of care, and is
proactive and flexible in its approach to service change; and
• ensuring our buildings, equipment and infrastructure are fit for purpose and able to re-
spond flexibly to future change in the provision of healthcare within London.
For each of these objectives we have identified a number of actions, which will be monitored
by the Board throughout the year.   Of particular importance are:
• delivery of the ‘Getting it Right for Patients’ strategy to address the issues raised by
our patients through the national patient survey results;
• the work we are doing with partner organisations in outer south east London – known
as A Picture of Health - to redesign healthcare provision in this part of the capital (see
below);
22

• our continuing drive to reduce the incidence of infections acquired at QEH; 
• a need to prepare a plan to migrate from our current integrated information systems 
platform to new systems in line with the Department of Health’s Connecting for Health 
programme.
A full description of our corporate objectives can be found via our website at 
www.queenelizabeth.nhs.uk
Our longer-term strategy
A Picture of Health (APOH)
In our Annual Report for 2006/07, we referred to the pressures faced by a number of hospitals
across the country, which was forcing many of them to consider how they needed to change.
These arise from a number of factors, which remain in place today:
• evidence that better clinical outcomes are achieved by creating larger clinical teams
and departments that treat greater numbers of patients;
• evidence that the treatment of the acute onset of some quite common conditions such
as strokes and heart attacks is better carried out in specialist units;
• the difficulty that smaller hospitals are increasingly facing in providing medical cover 24
hours a day in circumstances where staff can no longer work the hours or the working
patterns that they used to; and
• medical and other therapeutic advances which mean that patients need to come into
hospital much less frequently than in the past, and when they do they increasingly
spend much shorter times in hospital than used to be the case.
In outer south east London these factors are exacerbated by the difficult financial positions of
many of the organisations within the sector.  We reported last year that organisations in outer
south east London (covering the boroughs of Greenwich, Bexley, Lewisham and Bromley),
faced with these challenging pressures, had decided to work together to consider options for
reorganising health services within the area to enable the NHS locally to meet the needs of pa-
tients better, at the same time as securing health services that are clinically and financially sus-
tainable.  The programme - known as ‘A Picture of Health’ (APOH) - continues to have the full
commitment of the Boards of all the organisations involved in it, including QEH.  
During the year, a clinical strategy has been developed under the guidance of the APOH Project
Board and Executive with the engagement and involvement of local clinicians, managers, pa-
tients and the public.  Medical directors have led work across the four hospital trusts in outer
south east London to consider ways in which hospital services can be reorganised in the area
to improve clinical quality and outcomes and to make more effective use of the resources
available to us.  The case for change is a strong one and now generally accepted within the
local NHS and our communities.  
23

The work of these clinical groups led to the development of a number of options for the future
reconfiguration of services in outer south east London.  The project board measured each of
these options against a set of ‘must pass’ criteria and the three options, judged to have met
these criteria, have been the subject of a public consultation led by the four Primary Care
Trusts.  The consultation period ended in early April and the outcome is expected to be known
in the summer.  This consultation was undertaken in parallel with the work being led by Pro-
fessor Lord Ara Darzi on developing a healthcare strategy for London as a whole.
In all three options being considered, QEH remains a fully admitting hospital, providing the full
range of accident and emergency and intensive care facilities.  The QEH Board is in full agree-
ment with this element of the proposals and looks forward to working with partner organisa-
tions in outer south east London to develop services and, if necessary, facilities, to ensure that
QEH can accommodate all of the activity that is expected to flow to it in the future under the
preferred option. 
Project SARK
Project Sark was initiated across the four ‘financially challenged’ trusts in OSEL to enable us
to reduce costs in a number of key areas by working together, principally by consolidating
some of our clinical and non-clinical support functions.  The main areas of project work are as
follows:
• Estates – this workstream is looking at whether surplus land and buildings at the four
hospitals exists and/or can be created such that it can be sold, producing both capital 
receipts and reductions in recurring expenditure.  QEH has identified a section of the
site that is surplus to requirements and we are investigating the feasibility of disposing
of it.
• Management functions – this element comprises several separate workstreams
including Finance, HR, Payroll and IT, and is considering the opportunity to consolidate
some aspects of the work of these departments across the four trusts.  
• Pathology – this workstream is evaluating the possibility of consolidating routine
laboratory pathology activity on one, or possibly two, of the existing hospital sites, and
comparing the feasibility and costs of such an arrangement with alternative
‘contracted out’ options involving either Guy’s & St Thomas’ and King’s or a private
laboratory.
Financial report
Background
The Trust has been unable to balance its income and expenditure consistently since it came
into being in 2001. This has been the result of a numbers of factors including, in the past, op-
erating inefficiencies and the high costs of our PFI scheme. The ‘excess’ costs of the PFI
scheme – the costs that the Trust is unable to recover through the income it receives under the
payment by results system of funding hospitals – have been assessed by independent con-
24

sultants Tribal Consulting, and validated by Cambridge Economic Policy Associates, at approx-
imately £8M per annum. The consequence of this history is that the Trust’s balance sheet at
31 March 2008 contains a negative income and expenditure reserve of £46M, and we were re-
liant on cash borrowings of £65M at year end.
The full accounts for the year ending 31 March 2008 are included with this document on pages
47–94. The paragraphs which follow aim to describe in non-technical language our financial
performance for the year, and should be read in conjunction with the accounts.
Income and Expenditure
Our income and expenditure plan for 2007/08 was designed to produce a deficit of £3.3M. With
an underlying deficit of £12M coming into 2007/08 resulting from the need to deal with new
cost pressures of £4M, this required us to plan and implement savings measures amounting
to more than £8M in the year. In the event we realised recurrent savings of £8M and ended the
year with a deficit of £3.1M. The Trust initially planned to pay £3.1M in respect of interest on
past cash borrowings, but did not have to account for this during the year. This benefit was
used to subsidise other expenditure pressures that arose in year of £2M, asset write offs of
£0.5M and other expenditure of £0.5M. In addition the Trust achieved £1M more income than
initially planned.  
The following table compares the main elements of our income and expenditure account in
2006/07 and 2007/08 and comments on the main changes between the two.
25

Income and Expenditure
2006/07
2007/08
Income
(£ million)
(£ million)
Comment
Income from activities
134.4
141.3
Income from activities
increased by 5% in 2007/08.
Education, training 
4.5
5.1
Income was reduced in 
and research
2006/07 when funding short
falls were passed to NHS 
Trusts. This amount has been 
returned to the Trust in 
2007/08.
Other operating income
7.2
5.7
Income has reduced between 
years after the loss of support 
income for PFI and PBR 
support. 
TOTAL INCOME
146.1
152.1
EXPENDITURE
Pay
-91.5
-92.1
This represents a £3M 
reduction in pay costs after 
adjusting for 2007/08 pay 
awards. Average whole time 
equivalent staff numbers fell by 
37 during the year
Non-pay
-60.1
-62.6
Non-pay expenditure increased
by £4M after inflation is 
accounted for.
TOTAL EXPENDITURE
-151.6
-154.7
Interest receivable
0.2
0.6
Dividends payable
-2.0
-0.6
Asset Write Off
-0.5
SURPLUS/(DEFICIT)
-7.2
-3.1
Our income and expenditure plan for 2008/09 is for a deficit of £5.5M. Gross income is planned
to reduce by £1.3M as our activity is expected to remain static from 2007/08 levels while there
are significant planned income reductions that reflect PCT demand management plans, with
both of our major commissioners intending to divert work away from acute hospitals into com-
munity based settings. We will also lose income as transitional financial support for our PFI
scheme and the move to payment by results is withdrawn.
Without further measures to reduce costs, we would expect our expenditure to rise by £4M,
reflecting additional expenditure associated with general inflation and cost pressures. 
26

The net effect of these expected income and expenditure increases would be to produce a
deficit of £14.2M, an unacceptable outcome in the context of our need to balance our income
and expenditure as soon as we can and to start to repay the deficits we have incurred in the
past. We therefore have to find further savings and the Board has decided that £8.7M of sav-
ings is the maximum we can realistically aim to achieve in 2008/09.
The principal risks to this plan are twofold. Firstly it assumes that the ambitious demand man-
agement initiatives being developed by our commissioning primary care trusts will only be par-
tially successful. Secondly it relies on our being able to identify and implement significant
further savings measures without adversely affecting the quality of patient care. These risks will
be kept under review during the year and appropriate steps taken to address them as and
when they arise.
Capital expenditure
As a PFI hospital our capital expenditure needs are lower than for similar-sized hospitals that
have been financed in the traditional way, and our capital resource limit reflects this. During the
year we invested £1.2M in 26 capital schemes. The table below summarises our capital expen-
diture for the year.
Capital Expenditure
2007/08
(£ Million)
Description
IT Network and Equipment
0.5
Network and equipment to support our IT 
systems
Surgical Equipment
0.2
Purchase of Orthopaedic and other required 
surgical equipment 
Imaging 
0.2
Enabling works and contribution to the 
replacement of the Mammography scanner
Other
0.3
Other clinical / IT equipment and enabling 
works
Total
1.2
From 2007/08 the system of allocating capital resources to NHS trusts has changed as part
of a wider set of financial changes announced by the Department of Health. NHS Trusts will,
as a minimum, be required to spend the funds they set aside for the depreciation of their assets.
If a trust wishes to spend more than this on capital investments, it will need to borrow the
funds to do so. Trusts are only allowed to borrow if their financial strength, assessed by the De-
partment of Health, indicates that they will be able to afford to make the repayments associated
with these borrowings. QEH has the lowest financial strength rating because of its historic fi-
nancial difficulties, which means that no borrowing has been available for capital investment
in 2007/08, and we have been restricted to investing the sum set aside for depreciation and
amortisation of, approximately £1.2M. 
27

The Trust urgently needs to upgrade the electricity power supply to the hospital and plan to
carry out the work in 2008/09. An application for funding has been submitted to NHS London.
The capital costs are expected to be £2.5M in 2008/09 followed by a further £2M in 2009/10. 
Cash
Although we posted a £3.1M deficit, we were able to fund this adverse cash outflow with in-
ternal resources and did not need to borrow any further cash from the Department of Health
in 2007/08. This was in line with our plan, and the funding source amounts relating to 2007/08
that were paid in 2006/07, and increased cash payments from PCT commissioning bodies. We
were able to make our March tax and national insurance bill early, pay council rates in advance
and make advance payments to our PFI partner. These will reduce the amounts owing in
2008/09, and we anticipate being able to meet our estimated £5.5M cash outflow next year
without further borrowing, or with a small loan. 
The Trust has cumulative cash borrowings of £65.4M at the year end. This relates to historic
borrowing received by the Trust to fund past deficits. The Trust has planned that £3.1M of in-
terest on the cumulative cash borrowing will become a liability in 2008/09.   
NHS organisations are expected to comply with the Confederation of British Industry’s code
on payment to suppliers, known as the Better Payment Practice Code (BPPC). Details of how
we performed in relation to this code can be found in note 7.1 to the accounts.
Other financial matters
PFI
Queen Elizabeth Hospital was constructed and is maintained under a PFI contract with Merid-
ian Hospital Co plc (Meridian). The contract between Meridian and the Trust was signed in
1998 and Queen Elizabeth Hospital opened to patients in March 2001. Under the arrangement,
Meridian has granted a lease to the Trust for the exclusive use of the building and undertakes
to maintain, repair, and replace building, engineering, electrical and other plant and machinery,
as well as the fabric of the building and its grounds and gardens, over the 30 operational years
of the contract. The Trust has the option to extend this operational period to 45 or 60 years.
Meridian also provides catering, portering, domestic and cleaning, and a whole range of other
services on the Queen Elizabeth Hospital site. These contracts are subject to market testing
every five years (extendable to seven years with the agreement of both Meridian and the Trust).
Meridian delivers its obligations through sub-contractors: Skanska Rashleigh Weatherfoil
(SRW) and Skanska Facilities Services (SFS) provide the “hard” facilities management asso-
ciated with the building, its fabric and equipment; ISS Mediclean provides the “soft” services,
such as catering, portering and domestic services. The Trust retains ownership of the land at
the QEH site.
The Trust also has a PFI contract with Toshiba Medical Systems for the repair, maintenance and
replacement of our medical equipment. This is a 15 year contract which started in 2001, and
requires Toshiba to replace medical equipment to an agreed lifecycle, or before if it fails or
28

wears out, with an equivalent asset in line with the clinical preference of our clinicians. Annual
spend on this contract was £3.6M.
Organisations of key importance to the future of the Trust
We receive the majority of our income from two NHS organisations, Greenwich Teaching Pri-
mary Care Trust and Bexley Care Trust, each of which commissions clinical services from QEH
for the population it serves. We also receive smaller sums of money from the SHA to support
undergraduate and postgraduate medical and non-medical education and training, as well as
for research and development. We receive income from Oxleas NHS Foundation Trust, which
operates a 90 bed mental health facility on the QEH site, from Queen Mary’s Sidcup NHS Trust
for use of our facilities in the provision of oral and ophthalmology clinics at QEH, and from
King’s College Hospital NHS Foundation Trust which operates a renal dialysis unit on the QEH
site.
Other important contractual relationships exist with Meridian Hospital Co plc and Toshiba Med-
ical Systems, as described above, NHS Shared Business Services (NHS SBS) who run most
of our finance and accounting services, and McKesson Information Solutions UK Ltd who pro-
vide and support our key clinical systems, as well as our Electronic Staff Record (ESR) system.
The Trust is performance-managed by NHS London through its recently established arm’s
length provider agency.
Accounting policy changes
There have been no significant accounting policy changes in 2007/08.
Pension liabilities
Information about the accounting treatment of pension liabilities is provided in note 1.14 of
the 2007/08 accounts.
Auditors
The Trust’s auditors are PricewaterhouseCoopers LLP (PwC), who have been appointed by the
Audit Commission as our external statutory auditor. Audit was the only service provided by
PwC to QEH in 2007/08, at a cost of £218,000.
As far as the directors are aware, there is no relevant audit information of which the Trust’s au-
ditors are unaware, and the directors have taken all steps to make themselves aware of any
relevant audit information and to establish that the Trust’s auditors are aware of that informa-
tion.
29

Other Disclosures
The Operating and Financial Review has been prepared in accordance with the NHS Trusts
Manual for Accounts for 2007/08, as directed by the Secretary of State in accordance with Re-
porting Standard 1.
How we are addressing our environmental, social and community 
responsibilities

We take our environmental, social and community responsibilities seriously and our environ-
mental efforts have focused on our aim of reducing our carbon footprint.  In 2007/08, we were
successful in being selected to join phase 2 of the Carbon Trust’s NHS Carbon Management
programme.  This innovative programme will enable us to cut carbon emissions and reduce
energy bills.  The programme expects that, through their participation, the 16 trusts selected
across England, Wales and Scotland will cut their collective carbon footprint by 15% or 64,000
tonnes of carbon dioxide emissions per year as well as reduce their combined energy bill by
approximately £8M per year.
We have succeeded in the course of 2007/08 in reducing our output of clinical and domestic
waste, despite increased activity in the hospital, as a result of new waste segregation arrange-
ments. Energy consumption has fallen as a result of reviewing when our central heating is
turned on and off; reducing the number and duration of lights we have in use across the hos-
pital; and in providing guidance to staff about turning off lighting and computers when they are
away from their work area.  We have also reduced peak electrical usage by reviewing high
load periods, and by use of our combined heat and power plant.
We have undertaken simple water economisation work through the use of hippos in toilet cis-
terns, and future work is likely to increase our usage of intelligent controlled flushing devices
in toilets. We also actively promote recycling of non-clinical waste and provide facilities within
the hospital to recycle paper and other materials. 
Our work with the Carbon Trust will also look at methods of reducing our dependence on fossil
fuelled transport, in particular through rationalisation of the supply chain to reduce the number
of suppliers and deliveries we have, and reduced usage of Trust funded vehicles through route
rationalisation measures. Our use of NHS Logistics and NHS Purchasing and Supplies, in com-
mon with most NHS bodies, already ensures that we achieve relatively low carbon emissions
in these areas.
Our social and community responsibilities are focused on supporting the work of Greenwich
Council’s and Greenwich TPCT’s strategies for improving the social, economic and environ-
mental wellbeing of the residents of Greenwich. We do this principally through our involvement
with the Improving Health: Cutting Inequalities Strategic Partnership, a multi-agency partner-
ship that has led on the formulation of the Local Area Agreement, Local Public Service Agree-
ment and the Neighbourhood Renewal Programme. Feeding into this partnership is the Healthy
Greenwich Network Group, primarily involving the voluntary and community sectors, with rep-
resentation from QEH and Greenwich TPCT on its Executive Group.
30

Emergency planning 
Queen Elizabeth Hospital has in place a Major Incident Plan that is fully compliant with the re-
quirements of Department of Health guidance ‘Handling Major Incidents: An Operational Doc-
trine’ and all associated and subsequent guidance. This plan was tested through a live
rehearsal in July 2006 and is due to be tested again via a communications exercise during
2008 and another live rehearsal in 2009. 
The role of Emergency Planning Officer has now been combined with the role of Head of Nurs-
ing for the Clinical Site Management Team and a new Emergency Planning Committee has
been established under her chairmanship, with responsibility for the development and imple-
mentation of the Trust’s Emergency Preparedness Action Plan. This comprehensive business
continuity plan will cover all significant operational threats to the hospital’s ability to continue
to provide safe and high quality care to our patients.
31

STAFFING REPORT
In 2007/08 we planned to have an average 2,195 whole time equivalent (WTE) staff over the
course of the year, comprising both permanent and temporarily employed staff. We maintained
our staff in post close to plan throughout the year.
Key achievements
Workforce development has continued its high profile during the course of 2007/08 and the fol-
lowing were key elements in our strategy:
• The single biggest priority for the year has been Getting it Right for Patients, our
strategic response to the disappointing results of the 2006 Inpatient Survey, designed
to improve significantly the experience of patients using our services.
• Also high on the workforce agenda was the implementation of Modernising Medical
Careers, and the national MTAS (Medical Training and Staffing) recruitment process for
doctors in training, the adverse impact of which was widely reported, but was
successfully managed within the organisation with minimal impact on patient services.
• Improvements in cost effectiveness of temporary staffing were achieved through
bringing all temporary staff on to Agenda for Change on competitive rates of pay,
although changes in the labour market towards the end of the year led to minor
revisions in our approach in the light of a reduced supply.
• The increasing numbers of Trusts using ESR, (Electronic Staff Record - the NHS
National Payroll System) together with the development of the FIMS (Financial 
Information Management Submission) reporting framework, has led to an increasing
ability to benchmark against workforce productivity and other indicators in similar Trusts.
• We have worked on succession planning for the most senior roles within the Trust,
which in turn has built on our wide range of leadership and management development
activity. Specific leadership modules for consultants have included managing the
trainee in difficulty, leading teams, and appraisal. 
• An extensive programme of internal and external development activity has been
maintained, which has included the launch of e-learning for a range of mandatory
training and the development of bespoke learning interventions.  Our major training
activity for medical staff each week is the Grand Round, attracting an average of 80
participants weekly.  A full programme of weekly Foundation Programme teaching is
provided, at which attendance at 70% is mandatory, and programmes of weekly
teaching in medicine, surgery and anaesthetics.  
• Significant outer south east London collaboration, within Project Sark and in 
preparation for A Picture of Health, has included the development of a joint framework
for organisational change, and the establishment of joint staff side and management
partnership arrangements.
32

The coming year is one in which we will build on these achievements to deliver real, tangible
benefits, and continue our work to develop a caring, adaptable and highly skilled workforce,
fully engaged in its twin purpose of providing high quality clinical care and a positive experience
for patients.
Key workforce metrics
• Workforce actual against plan
Workforce whole time equivalent (w.t.e.) actual was maintained within 3% of plan throughout
the year whilst vacancy levels fluctuated from month to month, the overall level remained fairly
steady at around 9%, with bank staff employed flexibly largely making up the gap. (Source:
FIMS up to month 12 2007/08).
• Sickness absence
The Trust set a target of 3% sickness absence, and whilst it did not achieve this every month,
benchmarks showed steady improvement during the first half of the year. The sickness rate
climbed during the second half of the year, but fell back in the last quarter to a rate below the
NHS London average. The Trust has ranked between 8 and 34 of 171 Trusts nationally over the
past year. (Source: NHS Institute Quarterly Scorecard up to Q3 2007/08).
• Staff turnover
The Trust enjoys low staff turnover and consistently remained in the top ten Trusts within Lon-
don. (Source: NHS Institute Quarterly Scorecard up to Q3 2007/08).
• Bank and agency staff usage 
The Trust makes good use of flexible staffing through its own internal bank, which has consis-
tently met over 90% of demand.  Costs per w.t.e. have been kept down through careful man-
agement of pay rates.  As a result, agency spend has remained consistently low, placing the
Trust amongst the top performing Trusts in London. However, a dramatic increase in agency
use, largely for medical and AHP staff, saw the percentage of the paybill spent on agency staff
rise from less than 1% to 4.69% in the second quarter of the year. A combination of factors
contributed to this change, including a significant increase in demand for temporary staff, and
the reduced availability of medical locums.  The position in relation to nursing locums has been
changing too, and the hitherto strong supply of nursing bank staff has fallen. The situation ap-
peared to stabilise in quarter three as the percentage fell back to 2.72% (Source: NHS Institute
Quarterly Scorecard up to Q3 2007/08)
• Equality and diversity
We have a diverse mix of employees, with nearly 35% of non-white ethnicity, compared with
about 23% in the local population. Our active Black and Minority Ethnic network and annual
33

programme of cultural activities for staff and patients help to make the hospital an interesting
and inclusive environment.  We have race equality, disability equality and gender equality
schemes, and actively pursue action plans in each of these areas, reporting annually to our
Board. The Trust is a “Two Ticks” accredited employer of people with a disability.
• Staff survey results
We were pleased to note that we scored better than average for Acute Trusts in England in a
number of indicators including the extent of positive feeling within the organisation and man-
agers committed to helping staff achieve work/life balance.  However, we scored worse than
average in indicators such as staff being regularly appraised and having to work extra hours.
We know we have more work to do to restore the high levels of appraisals we were used to be-
fore the introduction of the national Knowledge & Skills Framework (KSF). In a multi-cultural en-
vironment such as ours, it is vital to maintain staff awareness of cultural and diversity issues.
Sadly, though we looked hard for a partner to work with us to help us develop our thinking be-
yond traditional diversity awareness towards developing much deeper understanding of the
barriers to effective health care, we were not able to find one that met our high specification.
It was not surprising therefore, that we scored low on staff having received recent training in
this area. This is work we are determined to progress in 2008/09.
• Recruitment spend
In 2007 we implemented e-recruitment for all posts, reducing spend on advertising to almost
nil.  However spend on press advertising was resumed in early 2008 as part of a major push
to recruit permanent staff, to reduce reliance on temporary staff, the supply of which has be-
come a challenge.
• FCEs per consultant
We have reviewed the consultant productivity metrics currently available, though because
these relate to 2005/06, a decision was made not to develop action plans until more recent data
are published.
Board development
Work on succession planning, within a framework which included Clinical Director, General
Manager and Head of Nursing posts as well as Executive Director posts, demonstrated
strength in relation to short-term cover for most senior posts but weaknesses in succession
to some Executive posts and significant weaknesses in terms of succession to Clinical Director,
General Manager and Head of Nursing posts.  The development of Project Sark and the po-
tential for change introduced through the A Picture for Health Strategy have increased the risks
in these areas.  During the year, we lost two non-executive directors but were only successful
in recruiting one new NED.  We are hoping to acquire two new recruits in early 2008/09 but fu-
ture risks to the Trust include the potential loss of the Trust Chairman and our two experienced
NEDs (Vice Chair and Audit Chair) during late 2008, at the end of their second term of office.
34

Disciplinary action, grievances and appeals
Grievances and appeals have increased from two per month to an average of three per month.
Tighter absence and performance management, together with the implementation of redun-
dancies, have contributed to this increase.
We dismissed 39 members of staff during the year.  Of these, 29 were redundancies and three
were for poor attendance.
Staff involvement and consultation
Our Joint Staff Council (JSC) has met regularly and continues to involve itself in all aspects of
our business, receiving regular reports on the Trust’s financial performance, supporting staff
through organisational change, reviewing and developing staffing policies, and contributing to
external consultations on issues ranging from the national ill health retirement review to A Pic-
ture of Health. Representatives have joined with management in a Joint Partnership Committee
established to oversee issues affecting all four outer south east London acute Trusts.
Communication with staff has continued to develop within our clinical directorates, supple-
mented by our monthly Team Brief, the intranet, our all-desks e-mails and the regular Staff
Open Forum, hosted by the Chief Executive and his director colleagues.
A regular programme of ‘walking the patch’ by the Chief Executive and Executive Directors has
given staff the opportunity to share their views with members of the senior team.
Learning and Development
We ran more than 1,000 training events or study days during the year covering a wide range
of clinical, professional, interpersonal and managerial skills. Our learning and development
team expanded their roles to provide coaching and other developmental support to teams ‘on
the job’.
Academic success was recognised at the annual Trust Awards event in December 2007. In total
103 staff received certificates, recognising success in courses ranging from NVQs in care to
masters degrees, six more staff than in 2006.
We consulted on a revised and simplified appraisal guide, to support the implementation of
KSF and restore the proportion of staff regularly appraised. Our KSF lead has provided full
training sessions, direct support to directorates and staff groups, drop-in sessions, and 1:1
sessions to support the process, as well as promoting KSF through email, posters, flyers and
stalls.
We have used ESR and its linked learning management system, Oracle Learning Management
(OLM), to bring together our disparate databases recording training attendance, to ensure a
comprehensive and effective process for monitoring mandatory training attendance, to ensure
that all relevant staff attend. We are among the first trusts to use OLM in this way.
35

Knowledge Services
Knowledge Services is committed to ensuring evidence based practice assists in embedding
patient care within the organisation. During 2007/08 two new courses have been introduced.
Introduction to Appraisal Skills teaches staff the basics of how to appraise both quantitative
and qualitative evidence while basic Research Skills allows staff to update and refresh their
skills in navigating through the mass array of information available both in print and electroni-
cally.
Staff are regularly assisted in conducting literature searches for systematic reviews and re-
search proposals. The Trust has continued to develop its Library Management System to allow
all staff to renew and reserve books online as well as allowing them to search for items in eight
Health Libraries across South East London.
Staff Wellbeing, Occupational Health and Safety
We have worked closely with local safety representatives to increase the role and influence of
the Health and Safety Committee and began consultation on a Health & Safety Strategy in an-
ticipation of new corporate manslaughter legislation.
We were pleased to see that our scores for staff suffering work related stress or injury were
lower than national averages (source: 2007 staff survey) though staff reported a higher than av-
erage incidence of violence and aggression by patients and visitors. We intend to continue our
work in this area with the aim of reducing this.
Our Occupational Health (OH) team have continued to increase the amount of business they
bring in to the Trust, through providing OH services to other NHS organisations and local busi-
nesses. 
We have continued to extend staff accommodation options through maintaining direct contact
with NHS Estates, and developing stronger links with estate agents, private landlords, Green-
wich Council and social landlords.
Spiritual and pastoral care
As well as our employed chaplains (2.6 WTE) the team now includes around 20 volunteer vis-
itors, supporting patients and families across diverse areas such as A&E and the stroke unit.
This year a highlight has been chaplaincy involvement with the implementation of the Liverpool
Care Pathway, to enable more integrated end of life care including the spiritual aspect.  Chap-
lains also support staff, not least encouraging them in a time of uncertainty, and through facil-
itating the Contact Officer Group. Sharing the lead with the Training Department on Mediation
training means we may help promote more understanding between parties when tensions
arise.
36

Modernising Medical Careers (MMC)
For the past two years QEH has been introducing the first part of a new national training pro-
gramme for young doctors. Foundation Training, as it is known, is a focused training pro-
gramme for doctors in the first two years after leaving medical school. The programme is
designed to equip these doctors with the most important skills and aptitudes required for work-
ing in today’s NHS. The formal educational content is backed up by workplace-based com-
petency assessments. The programme is working well with many additional benefits, including
better multi-professional working and increased liaison with our community based colleagues.
The second part of the MMC programme involves the introduction of training programmes
that begin at the end of the of the second Foundation Year and carry young doctors through
to completion of their training as either hospital specialists or General Practitioners. The start
of this part of the training programme has been fraught with difficulties in 2007, as a result of
national problems that have attracted widespread publicity. We are working hard to support in-
dividual doctors experiencing difficulties in finding training programme places, while many
consultants and other staff have devoted time to conducting interviews that are part of the se-
lection process. Much work remains to be done before this programme is in a satisfactory
state at a national level, and we will continue to play our part in supporting this work.
A new clinical skills laboratory was set up in the Education Centre to enable staff to practise
their clinical skills. The hospital has recently used the laboratory to host the Royal College of
Surgeons’ approved basic surgical skills course which allows the hospital to train clinicians in
surgical techniques. The new laboratory allows both pre and post registration practical skills
to be honed prior to attempting the chosen skill on a patient. It also provides a range of anatom-
ical models, manikins and simulators, together with audiovisual equipment and video camera
facilities to enable simulated consultations and team based patient scenarios. This enables
clinicians to practise their verbal and non-verbal communications with patients in a more re-
alistic environment.
37

REMUNERATION REPORT
This report covers the remuneration of the Trust’s executive and non-executive directors, these
being the only individuals with responsibility for directing or controlling the major activities of
the Trust.
Remuneration of the executive directors is determined by the Remuneration and Terms of
Service Committee, membership of which is indicated in the table below. The Department of
Health determines the remuneration of the non-executive directors.
Executive directors are paid a spot salary, and do not receive performance related pay.
Our policy on the remuneration of executive directors for 2006/07 and 2007/08 was to bring
their salaries broadly into line with the average for posts in similar trusts, over a two-year period,
subject to satisfactory performance. Further detailed benchmarking in 2007/08 revealed that
parity had once more been eroded.  A staged increase was implemented, ranging from 2.5%
to 7%, depending on how far salaries were from the published benchmarks.
The performance of Executive Directors is assessed each year by the Chief Executive, and
considered by the Remuneration and Terms of Service Committee. The Chairman of the Trust
assesses the performance of the non-executive directors. 
All substantive executive directors’ contracts are open ended, and provide for six months’ no-
tice on either side on termination. In the event of early termination, the Trust’s liabilities are lim-
ited to payment in lieu of notice, except in the event of redundancy, when standard NHS
conditions apply. There is no provision for compensation for early termination resulting from
summary dismissal. 
All other senior managers are on national contracts, pay and conditions, following job matching
or evaluation within the Agenda for Change framework.
The salaries, allowances and pensions benefits of the directors are set out in the tables below.
No significant awards have been made to past directors.
38

Salaries and Allowances
2007/08
2006/07
Salary
Other 
Benefits
Salary
Other 
Benefits
Remuneration
in Kind
Remuneration
in Kind
Name and Title
(bands of
(bands of
(bands 
Rounded
(bands 
Rounded
£5,000)
£5,000)
of £5,000)
to the
of £5,000)
to the
nearest
nearest
£000
£000
£000
£000
Colin Campbell*
20-25
0
0
20-25
0
0
Daphne Barnett*°
0-5
0
0
5-10
0
0
Lady Ann Jenkins*°
5-10
0
0
5-10
0
0
Dr Allan McNaught*°
0-5
0
0
5-10
0
0
John Pelly*
145-150
0
0
140-145
0
0
Sylvia Perrins*°
5-10
0
0
5-10
0
0
Terina Riches
80-85
0
0
75-80
0
0
Dr David Robson
45-50
145-150
0
45-50
150-155
0
Lynn Saunders
85-90
0
0
75-80
0
0
Elisa Steele
75-80
0
0
75-80
0
0
Sally Storey
65-70
0
0
60-65
0
0
Ruth Russell
80-85
0
0
30-35
0
0
Gary Kent*°
5-10
0
0
0-5
0
0
Susan Walker
-
-
-
0-5
0
0
David Wragg
95-100
0
0
85-90
0
0
*Member of the Remuneration and Terms of Service Committee.
°Member of the Audit and Assurance Committee
Total Directors’ Emoluments were £842K in 2007/08 (2006/07, £813K) 
Changes in executive directors 2007/08
• David Robson’s term started as Chief Executive on the 1 April 2008
• David Robson’s term ended as Medical Director on the 31 March 2008
• David Sulch’s term started as Medical Director on the 1 April 2008
• John Pelly’s term as Chief Executive ended on the 31 March 2008. 
Changes in non-executive directors 2007/08
• Daphne Barnett’s term of office as a non-executive director ended on 31 October 2007.
• Allan MacNaught resigned on 30 April 2007.
Changes in non-executive directors 2006/07
• Susan Walker’s term of office as a non-executive director ended on 30 November 2006.
• Gary Kent was appointed as non-executive director from 1 January 2007.
39

Pension Benefits
Real increase Total accrued
Cash 
Cash 
Real 
Employers
in pension
pension and
Equivalent
Equivalent
Increase in
Contribu-
and related
related lump
Transfer
Transfer
Cash 
tion to
lump sum at
sum  at 31
Value at 31
Value at 31
Name and title
Equivalent
Stake-
31 March
March 2008
March 2007
March 2008
Transfer
holder
2008
Value
Pension
Cash
(bands of
(bands of
Equivale
£2.500)
£2.500)
To nearest
Transfer V
£000
£000
£000
£000
£000
at 31 Ma
2007
Ruth Russell
17.5-20
80-85
198
270
21
-
John Pelly 
5-7.5
100-105
395
443
27
-
Terina Riches
7.5-10
125-130
419
474
31
-
£000
Dr David Robson 
7.5-10
340-345
0
0
0
-
Lynn Saunders 
10-12.5
60-65
189
241
33
-
Elisa Steele 
2.5-5
80-85
254
281
14
-
Sally Storey 
5-7.5
85-90
304
342
21
-
David Wragg 
10-12.5
75-80
210
256
29
-
• As non-executive directors do not receive pensionable remuneration, there are no
entries in respect of pensions for them
• A Cash Equivalent Transfer Value (CETV) is the actuarially assessed capital value of
the pension scheme benefits accrued by a member at a particular point in time.  The 
benefits valued are the member's accrued benefits and any contingent spouse's
pension payable from the scheme.  A CETV is a payment made by a pension scheme,
or arrangement to secure pension benefits in another pension scheme or 
arrangement when the member leaves a scheme and chooses to transfer the benefits
accrued in their former scheme.  The pension figures shown relate to the benefits that
the individual has accrued as a consequence of their total membership of the
pension scheme, not just their service in a senior capacity to which the disclosure
applies.  The CETV figures and  the other pension details, include the value of any
pension benefits in another scheme or arrangement which the individual has
transferred to the NHS pension scheme.  They also include any additional pension
benefit accrued to the member as a result of their purchasing additional years of
pension service in the scheme at their own cost.  CETVs are calculated within the
guidelines and framework prescribed by the Institute and Faculty of Actuaries.
• Real Increase in CETV reflects the increase in CETV effectively funded by the
employer. It takes account of the increase in accrued pension due to inflation
contributions paid by the employee (including the value of any benefits transferred
from another pension scheme or arrangement) and uses common market valuation
factors for the start and end of the period.
• The accrued pension and lump sum represent the current value that would be
received at retirement age, given that no further pension contributions are made.
David Robson Chief Executive
19.6.08
40

SERVICES PROVIDED AT QUEEN ELIZABETH HOSPITAL
Appendix 1
Accident & Emergency
Medical Diagnostic Centre
Adult Medicine
Metabolism Clinic
Anaesthetics
Microbiology
Anti-coagulation Services
Mortuary
MRI Scanning
Bereavement Services
Biochemistry
Neurology
Blood tests (phlebotomy)
Nuclear Medicine
Blood transfusion
Breast Services
Obstetrics
Occupational Therapy
Cancer Services (Oncology)
Oncology (Cancer Services)
Care of the Elderly
Ophthalmology Clinics**
Cardiology
Oral Surgery Clinics**
Chemotherapy
Orthopaedics
Clinical Haematology
Colorectal Surgery
Paediatric Medicine
Community paediatric nursing
Pain Management
Coronary Care Unit
Palliative Care***
CT scanning
Pathology
Cytology
Pharmacy
Cardiac Catheter Lab & Coronary Angioplasty
Phlebotomy (blood tests)
Dermatology
Physiotherapy
DEXA Scanning
Plastic Surgery****
Diabetic Medicine
Podiatry
Dietetics and Nutrition
Radiology
Ear, Nose and Throat Clinics*
Respiratory Medicine
Endocrinology
Endoscopy
Rheumatology
Fracture Clinic
Sexual Health
Fertility
Sleep Studies
Social Services
Gastroenterology
Special Care Baby Unit
General Medicine
Speech and Language Therapy
General Radiology
Stroke Unit
General Surgery
Surgical Appliances
Genitourinary Medicine
Gynaecology
Trauma Surgery
Haematology
Ultrasound
Histopathology
Upper Gastrointestinal Surgery
Urology
Imaging
Immunology
Virology
Infection Control
Intensive Care
Women’s Services
Lipid Clinic
X-ray
* Service provided by Lewisham Hospital NHS Trust
**Service provided by Queen Mary’s Sidcup NHS Trust
*** Service provided by Bexley and Greenwich Cottage Hospice
41
****Service provided by Guy’s and St Thomas’ Hospital NHS Foundation Trust






DIRECTORS’ BIOGRAPHIES for the year 2007/08
Appendix 2
Colin Campbell - Chairman
Colin is a former technology director with a global accounting and financial
services firm. He has been involved with the NHS since the late 1980s. He
is an elected Local Government Councillor for Bexley where he lives. Colin
chairs the Finance Committee.
Lady Ann Jenkins - Vice-Chairman and Non-Executive Director
Ann, who lives in Blackheath, previously served as a Non-Executive 
Director at Queen Mary's Sidcup NHS Trust. She is Chairman of the 
Ranyard Memorial Charitable Trust, which runs two nursing homes, Dowe
House and Mulberry House on the Lewisham/Blackheath borders. Ann
chairs the Clinical Governance and Risk Management Committee.
Daphne Barnett - Non-Executive Director
Daphne is a long term Greenwich resident and retired member of
Lewisham Social Services. She was a school governor for many years.
She was the Trust’s Champion for Older People and chaired the Joint Staff
Committee. Term of office ended 31 October 2007.
Gary Kent - Non-Executive Director
Gary is an independent consultant specialising in procurement and has 25
years’ experience working in the commercial sector in fleet management,
travel management and real estate.
Dr Allan McNaught - Non-Executive Director
Allan, who lives in Eltham, is a Senior Lecturer in Management and Health
Policy at Greenwich University. Previously he worked on projects in the
health and social care field both in the UK and overseas. In his spare time
Allan is involved with many charitable organisations including "AHEAD",
which provides support and services to black and ethnic minorities who
have AIDS or are HIV positive and the Sickle Cell Trust. Term of 
office ended on 30 April 2007.

42






Sylvia Perrins - Non-Executive Director
Sylvia lives in Eltham and is employed as the National Director for the 
National Skills Academy, Financial Services. She is a qualified accountant
and chairs the Audit and Assurance Committee.
John Pelly - Chief Executive
John first worked for the NHS in 1990 when he joined West Lambeth
Health Authority as Director of Finance. He moved to Guy's & St Thomas'
NHS Trust in 1993 and remained in post as Director of Finance until 1998
when he was appointed Chief Operating Officer. In January 2004 John was
seconded to Queen Elizabeth Hospital NHS Trust as acting Chief 
Executive. John was appointed Chief Executive with effect from 1 April
2005. John chaired the Trust Executive Committee. Resigned 31 March
2008.

Lynn Saunders – Deputy Chief Executive
Lynn has worked in the local NHS since the early 1980s. As Project 
Manager, she helped develop the new Queen Elizabeth Hospital and then,
as Director of Strategy and Planning, was responsible for opening the 
hospital in 2001. As the Trust's Director of Service Improvement Lynn has
had responsibility for leading the organisation to achieve the NHS 
modernisation agenda. Lynn was appointed Deputy Chief Executive in May
2007 and now leads on corporate planning and development, business
planning, performance monitoring, information, communications and 
external relations.  
Terina Riches - Director of Nursing & Patient Care
Terina started in the NHS in 1976 and trained as a registered nurse. She
joined the Trust in May 2000 as Director of Clinical Services following a 
variety of senior nursing and general management posts at St Mary's 
Hospital NHS Trust. She was appointed Director of Nursing and Patient
Care in July 2006 and leads on ensuring the delivery of high quality nursing
care. She is also the Director of Infection Prevention and Control.
Dr David Robson - Medical Director
David was appointed Medical Director in 2004. Prior to this he was the 
Director for IM&T. David was appointed as a Consultant Physician at
Greenwich District Hospital in 1978. He is still very active as a clinical 
doctor, working in Intensive Care and Cardiology. As Medical Director his
key concerns are the quality and organisation of the clinical services, 
together with the clinical governance arrangements of the Trust. Appointed
Chief Executive 1 April 2008.

43





David Wragg - Director of Finance
David has been the Finance Director at QEH since January 2000. He leads
the finance function and estates and facilities management. David has
worked in the NHS since 1987, as finance professional, management 
consultant and external auditor. David is a qualified accountant and is one
of the NHS appointed directors of NHS Shared Business Services (a joint
venture company set up by the NHS and the private sector to deliver 
financial services to NHS clients). 
Ruth Russell - Director of Clinical Services
Ruth qualified as a registered nurse in 1984 and pursued a career in 
nursing until she became General Manager of the Directorate of Surgery at
Guy’s and St Thomas’ NHS Foundation Trust in 2003.  She joined Queen
Elizabeth Hospital as General Manager, Surgery in August 2004.  In 
October 2006 she was appointed Director of Clinical Services and has
overall responsibility for the performance of the clinical services provided
by the Trust. 
Elisa Steele - Director of Information Communication Technology
Elisa joined the Trust as Director of Information Communication Technology
in July 2004. She was previously Head of IT Services at King's College
Hospital. Elisa has worked in IT for over 22 years including positions at the
National Hospital, Queen Square, South East Regional Health Authority
and the private sector. Her outside interests include acting as a volunteer
telephone counsellor for a national charity.
Sally Storey - Director of Human Resources & Organisational Development
Sally joined the Trust as Director of HR & OD in 2002.  She has over 20
years’ experience in HR in health care and in independent consultancy, in
mental health, community, children's and learning disability services as well
as general hospitals. A Chartered Companion of the CIPD, Sally has a 
particular interest in the areas of diversity and leadership development, and
maintains close involvement in these areas within her role. She is co-author
of a number of published training packages for GP Practice Staff.
44

COMMITTEE STRUCTURE
Appendix 3
TRUST BOARD
Clinical Gover-
Audit & 
Trust 
Remuneration 
nance 
Finance
Assurance Com-
Executive Com-
& Terms of Serv-
& Risk Manage-
Committee
mittee
mittee
ice Committee
ment
Information
Risk 
Clinical
Capital 
ICT Strategy
Governance
Management &
Governance
Planning
Programme
Steering
NHS Standards
Executive
Group
Board
Group
Committee
Estates &
Control of 
Cancer
Operations 
Facilities
Infection
Board
Executive
Management
Committee
Group
Toshiba
Clinical
Health &
Meridian
IT System
Investment
Records
Safety
Liaison
Managers
& Liaison
Group
Committee
Committee
Group
Committee
Data
Clinical
Medical IT
Quality
Coding
Advisory
Group
Group
Group
Clinical 
Child 
Incidents,
Resuscita-
Hospital
Clinical
Medicines
R&D
Protection
Complaints 
tion 
Transfusion
Ethics
Management
Committee
Working
& Litigation
Committee
Committee
Committee
Committee
Group
Committee
45

CLINICAL DIRECTORATE STRUCTURE
From June 2007
Appendix 4
Director of Clinical Services

Clinical Site Management Team (including Emergency Planning)

Pharmacy
Directorate of Acute Medicine
Emergency Department
Care of the Elderly (including the 
Surgical Appliances
Medical Diagnostic Centre)
Acute Admitting Medicine
Occupational Therapy
Stroke Unit
Respiratory Medicine (including 
Speech and Language 
the Respiratory Laboratory)
Inpatient and Outpatient 
Therapy
Gastroenterology Physiotherapy
Diabetes Services (including the 
Dietetics
Diabetic Day Centre)
Directorate of Pathology
Haematology (including Blood
Microbiology (including the 
Histopathology (including 
Transfusion
Infection Control Team)
the Bereavement Service)
Biochemistry
Virology
Cytopathology
Immunology
Directorate of Specialist Medicine
Critical Care Services
Haemato-Oncology and 
Imaging Services (including 
Chemotherapy
Reprographics and Medical 
Resuscitation Training
Photography
Rheumatology
Cardiology (including cardiac 
Anticoagulation Service
diagnostics
Neurology
Outpatient Services
Cancer Team
Dermatology
Medical Records
Palliative Care
Genito-Urinary Medicine
Directorate of Surgery
General Surgery
Anaesthetics
Sterile Supply Services
Trauma and Orthopaedics
Theatre Services
Discharge Lounge
Urology
Waiting List Administration
Hospital’s Main Reception
Area
Endoscopy Services
Directorate of Women’s and Children’s Services
Paediatrics (including dedicated 
Community Paediatric Nursing
Gynaecology
outpatient facility)
Maternity Services
46

QUEEN ELIZABETH HOSPITAL 
NHS TRUST
ANNUAL ACCOUNTS 
2007/08
47

STATEMENT OF THE CHIEF EXECUTIVE'S 
RESPONSIBILITIES AS THE ACCOUNTABLE 
OFFICER OF THE TRUST
The Secretary of State has directed that the Chief Executive should be the Accountable Officer to the
Trust.  The relevant responsibilities of Accountable Officers, including their responsibility for the propriety
and regularity of the public finances for which they are answerable, and for the keeping of proper
records, are set out in the Accountable Officers' Memorandum issued by the Department of Health.
To the best of my knowledge and belief, I have properly discharged the responsibilities set out in my let-
ter of appointment as an accountable officer.
David Robson
Chief Executive
19.6.08 
48

STATEMENT ON INTERNAL CONTROL 2007/08
QUEEN ELIZABETH HOSPITAL NHS TRUST
1. Scope of responsibility
The Board is accountable for internal control. Having taken up post in April 2008 as Accountable Of-
ficer, and Chief Executive of this Board, I have responsibility for maintaining a sound system of in-
ternal control that supports the achievement of the organisation’s policies, aims and objectives. I also
have responsibility for safeguarding the public funds and the organisation’s assets for which I am per-
sonally responsible as set out in the Accountable Officer Memorandum.
As Accountable Officer I am formally accountable both to the Board and, via the NHS Chief Execu-
tive, to Parliament. I exercise my accountability to the Board through attendance at, and provision
of reports to, formal meetings of the Board and its committees.
My accountability to the NHS Chief Executive and Parliament is exercised through the regular pro-
vision of a wide range of information to the Department of Health, and through the formal monitoring
of Trust performance by NHS London.
I also have a responsibility to report on performance against service agreements with the commis-
sioners of clinical services from the Trust, principally Greenwich Teaching Primary Care Trust and
Bexley Care Trust. This responsibility is discharged through regular meetings of officers of those or-
ganisations, including at Chief Executive level.
2. The purpose of the system of internal control
The system of internal control is designed to manage risk to a reasonable level rather than to elim-
inate all risk of failure to achieve policies, aims and objectives; it can therefore only provide reason-
able and not absolute assurance of effectiveness.  The system of internal control is based on an
ongoing process designed to:
• Identify and prioritise the risks to the achievement of the organisation’s policies, aims and
objectives; and
• Evaluate the likelihood of those risks being realised and the impact should they be realised,
and to manage them efficiently, effectively and economically.
The system of internal control has been in place in Queen Elizabeth Hospital NHS Trust for the year
ended 31 March 2008 and up to the date of approval of the annual report and accounts.
3. Capacity to handle risk
As Chief Executive I have overall responsibility for risk management. The Director of Finance is iden-
tified as the Board lead for non-clinical risk management, and the Medical Director and Director of
Nursing & Patient Care are the joint Board leads for clinical governance and clinical risk management.
The Trust invests in staff and systems resources to support these Directors in carrying out their risk
management roles. The Head of Clinical Governance attends the Clinical Governance and Risk Man-
agement Committee as well as the Risk Management and NHS Standards Committee.
49

A formal Board committee structure is in place, which oversees the Trust’s risk management activities
and performance. There is a Non-Executive Clinical Governance and Risk Management Committee
reporting to the Board. Executive management of risk is co-ordinated through the Trust Executive
Committee, which reports to the Board, and is supported by the Risk Management and NHS Stan-
dards Committee (covering non-clinical risk and supported by the Health and Safety Committee)
and the Clinical Governance Executive, which manages clinical risk through the coordination of eight
specific sub-committees. The Audit and Assurance Committee is a Non-Executive committee which
monitors the delivery of elements of the risk agenda.
The Trust provides risk management training for staff, which includes risk assessment, for those
with management responsibility, as well as basic risk management training for all new staff as part
of their corporate induction.
Communication of risk management matters, including sharing good practice, takes place in a wide
variety of ways, both at corporate and departmental level. These include the use of email and Team
Briefing on matters of general interest or concern; the circulation of findings, and development of ac-
tion plans, following reviews of complaints and incidents; clinical audit meetings; and departmental
newsletters.
4. The risk and control framework
There is a comprehensive Risk Management Strategy and Policy in place, which was updated and
approved by the Board in 2007/08. This describes the overall approach and methodology for man-
aging risks, and identifies corporate and departmental responsibilities. It also includes guidance on
risk identification and assessment processes using a matrix-based model. Key risks are entered on
to the Trust’s risk register and are reported to the Trust Board or its sub-committees.
Risks and policies relating to data security and information governance are managed by the Infor-
mation Governance Group and ICT Strategy Board, with both reporting to the Board via the Trust Ex-
ecutive Committee. Reports are routinely received identifying risks and issues by the Audit
Committee and IT Project Boards. The Trust annually completes the Information Governance Toolkit
to assess the policies and procedures in place to manage information, and has taken part in the In-
formation Governance Assurance Programme (IGAP), which is a national review of data flows and
security.  The Trust has a number of policies relating to data security, sharing and access.  
Assessing and evaluating risk, and monitoring the environment of the organisation for fire and health
and safety hazards, are a responsibility of line managers. In the course of 2007/08, the Trust main-
tained its CNST accreditation in maternity services at Level 2, this score having improved in 2006/07.
The CNST accreditation for other services remains at Level 1.
The Trust has a comprehensive incident reporting system in place, and a  “whistle blowing” policy,
which was revised in February 2006, for the anonymous reporting of staff concerns. Complaints are
actively monitored and managed in line with Department of Health recommendations.  
The Assurance Framework embodies a summary of the assurances in place, and an assessment of
the effectiveness of internal controls to mitigate the risks to the Trust achieving its organisational
objectives. It describes the key risks to achieving each objective, the internal controls in place, and
an assessment of the assurances reported to the Board and its sub-committees. It also identifies
50

where there are areas of poor control, or where a lack of assurance exists.  This, together with other
key processes, is used to provide the Board with assurance that an effective system of internal con-
trol is in place for the Trust. 
The Trust engages with its key stakeholders in a number of ways, including hosting and being in-
volved in meetings of the Patients’ Forum; holding regular open staff meetings; liaising with senior
officers of the London Borough of Greenwich and with the Health Scrutiny Panels of the London
Boroughs of Greenwich and Bexley; and regular meetings with the Trust’s PFI partners and their
sub-contractors. Objectives are clearly linked to the priorities of other partners and the wider com-
munity. The Trust engages formally with a range of statutory and voluntary sector partners to reflect
the diverse needs of the catchment population. 
As an employer with staff entitled to membership of the NHS Pension scheme, control measures are
in place to ensure all employer obligations contained within the Scheme regulations are complied
with. This includes ensuring that deductions from salary, employer’s contributions and payments in
to the Scheme are in accordance with the Scheme rules, and that member Pension Scheme records
are accurately updated in accordance with the timescales detailed in the Regulations.
Trust Board meetings are held in public; staff and members of the public regularly attend and ques-
tion Board members on a wide variety of matters. It should be noted that there is the potential to lose
the Trust Chairman and two experienced NEDs (Vice Chair and Audit Chair) during late 2008, at the
end of their second term of office. 
5. Review of effectiveness
As Accountable Officer, I have responsibility for reviewing the effectiveness of the system of internal
control. My review is informed in a number of ways. The head of internal audit provides me with an
opinion on the overall arrangements for gaining assurance through the Assurance Framework and
on the controls reviewed as part of the internal audit work. Executive managers within the organisa-
tion who have responsibility for the development and maintenance of the system of internal control
provide me with assurance. The Assurance Framework itself provides me with evidence that the ef-
fectiveness of controls that manage the risks to the organisation’s achieving its principal objectives
have been reviewed. My review is also informed by: -
• Reports from External Auditors;
• Reports from Internal Auditors;
• Reports from the Healthcare Commission;
• The results of the Clinical Negligence Scheme for Trusts (CNST) assessment;
• The PBR Assurance Framework and Clinical Coding audit report;
• The assessment of the Information Governance Toolkit;
• The monthly finance and performance reports to the Board;
• Reports from a wide variety of other external bodies, including the Medical Royal Colleges,
London Deanery, Clinical Pathology Accreditation (CPA), the Health & Safety Executive and
the London Fire & Civil Defence Authority;
51

• The Trust’s assessment of compliance with the standards set out in Standards for Better
Health;
• The Auditors Local Evaluation (ALE) to be reported as part of the Healthcare Commission’s
Annual Healthcheck for 2007/08; and
• Third party assurances on NHS Shared Business Services and Electronic Staff Record
activities.
I have been advised on the implications of the result of my review of the effectiveness of the system
of internal control by the Board, the Audit & Assurance Committee, the Clinical Governance and
Risk Management Committee, and the Trust Executive Committee. A plan to address weaknesses
and ensure continuous improvement of the system is in place.
The Board approves Corporate Objectives each year, and a Service & Development Plan designed
to achieve those objectives. During the year the Trust Executive Committee and Board receive
monthly financial and performance management reports, which set out performance against the key
plans and targets. The Board also reviews overall progress in achieving the Corporate Objectives two
or three times per year.
The Audit and Assurance Committee has monitored both internal and external audit activity, and
the effectiveness of key internal controls. An independent Internal Audit function is established and
an annual plan of Internal Audit activity is approved and monitored by the Audit and Assurance Com-
mittee.  The committee also reviews any incidence of fraud. Minutes of the Audit and Assurance
Committee are reported to the Board.
The Clinical Governance and Risk Management Committee scrutinises the Trust’s actions and per-
formance on all clinical risk and governance matters. Minutes of this committee are reported to the
Board.
The Trust’s Standards for Better Health declaration included two core standards for which the Board
believes there was insufficient assurance as to whether the standard had been met throughout the
year:
• Standard C7e: Healthcare organisations challenge discrimination, promote equality and
respect human rights. Although the Trust has the required policies and procedures in place,
some responses from the Trust staff survey related to training and development meant that 
the Trust prudently assessed itself as not having adequate assurance; and 
• Standard C16: Information made available to patients and public was self assessed as not
fully met throughout the year, but met by year-end. This was following the provision of an
improved range and quality of patient information. 
The Trust has identified the following significant control issues, which could impact on its services:
• The Trust had an underlying financial deficit in 2007/08, of approximately £2m per annum.
The actual reported deficit was £3.1m in 2007/08, of which £0.6m relates to asset disposals,
while the remainder relates to other non-recurrent items. The underlying deficit in 2008/09
has increased to approximately £14m as a result of income reductions (financial support for
payment by results and PFI are planned to reduce), having to pay interest on cash
52

borrowings for the first time, and significant PCT demand management aspirations. A plan to
reduce costs by approximately £9m in 2008/09 has been approved by the Board, leaving a
planned deficit of £5.5m., which has been agreed by the London Health Authority
• Because of the Trust’s financial deficit in 2007/08 the Trust’s external auditors, Pricewater-
houseCoopers LLP, following the Code of Audit Practice, have concluded adversely that:
o The Trust has not put in place arrangements to ensure that its spending matches its 
available resources; and
o The Trust has not put in place a medium-term financial strategy, budgets and a capital
programme that are soundly based and designed to deliver its strategic priorities.
• Under Section 19 of the Audit Commission Act 1998, the Trust external auditors are
considering writing to The Secretary of State for Health noting that the Trust will not meet its
statutory break even duty over a rolling three year period, under paragraph 2(1) of Schedule
5 to the National Health Service Act 2006. The report to the Secretary of State recognises
the significant cost saving programmes achieved by the Trust over recent years of £4.5m in
2004/05, £4.5m in 2005/06 and £10.8m in 2006/07.
• The Trust is unlikely to generate material surpluses that will enable it to recover historic
deficits without a reconfiguration of clinical services within SE London. It is therefore actively
engaged in a project, known as ‘A Picture of Health’, which is considering options for
achieving this among the four Outer South East London Hospitals.  Consultation on this 
finished in May 2008. 
• The Auditors Local Evaluation (ALE) to be reported as part of the Healthcare Commission’s
Annual Healthcheck for 2007/08, will award the Trust a score of 1 for Use of Resources. This
is the lowest score available and is automatically awarded based on the Trust’s financial
standing being a deficit position. The Trust has performed well on the individual elements of
the ALE review and are expecting a 2 for Financial Management, 3 for Internal Control, 3 for
Value for Money and 2 for Financial Reporting.
• The Trust has failed to reduce its MRSA (methicillin-resistant staphylococcus aureus)
infections to the targeted level of 12 in 2007/08. Although we missed our target, with 19
cases for the year, we have continued to invest considerable effort into improving infection
control and have secured a reduction in MRSA bacteraemia of some 14% over last year,
which follows a 46% reduction over the previous two years.  (Please see page 16 of the
Annual Report for further details). 
• Results of the PBR Assurance and Clinical Coding audit have identified inaccuracies in the
Trusts clinical coding, which affect the amount the Trust is paid for patients treated. The
report identifies the potential for increased income if accuracy is improved and in response
the Trust put in place an action plan from October 2007 and expects to achieve increased
income levels from more accurate coding in 2008/09. 
David Robson
Chief Executive
19.6.08            
53

STATEMENT OF DIRECTORS' RESPONSIBILITIES IN 
RESPECT OF THE ACCOUNTS
The directors are required under the National Health Service Act 2006 to prepare accounts for each fi-
nancial year.  The Secretary of State, with the approval of the Treasury, directs that these accounts give
a true and fair view of the state of affairs of the trust and of the income and expenditure of the trust for
that period.  In preparing those accounts, the directors are required to:
-  apply on a consistent basis accounting policies laid down by the Secretary of State with the
approval of the Treasury
-  make judgements and estimates which are reasonable and prudent
-  state whether applicable accounting standards have been followed, subject to any material
departures disclosed and explained in the accounts.
The directors are responsible for keeping proper accounting records which disclose with reasonable ac-
curacy at any time the financial position of the trust and to enable them to ensure that the accounts com-
ply with requirements outlined in the above mentioned direction of the Secretary of State.  They are
also responsible for safeguarding the assets of the trust and hence for taking reasonable steps for the
prevention and detection of fraud and other irregularities.
The directors confirm to the best of their knowledge and belief they have complied with the above re-
quirements in preparing the accounts.
By order of the Board
David Robson
David Wragg
Chief Executive
Finance Director
19.6.08
19.6.08
54

Independent auditors’ report to the Directors of the Board of
Queen Elizabeth Hospital NHS Trust
Opinion on the financial statements
We have audited the financial statements of Queen Elizabeth Hospital NHS Trust for the year ended
31 March 2008 under the Audit Commission Act 1998. These comprise the Income and Expenditure
Account, the Balance Sheet, the Cashflow Statement, the Statement of Total Recognised Gains and
Losses and the related notes. These financial statements have been prepared in accordance with
the accounting policies directed by the Secretary of State with the consent of the Treasury as relevant
to the National Health Service set out therein. We have also audited the information in the Remuner-
ation Report that is described as having been audited.
This report, including the opinion, has been prepared for and only for the Board of Queen Elizabeth
Hospital NHS Trust in accordance with Part II of the Audit Commission Act 1998 and for no other
purpose, as set out in paragraph 36 of the Statement of Responsibilities of Auditors and of Audited
Bodies prepared by the Audit Commission.  We do not, in giving this opinion, accept or assume re-
sponsibility for any other purpose or to any other person to whom this report is shown or into whose
hands it may come save where expressly agreed by our prior consent in writing.
Respective responsibilities of Directors and Auditors
The directors’ responsibilities for preparing the financial statements and the Remuneration Report
in accordance with directions made by the Secretary of State are set out in the Statement of Direc-
tors’ Responsibilities.
Our responsibility is to audit the financial statements and the part of the Remuneration Report to be
audited in accordance with relevant legal and regulatory requirements and International Standards
on Auditing (UK and Ireland). 
We report to you our opinion as to whether the financial statements give a true and fair view, and
whether the part of the Remuneration Report to be audited has been properly prepared, in accor-
dance with the accounting policies directed by the Secretary of State as being relevant to the Na-
tional Health Service in England. We report to you whether, in our opinion, the information which
comprises the commentary on the financial performance included within the Operating and Financial
Review, included in the Annual Report, is consistent with the financial statements.
We review whether the directors' Statement on Internal Control reflects compliance with the Depart-
ment of Health's requirements “Statement on Internal Control 2007/08 – Disclosures”, issued on 7
April 2008 and 20 May 2008.  We report if it does not meet the requirements specified by the De-
partment of Health or if the statement is misleading or inconsistent with other information we are
aware of from our audit of the financial statements. We are not required to consider, nor have we con-
sidered, whether the directors' Statement on Internal Control covers all risks and controls. We are
also not required to form an opinion on the effectiveness of the Trust’s corporate governance pro-
cedures or its risk and control procedures.
55

We read other information contained in the Annual Report, and consider whether it is consistent
with the audited financial statements. This other information comprises only the unaudited part of
the Remuneration Report, the Message from the Chairman, the Chief Executive’s Summary, the
Staffing Report and the remaining elements of the Operating and Financial Review. We consider the
implications for our report if we become aware of any apparent misstatements or material inconsis-
tencies with the financial statements. Our responsibilities do not extend to any other information.
Basis of audit opinion
We conducted our audit in accordance with the Audit Commission Act 1998 and the Code of Audit
Practice issued by the Audit Commission, which requires compliance with International Standards
on Auditing (UK and Ireland) issued by the Auditing Practices Board. An audit includes examination,
on a test basis, of evidence relevant to the amounts and disclosures in the financial statements and
the part of the Remuneration Report to be audited. It also includes an assessment of the significant
estimates and judgments made by the directors in the preparation of the financial statements, and
of whether the accounting policies are appropriate to the Trust’s circumstances, consistently applied
and adequately disclosed.
We planned and performed our audit so as to obtain all the information and explanations which we
considered necessary in order to provide us with sufficient evidence to give reasonable assurance
that the financial statements are free from material misstatement, whether caused by fraud or other
irregularity or error; and the financial statements and the part of the Remuneration Report to be au-
dited have been properly prepared. In forming our opinion we also evaluated the overall adequacy
of the presentation of information in the financial statements and the part of the Remuneration Report
to be audited.
Opinion
As stated in our audit report for the year ended 31 March 2008 issued on 20 June 2008:
• the financial statements give a true and fair view, in accordance with the accounting policies
directed by the Secretary of State as being relevant to the National Health Service in
England, of the state of the Trust’s affairs as at 31 March 2008 and of its income and
expenditure for the year then ended; 
• the financial statements and the part of the Remuneration Report to be audited has been
properly prepared in accordance with the accounting policies directed by the Secretary of
State as being relevant to the National Health Service in England; and
• information which comprises commentary on the financial performance included within the
Operating and Financial Review, included within the Annual Report, is consistent with the
financial statements.
56

Emphasis of matter – liquidity
Without qualifying our opinion, we draw attention to note 22 in the financial statements which indi-
cates that the Trust has £65 million cash in PDC which it will be required to repay in 2008/09. Re-
payment terms have not been negotiated with the Department of Health. These conditions indicate
the existence of a material uncertainty which may cast significant doubt about the Trust’s liquidity.
PricewaterhouseCoopers LLP
80 Strand
London
WC2R 0AF
23 July 2008
57

INCOME AND EXPENDITURE ACCOUNT FOR THE YEAR
ENDED 31 March 2008
Restated *
2007/08
2006/07
NOTE
£000
£000
Income from activities
3
141,302
134,362
Other operating income
4
10,819
11,736
Operating expenses
5
(154,670)
(151,579)
OPERATING DEFICIT
(2,549)
(5,481)
Loss on disposal of fixed assets
8
(516)
0
DEFICIT BEFORE INTEREST
(3,065)
(5,481)
Interest receivable
632
288
Other finance costs - unwinding of discount
16
(70)
(66)
DEFICIT FOR THE FINANCIAL YEAR
(2,503)
(5,259)
Public Dividend Capital dividends payable
(622)
(1,985)
RETAINED DEFICIT FOR THE YEAR
(3,125)
(7,244)
The notes on pages 5 to 36 form part of these accounts.
All income and expenditure is derived from continuing operations.
* See note 1.3 for details of the prior year restatement
58

BALANCE SHEET AS AT
31 March 2008
31 March
31 March 
2008
2007
NOTE
£000
£000
FIXED ASSETS
Intangible assets
10
1,355
1,090
Tangible assets
11
66,698
61,387
68,053
62,477
CURRENT ASSETS
Stocks and work in progress
12
1,663
1,636
Debtors
13
27,240
60,842
Investments
14.2
0
6,000
Cash at bank and in hand
18.3
6,485
480
35,388
68,958
CREDITORS: Amounts falling due within one year
15
(7,812)
(8,753)
NET CURRENT ASSETS
27,576
60,205
TOTAL ASSETS LESS CURRENT LIABILITIES
95,629
122,682
CREDITORS:  Amounts falling due after more 
than one year
15
(603)
(632)
PROVISIONS FOR LIABILITIES AND CHARGES
16
(3,600)
(3,770)
TOTAL ASSETS EMPLOYED
91,426
118,280
FINANCED BY:
TAXPAYERS' EQUITY
Public dividend capital
22
88,348
115,476
Revaluation reserve
17
48,268
44,876
Donated asset reserve
17
381
416
Income and expenditure reserve
17
(45,571)
(42,488)
TOTAL TAXPAYERS' EQUITY
91,426
118,280
Included within Public Dividend Capital are cash borrowings to the value of £65.4m, repayable to
the Department of Health.  These monies have been allocated to the Trust in the past to fund historic
deficits. 
The financial statements on pages 1 to 36 were approved by the Board on 5 June 2008 and signed
on its behalf by:
David Robson
Chief Executive
19.6.08
59

STATEMENT OF TOTAL RECOGNISED GAINS AND
LOSSES FOR THE YEAR ENDED 31 March 2008
2007/08
2006/07
£000
£000
Deficit for the financial year before dividend payments
(2,503)
(5,259)
Unrealised surplus on fixed asset indexation
3,442
3,200
Increases in the donated asset and government grant 
reserve due to receipt of donated assets
156
87
Total gains and losses recognised in the financial year
1,095
(1,972)
60

CASH FLOW STATEMENT FOR THE YEAR ENDED
31 March 2008
2007/08
2006/07
NOTE
£000
£000
OPERATING ACTIVITIES
Net cash inflow/(outflow) from 
operating activities

18.1
29,025
(36,337) 
RETURNS ON INVESTMENTS AND 
SERVICING OF FINANCE:
Interest received
632
288
Net cash inflow/(outflow) from returns on 
investments and servicing of finance

632
288
CAPITAL EXPENDITURE
(Payments) to acquire tangible fixed assets
(1,415)
(3,816)
(Payments) to acquire intangible assets
(487)
(72)
Net cash inflow/(outflow) from capital expenditure
(1,902)
(3,888)
DIVIDENDS PAID
(622)
(1,985)
Net cash inflow/(outflow) before management 
of liquid resources and financing

27,133
(41,922)
MANAGEMENT OF LIQUID RESOURCES
(Purchase) of investments with DH
0
(6,000)
Sale of investments with DH
6,000
0
Net cash inflow/(outflow) from management of 
liquid resources

6,000
(6,000)
Net cash inflow/(outflow) before financing
33,133
(47,922)
FINANCING
Public dividend capital received
2,097
66,832
Public dividend capital repaid (not previously accrued)
(29,225)
(18,842)
Net cash inflow/(outflow) from financing
(27,128)
47,990
Increase in cash
6,005
68
61

NOTES TO THE ACCOUNTS
1
ACCOUNTING POLICIES
The Secretary of State for Health has directed that the financial statements of NHS trusts shall
meet the accounting requirements of the NHS Trust Manual for Accounts which shall be agreed
with HM Treasury. Consequently, the following financial statements have been prepared in accor-
dance with the 2007/08 NHS Trusts Manual for Accounts issued by the Department of Health.  The
accounting policies contained in that manual follow UK generally accepted accounting practice
and HM Treasury's Government Financial Reporting Manual to the extent that they are meaningful
and appropriate to the NHS.  The accounting policies have been applied consistently in dealing
with items considered material in relation to the accounts.
1.1
Accounting convention
These accounts have been prepared under the historical cost convention modified to account for
the revaluation of fixed assets at their value to the business by reference to their current costs.
NHS Trusts are not required to provide a reconciliation between current cost and historical cost
surpluses and deficits.
1.2
Income Recognition
Income is accounted for applying the accruals convention.  The main source of income for the
Trust is from commissioners in respect of healthcare services provided under local agreements
(NHS contracts).  Income is recognised in the period in which services are provided. For patients
whose treatment straddles the year-end this means income is apportioned across the financial
years on the basis of length of stay.  Where income is received for specific activity which is to be
delivered in the following financial year, that income is deferred.
1.3
Prior Year Restatement
Income and expenditure for the year ended 31 March 2007 has been restated to exclude
recharges in line with the Manual for Accounts. Changes have been made to several lines within
notes 3 and 4, and primarily staff costs within note 5.  This has had no effect on the Trust in year
or prior year reported deficit. 
1.4
Intangible fixed assets
Intangible assets are capitalised when they are capable of being used in a Trust's activities for
more than one year; they can be valued; and they have a cost of at least £5,000.
Intangible fixed assets held for operational use are valued at historical cost and are depreciated
over the estimated life of the asset on a straight line basis, except capitalised Research and De-
velopment which is revalued using an appropriate index figure.  The carrying value of intangible
assets is reviewed for impairment at the end of the first full year following acquisition and in other
periods if events or changes in circumstances indicate the carrying value may not be recoverable.
62

Purchased computer software licences are capitalised as intangible fixed assets where expendi-
ture of at least £5,000 is incurred.  They are amortised over the shorter of the term of the licence
and their useful economic lives.
1.5
Tangible fixed assets
Capitalisation
Tangible assets are capitalised if they are capable of being used for a period which exceeds one
year and they:
- individually have a cost of at least £5,000;  or
- collectively have a cost of at least £5,000 and individually have a cost of more than £250, 
where the assets are functionally interdependent, they had broadly simultaneous purchase
dates, are anticipated to have simultaneous disposal dates and are under single managerial 
control;  or
-  form part of the initial equipping and setting-up cost of a new building, ward or unit
irrespective of their individual or collective cost.
-  The finance costs of bringing fixed assets into use are not capitalised.
Valuation
Tangible fixed assets are stated at the lower of replacement cost and recoverable amount.  On
initial recognition they are measured at cost (for leased assets, fair value) including any costs such
as installation directly attributable to bringing them into working condition.  They are restated to
current value each year.  The carrying values of tangible fixed assets are reviewed for impairment
if events or changes in circumstances indicate the carrying value may not be recoverable.
All land and buildings are restated to current value using professional valuations in accordance
with FRS15 every five years and in the intervening years by the use of indices. The buildings index
is based on the All in Tender Price Index published by the Building Cost Information Service (BCIS).
The land index is based on the residential building land values reported in the Property Market Re-
port published by the Valuation Office.
Professional valuations are carried out by the District Valuers of Her Majesty's Revenue and Cus-
toms. The valuations are carried out in accordance with the Royal Institute of Chartered Surveyors
(RICS) Appraisal and Valuation Manual insofar as these terms are consistent with the agreed re-
quirements of the Department of Health and HM Treasury.  In accordance with the requirements
of the Department of Health, the last asset valuations were undertaken in 2004 as at the prospec-
tive valuation date of 1 April 2005 and were applied on 31 March 2005.
The Department of Health has directed certain departures from the RICS Appraisal and Valuation
Manual in all periodic NHS valuation exercises. The most significant of these are as follows:
63

Specialised operational NHS assets are valued on the basis that the existing building will be
replaced by an asset of similar construction, whereas the RICS Appraisal and Valuation
Manual requires the valuer to have regard to a modern substitute building where the cost is
lower, except in cases where there is a paramount commitment to the retention of an existing 
building; and
In valuing assets under construction, no deduction is made for the risk of failure to complete
the project, whereas the RICS Appraisal and Valuation Manual requires such deductions to 
be made.
Additional assumptions, in addition to those required by the RICS Appraisal and Valuation Manual,
are required in the valuation of nonoperational assets to market value:      
-   The NHS body is assumed not to be in the market for the asset;
-   Regard is had to dividing properties into lots to achieve the best price; and
-   No adjustments are made to reflect hypothetical flooding of the market.
The RICS Appraisal and Valuation Manual requires adjustments to be made to the valuation of a
building in respect of dilapidations. The Department of Health has directed that such adjustments
should not be made for NHS properties. However, dilapidations are still reflected in the remaining
useful economic life attached to properties.
The valuations are carried out primarily on the basis of Depreciated Replacement Cost for spe-
cialised operational property and Existing Use Value for non-specialised operational property.
The value of land for existing use purposes is assessed at Existing Use Value.  For non-operational
properties including surplus land, the valuations are carried out at Open Market Value.
Additional alternative Open Market Value figures have only been supplied for operational assets
scheduled for imminent closure and subsequent disposal.
No adjustments are made to valuations for perceived functional or economic obsolescence,
whereas the RICS Appraisal and Valuation Manual includes such adjustments.
All adjustments arising from indexation and five-yearly revaluations are taken to the Revaluation
Reserve.  Falls in value when newly constructed assets are brought into use are also charged
there.  These falls in value result from the adoption of ideal conditions as the basis for depreciated
replacement cost valuations.
All impairments resulting from price changes are charged to the Statement of Total Recognised
Gains and Losses for the year.
Assets in the course of construction are valued at current cost using the indexes as for land and
buildings, as above.  These assets include any existing land or buildings under the control of a
contractor.
Residual interests in off-balance sheet Private Finance Initiative properties are included in tangible
fixed assets as 'assets under construction and payments on account' where the PFI contract
64

specifies the amount at which the assets will be transferred to the Trust at the end of the contract.
The residual interest is built up, on an actuarial basis, during the life of the contract by capitalising
part of the unitary charge so that at the end of the contract the balance sheet value of the residual
value plus the specified amount equal the expected fair value of the residual asset at the end of
the contract.  The estimated fair value of the asset on reversion is determined by the District Valuer
based on Department of Health guidance.  The District Valuer should provide an estimate of the
anticipated fair value of the assets on the same basis as the District Valuer values the NHS Trust's
estate.
Operational equipment other than IT equipment, which is considered to have nil inflation, is valued
at net current replacement cost through annual uplift by the change in the value of the GDP de-
flator.  Equipment surplus to requirements is valued at net recoverable amount.
Depreciation, amortisation and impairments
Tangible fixed assets are depreciated at rates calculated to write them down to estimated residual
value on a straight-line basis over their estimated useful lives.  No depreciation is provided on free-
hold land and assets surplus to requirements.
Assets in the course of construction and residual interests in off-balance sheet PFI contract assets
are not depreciated until the asset is brought into use or reverts to the Trust, respectively. 
Buildings, installations and fittings are depreciated on their current value over the estimated re-
maining life of the asset as advised by the District Valuer.  Leaseholds are depreciated over the
primary lease term.
Equipment is depreciated on current cost evenly over the estimated life of the asset using the fol-
lowing lives:
Years
Medical equipment and engineering plant and equipment
5 to 15
Furniture
10
Mainframe information technology installations
8
Soft furnishings
7
Office and information technology equipment
5
Set-up costs in new buildings
10
Impairment losses resulting from short-term changes in price that are considered to be recover-
able in the longer term are taken in full to the revaluation reserve.  These include impairments re-
sulting from the revaluation of fixed assets from their cost to their value in existing use when they
become operational.  This may lead to a negative revaluation reserve in certain instances.
65

Where, under Financial Reporting Standard 11, a fixed asset impairment is charged to the Income
and Expenditure Account, offsetting income may be paid by the Trust's main commissioner using
funding provided by the NHS Bank.
Where this funding is received it is included in income from PCTs and is separately disclosed at
the foot of note 3.
1.6
Donated fixed assets
Donated fixed assets are capitalised at their current value on receipt and this value is credited to
the Donated Asset Reserve.  Donated fixed assets are valued and depreciated as described above
for purchased assets.  Gains and losses on revaluations are also taken to the Donated Asset Re-
serve and, each year, an amount equal to the depreciation charge on the asset is released from
the Donated Asset Reserve to the Income and Expenditure account.  Similarly, any impairment
on donated assets charged to the Income and Expenditure Account is matched by a transfer
from the Donated Asset Reserve.  On sale of donated assets, the value of the sale proceeds is
transferred from the Donated Asset Reserve to the Income and Expenditure Reserve.
1.7
Private Finance Initiative (PFI) transactions
The NHS follows HM Treasury's Technical Note 1 (Revised) "How to Account for PFI transactions"
which provides practical guidance for the application of the Application Note F to FRS 5 and the
guidance 'Land and Buildings in PFI schemes Version 2'.
Where the balance of the risks and rewards of ownership of the PFI property are borne by the PFI
operator, the PFI obligations are recorded as an operating expense.  Where the Trust has con-
tributed land or buildings to the PFI provider to be used in the PFI scheme, a prepayment is recog-
nised, valued at the net present value of the resulting reduction in the unitary charge payable
under the PFI contract, and amortised over the life of the PFI contract by charge to the Income
and Expenditure Account.
Where the balance of risks and rewards of ownership of the PFI property are borne by the Trust,
it is recognised as a fixed asset along with the liability to pay for it which is accounted for as a fi-
nance lease.  Contract payments are apportioned between an imputed finance lease charge and
a service charge.
1.8
Stocks and work-in-progress
Stocks and work-in-progress are valued at the lower of cost and net realisable value.  This is con-
sidered to be a reasonable approximation to current cost due to the high turnover of stocks.
Work-in-progress comprises goods in intermediate stages of production.   Partially completed
contracts for patient services are not accounted for as work-in-progress.
1.9
Research and development
Expenditure on research is not capitalised.  Expenditure on development is capitalised if it meets
the following criteria:
66

-   there is a clearly defined project;
-   the related expenditure is separately identifiable;
-   the outcome of the project has been assessed with reasonable certainty as to:
-   its technical feasibility;
-   its resulting in a product or service which will eventually be brought into use;
-   adequate resources exist, or are reasonably expected to be available, to enable the project 
to be completed and to provide any consequential increases in working capital.
Expenditure so deferred is limited to the value of future benefits expected and is amortised through
the income and expenditure account on a systematic basis over the period expected to benefit
from the project.  It is revalued on the basis of current cost.  The amortisation charge is calculated
on the same basis as used for depreciation i.e. on a quarterly basis.  Expenditure which does not
meet the criteria for capitalisation is treated as an operating cost in the year in which it is incurred.
NHS Trusts are unable to disclose the total amount of research and development expenditure
charged in the income and expenditure account because some research and development activity
cannot be separated from patient care activity.
Fixed assets acquired for use in research and development are amortised over the life of the as-
sociated project.
1.10 Provisions
The Trust provides for legal or constructive obligations that are of uncertain timing or amount at
the balance sheet date on the basis of the best estimate of the expenditure required to settle the
obligation.  Where the effect of the time value of money is material, the estimated risk-adjusted
cash flows are discounted using the Treasury's discount rate of 2.2% in real terms. 
Clinical negligence costs
The NHS Litigation Authority (NHSLA) operates a risk pooling scheme under which the NHS Trust
pays an annual contribution to the NHSLA which in return settles all clinical negligence claims.  Al-
though the NHSLA is administratively responsible for all clinical negligence cases the legal liability
remains with the Trust.  The total value of clinical negligence provisions carried by the NHSLA on
behalf of the Trust is disclosed at note 16.
Since financial responsibility for clinical negligence cases transferred to the NHSLA at 1 April
2002, the only charge to operating expenditure in relation to clinical negligence in 2007/08 relates
to the Trust's contribution to the Clinical Negligence Scheme for Trusts.
Non-clinical risk pooling
The Trust participates in the Property Expenses Scheme and the Liabilities to Third Parties
Scheme.  Both are risk pooling schemes under which the Trust pays an annual contribution to the
NHS Litigation Authority and, in return, receives assistance with the costs of claims arising.  The
annual membership contributions, and any 'excesses' payable in respect of particular claims are
charged to operating expenses as and when they become due.
67

1.11 Pension costs
Past and present employees are covered by the provisions of the NHS Pensions Scheme.  Details
of the benefits payable under these provisions can be found on the NHS Pensions website at
www.pensions.nhsbsa.nhs.uk.  The Scheme is an unfunded, defined benefit scheme that covers
NHS employers, General Practices and other bodies, allowed under the direction of the Secretary
of State, in England and Wales. The scheme is not designed to be run in a way that would enable
NHS bodies to identify their share of the underlying Scheme assets and liabilities. Therefore, the
Scheme is accounted for as if it were a defined contribution scheme: the cost to the NHS Body
of participating in the Scheme is taken as equal to the contributions payable to the Scheme for
the accounting period.  
The Scheme is subject to a full actuarial valuation every four years (until 2004, based on a five year
valuation cycle), and a FRS17 accounting valuation every year.  An outline of these follows:
a) Full actuarial (funding) valuation
The purpose of this valuation is to assess the level of liability in respect of the benefits due under
the scheme (taking into account its recent demographic experience), and to recommend the con-
tribution rates to be paid by employers and scheme members.  The last such valuation, which de-
termined current contribution rates was undertaken as at 31 March 2004 and covered the period
from 1 April 1999 to that date.
The conclusion from the 2004 valuation was that the Scheme had accumulated a notional deficit
of £3.3 billion against the notional assets as at 31 March 2004.  However, after taking into account
the changes in the benefit and contribution structure effective from 1 April 2008, the Scheme ac-
tuary reported that employer contributions could continue at the existing rate of 14% of pension-
able pay.  On advice from the Scheme actuary, scheme contributions may be varied from time to
time to reflect changes in the scheme’s liabilities.  Up to 31 March 2008, the vast majority of em-
ployees paid contributions at the rate of 6% of pensionable pay. From 1 April 2008, employees
contributions are on a tiered scale from 5% up to 8.5% of their pensionable pay depending on
total earnings.
b) FRS17 Accounting valuation
In accordance with FRS17, a valuation of the Scheme liability is carried out annually by the
Scheme Actuary as at the balance sheet date by updating the results of the full actuarial valua-
tion.
Between the full actuarial valuations at a two-year midpoint, a full and detailed member data-set
is provided to the Scheme Actuary. At this point the assumptions regarding the composition of
the Scheme membership are updated to allow the Scheme liability to be valued.  
The valuation of the Scheme liability as at 31 March 2008, is based on detailed membership data
as at 31 March 2006 (the latest midpoint) updated to 31 March 2008 with summary global member
and accounting data.
The latest assessment of the liabilities of the Scheme is contained in the Scheme Actuary report,
which forms part of the annual NHS Pension Scheme (England and Wales) Resource Account,
68

published annually.  These accounts can be viewed on the NHS Pensions website.  Copies can
also be obtained from The Stationery Office.
Scheme provisions as at 31 March 2008
The Scheme is a “final salary” scheme.  Annual pensions are normally based on 1/80th of the
best of the last 3 years pensionable pay for each year of service.  A lump sum normally equivalent
to 3 years pension is payable on retirement.  Annual increases are applied to pension payments
at rates defined by the Pensions (Increase) Act 1971, and are based on changes in retail prices in
the twelve months ending 30 September in the previous calendar year.  On death, a pension of
50% of the member’s pension is normally payable to the surviving spouse. 
Early payment of a pension, with enhancement, is available to members of the Scheme who are
permanently incapable of fulfilling their duties effectively through illness or infirmity.  A death gra-
tuity of twice final year’s pensionable pay for death in service, and five times their annual pension
for death after retirement, less pension already paid, subject to a maximum amount equal to twice
the member’s final year’s pensionable pay less their retirement lump sum for those who die after
retirement, is payable.
For early retirements other than those due to ill health the additional pension liabilities are not
funded by the scheme. The full amount of the liability for the additional costs is charged to the in-
come and expenditure account at the time the Trust commits itself to the retirement, regardless
of the method of payment.
The Scheme provides the opportunity to members to increase their benefits through money pur-
chase Additional Voluntary Contributions (AVCs) provided by an approved panel of life companies.
Under the arrangement the employee/member can make contributions to enhance an employee's
pension benefits.  The benefits payable relate directly to the value of the investments made. 
Scheme provisions from 1 April 2008
From 1 April 2008 changes have been made to the NHS Pension Scheme contribution rates and
benefits.  Further details of these changes can be found on the NHS Pensions website. 
1.12 Liquid resources
Deposits and other investments that are readily convertible into known amounts of cash at or
close to their carrying amounts are treated as liquid resources in the cashflow statement.  The Trust
does not hold any investments with maturity dates exceeding one year from the date of purchase.
1.13 Value Added Tax
Most of the activities of the Trust are outside the scope of VAT and, in general, output tax does
not apply and input tax on purchases is not recoverable.  Irrecoverable VAT is charged to the rel-
evant expenditure category or included in the capitalised purchase cost of fixed assets.  Where
output tax is charged or input VAT is recoverable, the amounts are stated net of VAT.
69

1.14 Foreign Exchange
Transactions that are denominated in a foreign currency are translated into sterling at the exchange
rate ruling on the dates of the transactions.  Resulting exchange gains and losses are taken to the
Income and Expenditure Account.
1.15 Third Party Assets
Assets belonging to third parties (such as money held on behalf of patients) are not recognised
in the accounts since the Trust has no beneficial interest in them.  Details of third party assets are
given in Note 27 to the accounts.
1.16 Leases
Where substantially all risks and rewards of ownership of a leased asset are borne by the NHS
Trust, the asset is recorded as a tangible fixed asset and a debt is recorded to the lessor of the
minimum lease payments discounted by the interest rate implicit in the lease.  The interest element
of the finance lease payment is charged to the Income and Expenditure Account over the period
of the lease at a constant rate in relation to the balance outstanding.  Other leases are regarded
as operating leases and the rentals are charged to the Income and Expenditure Account on a
straight-line basis over the term of the lease.
1.17 Public Dividend Capital (PDC) and PDC Dividend
Public Dividend Capital represents the outstanding public debt of an NHS Trust.  At any time the
Secretary of State can issue new PDC to, and require repayments of PDC from, the NHS Trust.
A charge, reflecting the forecast cost of capital utilised by the NHS Trust, is paid over as public
dividend capital dividend.  The charge is calculated at the real rate set by HM Treasury (currently
3.5%) on the forecast average carrying amount of all assets less liabilities, except for donated as-
sets and cash with the Office of the Paymaster General.  The average carrying amount of assets
is calculated as a simple average of opening and closing relevant net assets.  A note to the ac-
counts discloses the rate that the dividend represents as a percentage of the actual average car-
rying amount of assets less liabilities in the year.
1.18 Losses and Special Payments
Losses and Special Payments are items that Parliament would not have contemplated when it
agreed funds for the health service or passed legislation.  By their nature they are items that ideally
should not arise.  They are therefore subject to special control procedures compared with the
generality of payments.  They are divided into different categories, which govern the way each in-
dividual case is handled.
Losses and Special Payments are charged to the relevant functional headings in the Income and
Expenditure Account on an accruals basis, including losses which would have been made good
through insurance cover had NHS Trusts not been bearing their own risks (with insurance premi-
ums then being included as normal revenue expenditure).  
70

Note 29 is compiled directly from the losses and compensations register which is prepared  on
an accruals basis for 2007/08. However, the 2006/07 comparatives are prepared on a cash basis
and are therefore not a like for like comparative.
1.19 Financial Instruments
The Trust may hold any of the following financial assets and liabilities:
1 Assets
- investments
- long-term debtors and accrued income
- short-term debtors and accrued income (not disclosed in note 26 under exemptions 
permitted by FRS 13)
2 Liabilities
- loans and overdrafts
- long-term creditors
- short-term creditors (not disclosed in note 26 under exemptions permitted by FRS 13)
- provisions arising from contractual arrangements
- finance lease obligations
Trusts have no powers to invest or borrow and can only draw cash from the Office of the Paymas-
ter General when it is required. Cash, Bank and Overdraft balances are recorded at current values.
Account balances are set-off only where there is a formal agreement with the bank to do so. In-
terest earned on bank accounts and interest charged on overdrafts are recorded as, respectively,
‘Interest receivable’ and ‘Interest Payable’ in the periods to which they relate. Bank charges are
recorded as operating expenditure in the periods to which they relate.
The Trust will only enter into finance leases where these represent better value for money than pur-
chasing or other leasing arrangements.
All other financial instruments are held for the sole purpose of managing the cash flow of the Trust
on a day to day basis or arise from the operating activities of the Trust.  The management of risks
around these financial instruments therefore relates primarily to the Trust’s overall arrangements
for managing risks to their financial position.
Cash, bank and overdraft
Cash, bank and overdraft balances are recorded at current values.  Interest earned on bank ac-
counts and interest charged on overdrafts are recorded as, respectively, “interest receivable” and
“interest payable” in the periods to which they relate.  Bank charges are recorded as operating ex-
penditure in the periods to which they relate.
71

2.
Segmental Analysis
The Trust only provides healthcare, therefore no segmental analysis is required
3. 
Income from Activities
Restated *
2007/08
2006/07
£000
£000
Primary Care Trusts
121,345
114,437
Department of Health
19,130
19,137
Non NHS:
- Private patients
105
92
- Overseas patients (non-reciprocal)
331
241
- Injury cost recovery
371
455
141,302
134,362
Injury cost recovery income is subject to a provision for doubtful debts of 50% of the current outstand-
ing debt to reflect expected rates of collection (30% in 2006/07). 
* See note 1.3 for details of the prior year restatement
4.
Other Operating Income
Restated *
2007/08
2006/07
£000
£000
Education, training and research
5,140
4,493
Transfers from donated asset reserve 
199
184
Non-patient care services to other bodies
3,290
4,368
Income Generation
627
632
Other income
1,563
2,059
10,819
11,736
£000
£000
Included within Non-Patient care services to other bodies are the 
following significant items:
Oxleas SLA (This SLA is not activity related, it relates to the occupation 
of a Trust owned building by Oxleas NHS Foundation Trust).
1,646
1,665
PFI smoothing monies from the Department of Health. This income 
has been received as the Trust were one of the first to enter a 
PFI partnership. 
367
713
Greenwich Teaching PCT non-patient SLA for payroll and 
human resources services . 
600
560
* See note 1.3 for details of the prior year restatement
72

5.       Operating Expenses
5.1
Operating expenses comprise:
Restated *
2007/08
2006/07
£000
£000
Services from other NHS Trusts
835
838
Services from other NHS bodies
1,089
962
Directors' costs
842
813
Staff costs
91,284
90,660
Supplies and services - clinical
24,295
23,124
Supplies and services - general
7,190
6,941
Consultancy services
673
516
Establishment
1,364
1,613
Transport
555
515
Premises
19,705
18,780
Bad debts
271
563
Depreciation 
876
939
Amortisation
421
378
Audit fees
218
218
Clinical negligence
2,259
2,400
Redundancy costs
20
464
Other
2,773
1,855
154,670
151,579
Other Expenditure includes the amortisation of the Trust Deferred Asset of  £1,025k (2006/07 
£1,025k).
* See note 1.3 for details of the prior year restatement
2006/07 operating expenses have been restated to separately disclose consultancy services in line with
the manual for accounts. This has resulted in a restated figure for “Staff Costs” for 2006/07.
5.2 Operating 
leases
5.2/1 Operating expenses include:
2007/08
2006/07
£000
£000
Other operating lease rentals
41
32
41
32
73

5.2/2
Annual commitments under non - cancellable operating leases are:
Land and buildings
2007/08
2006/07
£000
£000
Operating leases which expire:
After 5 years
41
38
41
38
The operating lease relates to the rental of a warehouse owned by the London Borough of Greenwich.
6.
Staff costs and numbers
6.1 Staff 
costs
2007/08
2006/07
Total
Permanently
Other
Employed
£000
£000
£000
£000
Salaries and wages
77,111
69,211
7,900
78,302
Social Security Costs
6,692
6,210
482
6,880
Employer contributions to 
NHS Pension Scheme
8,276
8,092
184
8,184
92,079
83,513
8,566
93,366
The total employer pension contributions payable in 2007/ 08 were £8,092,000 (2006/07 £8,016,000).  
74

6.2 
Average number of persons employed
2007/08
2006/07
Total
Permanently Other
Employed
Number
Number
Number
Number
Medical and dental
326
303
23
317
Ambulance staff
0
0
0
0
Administration and estates
439
419
20
452
Healthcare assistants and other 
support staff
386
305
81
386
Nursing, midwifery and health 
visiting staff
839
712
127
855
Nursing, midwifery and health 
visiting learners
22
22
0
22
Scientific, therapeutic and technical staff 229
219
10
247
Social care staff
0
0
0
0
Other
2
2
0
2
Total
2,243
1,982
261
2,281
*2006/07 figures have been restated in line with changes in classification introduced in 2007/08 to pro-
vide consistency between the two financial years. 
6.3
Employee benefits
There were no employee benefits in 2007/08 (2006/07 £0)
6.4 Management 
costs
2007/08
2006/07
£000
£000
Management costs
5,328
5,160
Income
152,121
146,098
Management costs are defined as those on the management costs website at 
www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/FinanceAndPlanning/NHSManagementCosts/
fs/en
6.5
Retirements due to ill-health
During 2007/08 there were six (2006/07 seven) early retirements from the NHS Trust on the grounds
of ill-health.  The estimated additional pension liabilities of these ill-health retirements will be £333K
(2006/07 £242K).  The cost of these ill-health retirements will be borne by the NHS Business Services
Authority - Pensions Division.
75

-
£000
83%
95%
harmacy
58,667
48,453
39,657
37,554
receipt of 
eported per
rust p
s r
rust'
77%
732
1,252
58%
32,533
25,201
elate to the T
2006/07
Number
0
0
fect of worstening the T
£000
92%
96%
£000
61,377
56,313
12,299
11,852
2006/07
ded as such.  These r
ecor
. This has the ef
0
0
75%
948
1,297
73%
ectly
£000
32,213
24,070
2007/08
Number
2007/08
 not able to be r
e
 compliance corr
om 
e
est) Act 1998
get
 disputed but wer
e of compliance
get
rust to aim to pay all undisputed invoices by the due date or within 30 days of 
e
get
es the T
.
get
cial Debts (Inter
equir
ecovery costs under this legislation
est Payable (Note 9) arising fr
ficient data available to measur
get.
e is insuf
 ther
e
Better Payment Practice Code
The Late Payment of Commer
centage of Non-NHS trade invoices paid within tar
centage of NHS trade invoices paid within tar
7.
7.1    Better Payment Practice Code - measur
Total Non-NHS trade invoices paid in the year
Total Non NHS trade invoices paid within tar
Per
Total NHS trade invoices paid in the year
Total NHS trade invoices paid within tar
Per
The Better Payment Practice Code r
goods or a valid invoice, whichever is later
The statistics include some payments which wer
system wher
formance against this tar
7.2
Amounts included within Inter
claims made under this legislation
Compensation paid to cover debt r
76

8.
Loss on Disposal of Fixed Assets
Loss on the disposal of fixed assets is made up as follows:
2007/08
2006/07
£000
£000
Loss on disposal of intangible fixed assets
(66)
0
Loss on disposal of land and buildings
(11)
0
Loss on disposal of plant and equipment
(439)
0
(516)
0
The Trust has undertaken a full review of fixed assets purchased in prior financial periods during
the financial year resulting in £0.5m of assets no longer in use being written off to expenditure.
9.
Interest Payable
There was no interest payable in 2007/08 (2006/07 £0) 
10.
Intangible Fixed Assets
Software licences 
£000 
Gross cost at 1 April 2007
2,561
Indexation 0
Impairments 0
Reclassifications
265
Revaluation 0
Additions purchased 
487
Additions donated
0
Additions government granted 
0
Disposals (741) 
Gross cost at 31 March 2008
2,572
Amortisation at 1 April 2007
1,471
Indexation 0
Impairments 0
Reversal of impairments
0
Reclassifications
0
Revaluation 0
Charged during the year 
421
Disposals (675) 
Amortisation at 31 March 2008
1,217
Net book value
- Purchased at 1 April 2007
1,049
- Donated at 1 April 2007
41
- Total at 1 April 2007
1,090
- Purchased at 31 March 2008
1,333
- Donated at 31 March 2008
22
- Total at 31 March 2008
1,355
Following a full asset verification exercise and full review of asset accounting, a number of re-
classifications have occurred between asset categories.
77

0
0
0
0
0
0
4
0
7
otal
156
876
375
359
T
£000
3,305
(265) 
3,516
6,091
2,425
67,478
(5,067) 
69,123
(4,616) 
61,012
61,387
66,339
66,698
0
0
0
0
1
0
6
0
0
0
0
0
4
7
4
(2) 
(2) 
e &
47
80
16
20
2
31
82
2
126
106
nitur
fittings
Fur
rust had no assets held at open 
0
0
0
0
0
0
0
0
0
0
5
3
 T
 £11.8m (2006/07 £8.2m).
388
457
£000 £000 
7,173
(292) 
2,753
4,817
1,185
2,351
2,356
1,565
1,568
etween asset categories.
(4,516) 
(4,089) 
ed b
Information
technology 
ch 2008, the
0
0
0
0
0
2
0
6
0
0
0
2
0
0
0
91
40
69
24
22
22
16
16
(53) 
(53) 
£000 
ransport
T

equipment
0
0
0
0
0
0
0
eclassifications have occurr
63
32
405
156
(48) 
344
(35) 
818
303
298
2,310
2,857
1,189
1,530
1,121
1,029
1,327
Plant and
machinery
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
(44) (29) 
736
£000 £000 
8,999
2,263
8,999
8,999
11,954
11,954
11,954
on account* 
Assets under
and payments
0
0
0
0
0
3
0
0
0
0
0
8
8
6
4
1
1
169
100
134
£000 
1,128
(448) 
1,083
(437) 
(334) 
1,110
1,128
1,399
1,417
est in the hospital is shown under assets under construction at a value of
eview of asset accounting, a number of r
Buildings
excluding construction
dwellings
0
0
0
0
0
0
0
0
0
0
0
Land 
£000 
47,730
50,310
47,730
47,730
50,310
50,310
cise and full r
ch 2008
ch 2008
ch 2008
ch 2008
ch 2008
nment granted 
31 Mar
hased
c
 no fixed assets held under finance lease at the balance sheet date (2006/07 £0). Of the totals at 31 Mar
aluation at 31 Mar
1 April 2007
e
eciation at 1 April 2007
ged during the year 
eciation at 
chased at 1 April 2007
chased at 31 Mar
e wer
angible Fixed Assets
angible fixed assets at the balance sheet date comprise the following elements:
otal at 
otal at 31 Mar
T
T
Cost or valuation at 1 April 2007
Additions pur
Additions donated 
Additions gover
Impairments 0
Reclassifications
Indexation 2,580
Revaluation 0
Disposals 0
Cost or V
Depr
Char
Impairments 0
Reversal of Impairments 
Reclassifications
Indexation 0
Revaluation 0
Disposals 0
Depr
Net book value 
- Pur
- Donated at 1 April 2007
- T
- Pur
- Donated at 31 Mar
- T
Following a full asset verification exer
Ther
market valuation (2006/07 £0). The Reversionary Inter
11.
11.1
78

11.2 The net book value of land, buildings and dwellings at 31 March 2008 comprises:
31 March 2008
31 March 2007
£000
£000
Freehold 
51,727
48,858
TOTAL
51,727
48,858
12.
Stocks and Work in Progress
31 March 2008
31 March 2007
£000
£000
Raw materials and consumables
1,663
1,636
TOTAL 1,663
1,636
13.
Debtors
Amounts falling due within one year:
NHS debtors
2,360
35,566
Provision for irrecoverable debts
(1,674)  
(1,502)
Other prepayments and accrued income
2,780  
1,262
Other debtors
3,430  
4,120
Sub Total
6,896   
39,446
Amounts falling due after more than one year:
Provision for irrecoverable debts
0  
0
Other prepayments and accrued income
20,344   
21,396
Other debtors
0  
0
Sub Total
20,344  
21,396
TOTAL
27,240  
60,842
Other Debtors include no prepaid pension contributions at 31 March 2008 (none at 31 March
2007).
Within the Other Prepayments and Accrued Income greater than one year is the PFI Deferred
Asset value of the Hospital.
Included within NHS Debtors in 2006/07 is an amount of £29.2m in relation to the reversal of the
NHS RAB system.
Other prepayments and accrued income falling due within one year includes £1.1m paid to the
Trust PFI partner, Meridian Hospital Company, and £1.2m paid to Greenwich Council. These
amounts relate to future accounting periods.
79

14.
Investments
14.1 Fixed Asset Investments
The Trust has no fixed asset investments (2006/07 £0).
14.2  Current Asset Investments
Department 
of Health
£000
Balance at 1 April 2007
6,000
Additions
0
Disposals
(6,000)
Revaluations
0
Balance at 31 March 2008
0
The Trust had £6m of deposit with the National Loan Fund as at 31 March 2007; the deposit was
£0 as at 31 March 2008.
15.
Creditors
15.1 Creditors at the balance sheet date are made up of:
31 March 2008
31 March 2007
£000
£000
Amounts falling due within one year:
Payments received on account
81
0
NHS creditors
1,280
3,836
Non - NHS trade creditors - revenue
716
0
Non - NHS trade creditors - capital
508
687
Tax 
90
0
Other creditors
246
1,893
Accruals and deferred income
4,891
2,337
Sub Total
7,812
8,753
Amounts falling due after more than one year:
Other
603
632
Sub Total
603
632
TOTAL
8,415
9,385
Other creditors falling due after more than one year of  £603k relates to the contract between
Oxleas NHS Foundation Trust, Meridian and Queen Elizabeth Hospital NHS Trust for building im-
provement works.
There were no outstanding pensions contributions at 31 March 2008 (none at 31 March 2007).
80

15.2 Loans
The Trust has no loans outstanding as at 31 March 2008 (£0 as at 31 March 2007).
15.3 Finance lease obligations
Queen Elizabeth Hospital NHS Trust  has no finance lease obligation (2006/07 £0).
15.4 Finance lease commitments
Queen Elizabeth Hospital NHS Trust has no finance lease commitments (2006/07 £0).
81

0
70
otal
624
rust
T
£000
ents
3,770
1,742
(756)
3,600
2,976
 final
(1,226)
information
s either legally
ities of the T
0
2
0
0
2
2
0
rust i
6
6
6
ther
O
£000
ovision is based on 
0
0
0
0
464
(20)
£000
(444)
espect of clinical negligence liabil
Restructurings
 financial periods for which the T
e
f
68
28
rust.  The value of the pr
290
(24)
(32)
302
274
£000
ch 2008 in r
egal claim
relating to 
other staf
L
ovision is based upon estimated lifespan of individuals, and
e liabilities in futur
0000
0000
7
288
£000
3,238
1,390
(288)
3,236
2,948
(1,174)
Pensions
ed to becom
ement arrangements. The timing of payment has been calculated based on paym
etir
ges
e amounts consider
f under early r
ovision of the NHS Litigation Authority at 31 Mar
ement.
etir
ovisions ar
elate to staf
esent the insurance excess applied to legal claims against the T
epr
ovisions r
ch 2008
ovisions for liabilities and char
ch 2007 £8,638k).
ovided by the NHS Litigation Authority on a case by case basis.
16.   Pr
At 1 April 2007
Arising during the year
Utilised during the year
Reversed unused
Unwinding of discount
At 31 Mar
Expected timing of cashflows:
Within one year
Between one and five years
After five years
£14,176k is included in the pr
(31 Mar
Pension pr
made to the NHS Pensions Agency during 2007/08. The value of the pr
salaries at the date of r
Legal claims r
pr
Included within other pr
or constructively liable at the balance sheet date.
82

17.    Movements on Reserves
Movements on reserves in the year comprised the following:
Revaluation Donated
Income 
and
Total
Asset Expenditure 
Reserve
Reserve
£000
£000
£000
£000
At 1 April 2007 
44,876
416
(42,488)
2,804
Transfer from the income and 
expenditure account
0
0
(3,125)
(3,125)
Surplus on indexation of fixed assets
3,434
8
0
3,442
Transfer of realised profits/(losses) to 
the income and expenditure reserve
(42)
0
42
0
Receipt of donated assets
0
156
0
156
Transfers to the income and 
expenditure account for depreciation, 
impairment, and disposal of 
donated assets
0
(199)
0
(199)
At 31 March 2008
48,268
381
(45,571)
3,078
18.      Notes to the cash flow Statement
18. 1  Reconciliation of operating surplus to net cash flow from operating activities:
2007/08
2006/07
£000
£000
Total operating deficit
(2,549)
(5,481)
Depreciation and amortisation charge
1,297
1,317
Transfer from donated asset reserve
(199)
(184)
(Increase)/decrease in stocks
(27)
(116)
(Increase)/decrease in debtors
31,534
(26,773)
Increase/(decrease) in creditors 
(791)
(5,430)
Increase/(decrease) in provisions 
(240)
330
Net cash inflow from operating activities
29,025
(36,337)
83

18.2  Reconciliation of net cash flow to movement in net debt
2007/08
2006/07
£000
£000
Increase in cash in the period
6,005
68
Cash (inflow)/outflow from (decrease)/increase in liquid resources
(6,000)
6,000
Change in net debt resulting from cash flows
5
6,068
Net debt at 1 April 2007
6,480
412
Net debt at 31 March 2008
6,485
6,480
18.3  Analysis of changes in net debt
At 1 April 2007
Other cash 
At 31 March 2008
£000
£000
£000
OPG cash at bank
470
6,008
6,478
Commercial cash at bank and in hand
10
(3)
7
Bank overdraft
0
0
0
Loan from DH due within one year
0
0
0
Other debt due within one year
0
0
0
Loan from DH due after one year
0
0
0
Other debt due after one year
0
0
0
Finance leases
0
0
0
Current asset investments
6,000
(6,000)
0
6,480
5
6,485
19. Capital Commitments
Commitments under capital expenditure contracts at 31 March 2008 were £508k (31 March 2007 £643k)
20. Post Balance Sheet Events
There are no post balance sheet events.
84

21. Contingencies
2007/08
2006/07
£000
£000
Contingent liabilities 
(644)
(644)
Amounts recoverable against contingent liabilities
0
0
Net value of contingent liabiliies
(644)
(644)
Contingent Assets
0
0
The Contingent liability of £644k relates to the possible compensation on termination of a contract be-
tween Macmillan Cancer Relief and the Queen Elizabeth Hospital NHS Trust, for contribution towards
the Oncology Unit at the Queen Elizabeth Hospital.
The compensation on termination clause is activated in the event that the agreement is terminated at
any time in the period of 10 years from the completion of the hospital (2007/08 represents year 7 of
the 10 year period).
22.  Movement in Public Dividend Capital
2007/08
2006/07
£000
£000
Public Dividend Capital as at 1 April 2007
115,476
67,486
New Public Dividend Capital received (including transfers 
from dissolved NHS Trusts)
2,097
66,832
Public Dividend Capital repaid in year 
(29,225)
(18,842)
Public Dividend Capital written off
0
0
Public Dividend Capital issued as originating capital on 
new establishment
0
0
Public Dividend Capital transferred to Foundation Trust
0
0
Other movements in Public Dividend Capital in year
0
0
Public Dividend Capital as at 31 March 2008
88,348
115,476
Cash
To maintain liquidity the Trust hasd cash borrowings issued as PDC to the value of £65.4m from the
Department of Health in 2006/07. This borrowing will require repayment and does not present a per-
manent solution to the Trust's cash shortfall but repayment terms have not been negotiated with the
Department of Health.
85

0
0
0
 fi-
e
£000
rusts
(3,125)
(3,125)
2007/08
152,121
(42,953)
(2.05%)
(28.24%)
ithin the
ing T
ther details
e based on
. The futur
0
0
£000
(7,244)
(7,244)
2006/07
146,098
(39,828)
(4.96%)
(27.26%)
ecovery of deficit w
 planned deficits ar
e
0
200
£000
2005/06
132,983
(19,289)
(19,089)
(32,584)
(14.35%)
(24.50%)
, below which r
0
over
n
£000
(136)
(9,186)
(9,322)
2004/05
130,090
(13,495)
(7.17%)
(10.37%)
ocess, which has been publicly consulted on. Fur
rust is actively working with NHS London, neighbour
00000
00000
00000
00000
0
ecast deficit of £5.5m, while futur
917
£000
(4,417)
(3,500)
(4,173)
2003/04
125,436
(2.79%)
(3.33%)
eshold of 0.5% of tur
elating to RAB system. This movement has been adjusted.
econfiguration of clinical services in Outer South East London
over
n
ogramme, and a for
over
eakeven position. The T
n
 than two years 
eements]
e
ed to a materiality thr
ed by the Department of Health.
 of Health'.
e
rust to a br
centage of tur
equir
centage of tur
elating to 1997/98 to 2003/04)
elating to 1997/98 to 2004/05)
elating to 1997/98 to 2005/06)
elating to 197/98 to 2006/07)
om 'A Pictur
rgets
ecovery is mor
a
 of Health', a local consultation on the r
e
eed with SHA
ecovery plan will not be r
e based on the financial modelling completed as part of this pr
eakeven performance for 2007/08 is as follows:
eakeven performance is compar
eed plan which moves the T
e - 1.4.97 surpluses [FDL(97)24 Agr
eed adjustments
eceived an advance i&e movement £0.2M in 2005/06 r
s br
 on  'A Pictur
eakeven Performance
s
rust's br
rust r
rust’
over
e is no agr
rusts plan for 2008/09 includes a £9m savings pr
rn
eak-even in-year position
eak-even cumulative position
eak-even in-year position as a per
eak-even cumulative position as a per
u
3.  Financial Performance T
23.1  Br
The T
T
Retained surplus/(deficit) for the year
Adjustment for:
-Timing/non-cash impacting distortions
-Use of pr
-2004/05 Prior Period Adjustment (r
-2005/06 Prior Period Adjustment (r
-2006/07 Prior Period Adjustment (r
-2007/08 Prior Period Adjustment (r
-Other agr
Br
Br
If anticipated financial year of r
state the period agr
Materiality test (I.e. is it equal to or less than 0.5%):
-Br
-Br
The T
The T
framework of a r
Ther
and PCT
nancial plans ar
can be found in the Annual Report.
The T
the financial modelling arising fr
86

23.2 Capital cost absorption rate
The Trust is required to absorb the cost of capital at a rate of 3.5% of average relevant net assets.  The
rate is calculated as the percentage that dividends paid on public dividend capital, totalling £0.6m,
bears to the average relevant net assets of £100.9m, that is 0.6%.
The Trust is set a dividend payment based on estimates of future assets and liabilities, completed a
year in advance of the opening period to which the dividend relates. During the estimation process for
2007/08, the Trust recognised a material liability in respect of an expected cash loan with the Depart-
ment of Health. The Trust was not issued with this loan in 2007/08 causing the absorption rate to drop
below the allowed 3% threshold.
23.3  External financing
The Trust is given an external financing limit which it is permitted to undershoot.
2007/08
2006/07
£000
£000
£000
External financing limit
(27,128)
47,990
Cash flow financing
(27,133)
41,922
Finance leases taken out in the year
0
0
Other capital receipts
0
0
External financing requirement
(27,133)
41,922
Undershoot
5
6,068
23.4  Capital Resource Limit
The Trust is given a capital resource limit which it is not permitted to overspend
2007/08
2006/07
£000
£000
Gross capital expenditure
3,948
4,323
Less: book value of assets disposed of 
(517)
0
Plus: loss on disposal of donated assets
0
0
Less: donations towards the acquisition of fixed assets
(156)
(87)
Charge against the capital resource limit
3,275
4,236
Capital resource limit
3,823
4,585
Underspend against the capital resource limit
548
349
87

24. Related Party Transactions
Queen Elizabeth Hospital NHS Trust  is a body corporate established by order of the Secretary of State
for Health.
During the year none of the Board Members or members of the key management staff or parties related
to them has undertaken any material transactions with Queen Elizabeth Hospital NHS Trust.
The Department of Health is regarded as a related party.  During the year Queen Elizabeth Hospital
NHS Trust has had a significant number of material transactions with the Department, and with other
entities for which the Department is regarded as the parent Department.  These entities are listed below
along with the corresponding amount of debtor and creditor balances recorded at the year end, and
amount received and paid during the year:
Debtor
Creditor
Income
Expenditure
2007/08
2006/07
2007/08
2006/07
2007/08
2006/07
2007/08
2006/07
£000s
£000s
£000s
£000s
£000s
£000s
£000s
£000s
Greenwich PCT
760 30,292
33
2,916 98,633 93,394
56
16
Bexley PCT
463
339
32
8 19,007 18,005
29
8
The NHS London 
86
199
0
0
5,610
4,458
44
3
The NHS Litigation Authority
0
0
0
0
0
0
2,373
2,400
Lewisham PCT
41
306
2
2
2,387
2,322
8
7
London Ambulance Service 
NHS Trust
0
0
14
47
0
0
887
1,010
NHS Blood and Transplant
0
0
0
11
0
0
1,288
1,391
NHS Purchasing and 
Supply Agency
0
0
204
0
0
0
2,413
1,874
Department of Health
0
0
0
0 19,130 19,200
137
0
Gree
  nwich Council
40
0
2
0
40
0
1,586
1,171
In addition, the Trust has had a number of material transactions with other Government Departments
and other central and local Government bodies. 
The Trust has also received revenue and capital payments from a number of charitable funds, certain
Trustees are also members of the NHS Trust Board.  The Trust has received £156,000 worth of capital
donations during 2007/08 (in 2006/07 £87k).
David Wragg, the Trust Finance Director is a Director of the NHS Shared Business Service, a joint venture
between Steria and the Department of Health created to manage finance transaction processing for
NHS bodies. Mr Wragg receives no remuneration for this post.
The Trust has outsourced some of its finance processing functions to the NHS Shared Business Service
part owned by the Department of Health.
88

25. Private Finance Transactions
25.1 PFI schemes deemed to be off-balance sheet
2007/08
2006/07
£000
£000
Amounts included within operating expenses in respect of 
PFI transactions deemed to be off-balance sheet - gross
26,316
25,013
Amortisation of PFI deferred asset
(1,025)
(1,025)
Net charge to operating expenses
25,291
23,988
The NHS Trust is committed to make the following payments during the next year.
PFI scheme which expires;
Within one year
0
0
2nd to 5th years (inclusive)
0
0
6th to 10th years (inclusive)
3,924
3,754
11th to 15th years (inclusive)
0
0
16th to 20th years (inclusive)
0
0
21st to 25th years (inclusive)
23,446
21,891
£000
£000
Estimated capital value of the PFI scheme 
116,153
116,153
Contract Start date:
01/01/2001
01/01/2001
Contract End date:
31/12/2060
31/12/2060
The Trust has entered into a 60 year PFI contract with Meridian Hospital Company PLC to supply the
hospital premises and a range of services. The Trust has undertaken an assessment of the contract
under SSAP 21 (Accounting for leases and hire purchase contracts) and FRS 5 (Reporting the substance
of transactions) and determined that the contract should be accounted for off balance sheet. 
The Trust takes the view that the rights and privileges of ownership of the Hospital will transfer to the
NHS after 30 years and there is the option to terminate the concession to provide Facilities management
services from the PFI contractor at 30 and 45 years.
The Trust retains the freehold to the land on which the new hospital is based. The Trust has granted a
head lease to Meridian Hospital Company Plc for a period of 125 years.
The Trust has assessed the lease agreement under SSAP 21  and FRS 5 and determined that the land
should be accounted for on balance sheet. The net book value of this land (disclosed in note 11.1) is
£50.3M.
89

Toshiba Managed Equipment
2007/08
2006/07
£000
£000
Estimated capital value of the PFI scheme 
6,094
6,094
Contract Start date:
27/09/2001
Contract End date:
14/09/2016
The Trust has entered into a 15 year PFI contract with Toshiba Medical Systems for maintenance and
replacement of medical equipment.
The Trust has undertaken an assessment of the contract under SSAP 21 (Accounting for leases and hire
purchase contracts) and FRS 5 (Reporting the substance of transactions) and determined that the con-
tract should be accounted for off balance sheet.
26 Financial Instruments
FRS 13, Derivatives and Other Financial Instruments, requires disclosure of the role that financial instru-
ments have had during the period in creating or changing the risks an entity faces in undertaking its ac-
tivities.  Because of the continuing service provider relationship that the NHS Trust has with local Primary
Care Trusts and the way those Primary Care Trusts are financed, the NHS Trust is not exposed to the
degree of financial risk faced by business entities.  Also financial instruments play a much more limited
role in creating or changing risk than would be typical of the listed companies to which FRS 13 mainly
applies.  The NHS Trust has limited powers to borrow or invest surplus funds and financial assets and
liabilities are generated by day-to-day operational activities rather than being held to change the risks
facing the NHS Trust in undertaking its activities.
As allowed by FRS 13, debtors and creditors that are due to mature or become payable within 12
months from the balance sheet date have been omitted from all disclosures other than the currency pro-
file.  Provisions are shown gross.  Any amount expected in reimbursement against a provision (and in-
cluded in debtors) is separately disclosed.
Liquidity risk
The NHS Trust's net operating costs are incurred under annual service agreements with local Primary
Care Trusts, which are financed from resources voted annually by Parliament.  The Trust also largely fi-
nances its capital expenditure from funds made available from Government under an agreed borrowing
limit.  Queen Elizabeth Hospital Trust is not, therefore, exposed to significant liquidity risks.
Interest-Rate Risk
2.8% of the Trust's financial assets carry nil or fixed rates of interest.   Queen Elizabeth Hospital NHS
Trust is exposed to interest rate risk to the extent of cash held within the Trust bank account, where the
interest varies in line with the Bank of England base rate.   The following two tables show the interest
rate profiles of the Trust's financial assets and liabilities:
90

0
0
est
ears 
Y

bearing
eighted
W

Non-inter
average term
for which fixed 
0
0
ears 
Y

eighted
est rate
W
inter
average period
Fixed rate

0.00%
0.00%
eighted
average
bearing
W
0
0
0
0
0
est
Non-
inter
0
0
0
0
0
rate
Fixed 
rate
6,485
6,485
6,480
6,480
6,485
Floating
0000
0000
0000
otal 
£000 £000 £000 £000 
6,485
6,480
6,485
rust has no financial liabilities in 2007/08 (2006/07 nil).
estated following further guidance as per the NHS Manual for Accounts. 
ear
es have been r
ofile
ch 2008
ch 2007
ency T
e than five years
oss financial assets 
oss financial assets 
26.1 Financial Assets
Curr
At 31 Mar
Sterling 6,485
Gr
At 31 Mar
Sterling 6,480
Gr
Maturity Pr
Less Than 1 Y
Between one and two years
Between two and five years
Mor
26.2 Financial Liabilities
Queen Elizabeth Hospital T
2006/07 figur
91

0
0
0
0
ch
alue
480
£000
6,000
6,480
line with
Fair V
as at 31 Mar
0
0
0
0
00
alue
480
£000
6,000
6,480
Book V
ges. 
fair
Basis of
valuation
rust's financial assets and liabilities 
0
0
0
0
0
alue
£000
6,485
6,485
2006/07
ovisions for liabilities and char
Fair V
0
0
00
est and pr
alue
.
£000
6,485
e
2006/07
Book V
esidual inter
estated to include cash, and cash on deposit with the Bank of England in 
 included r
e
, of book values and fair values of the NHS T
ency income or expenditur
eign curr
ency Risk
ovisions
alues
estated*)
eign Curr
rust has negligible for
eements with commissioners to cover 
draft 0
editors and pr
editors over 1 year: 
otal 
otal 
26.3  For
The T
26.4 Fair V
Set out below is a comparison, by category
2008. (As r
Financial assets
Cash 6,485
Debtors over 1 year: 
- Agr
cr
Investments 0
T
Financial liabilities 
Over
Cr
- Finance leases 
Loans 0
T
*The value of financial assets for 2006/07 have been r
the Manual for Accounts. Last year this figur
92

27 Third Party Assets
The Trust held £9k cash at bank and in hand at 31 March 2008 (£7k at 31 March 2007) which relates to
monies held by the NHS Trust on behalf of patients.  This has been excluded from cash at bank and in
hand figure reported in the accounts.
28 Intra-Government and Other Balances
Debtors:
Debtors:
Creditors:
Creditors:
amounts
amounts
amounts
amounts
falling
falling
falling due
falling due
due within
due after
within one
after one
one year
more than
year
than one
one yeear
£000
£000
£000
£000
Balances with other Central 
Government Bodies
1,956
0
277
0
Balances with Local Authorities
58 
0
11
0
Balances with NHS Trusts and 
Foundation Trusts
529
0
765
0
Balances with Public Corporations 
and Trading Funds
0
0
0
0
Balances with bodies external to 
government
4,353
20,344
6,759
603
At 31 March 2008
6,896
20,344
7,812
603
Balances with other Central 
Government Bodies
32,817
0
2,874
0
Balances with Local Authorities
0
0
0
0
Balances with NHS Trusts and 
Foundation Trusts
2,749
0
950
0
Balances with Public Corporations 
and Trading Funds
0
0
0
0
Balances with bodies external to 
government
3,327
21,949
4,929
632
At 31 March 2007
38,893
21,949
8,753
632
93

29 Losses and Special Payments
There were 578 cases of losses and special payments (2006/07: 200 cases) totalling £459,000 (2006/07:
£1,040,000) paid during 2007/08.
The Trust has written off £400,431 of debt against provisions that were made against specific debts in
previous accounting periods.
There were no clinical negligence cases where the net payment exceeded £100,000 (prior year 0 cases
2006/07).
There were no fraud cases where the net payment exceeded £100,000  (prior year 0 cases 2006/07).
There were no personal injury cases where the net payment exceeded £100,000 (prior year 0 cases
2006/07). 
There were no compensation under legal obligation cases where the net payment exceeded £100,000
(prior year 0 cases 2006/07).
There were no fruitless payment cases where the net payment exceeded £100,000 (prior year 0 cases
2006/07).
Losses and special payments are transactions that Parliament would not have contemplated when it
agreed funds for the health service or passed legislation.  By their nature they are items that ideally
should not arise.  They are therefore subject to special control procedures compared with the generality
of payments, and special notation in the accounts to draw them to the attention of Parliament.  They
are divided into different categories, which govern the way each individual case is handled.  
Clinical negligence cases are managed by the National Health Service Litigation Authority and transac-
tions relating to such cases is held in their accounts.  The NHS Trust pays a premium for their services
and excesses on some cases.  Therefore, these cases have not been accounted for in the NHS Trust’s
accounts.
This note has been prepared on an accruals basis for 2007/08. However, the 2006/07 comparatives are
prepared on a cash basis and are therefore not a like for like comparative.
94