Transcript 2015 General Presentation

St John of Jerusalem
Eye Hospital Group
2016
Nicholas Woolf and Tom Ogilvie Graham
Chairman & CEO
1
Middle East context
REFUGEE
CRISIS
ISIS
(e.g.”The Islamic
State of
Molenbeek?”)
POLARISATION
(in politics and
society)...
2
Palestine: some key facts
Dire living conditions
• 75% Palestinians in East Jerusalem live below the poverty line
• Gaza unemployment rate averages 43%, highest in the world 60% youth unemployment
• Gaza: 1.8 million people “locked in”, 80% rely on international aid
• 20% patients (and their companions) from the West Bank were
denied permits to enter Jerusalem
• 33% patients (referred on health grounds) from Gaza denied exit in
December 2015, the highest in 7 years
References: The World Bank, Oxfam, Association for
Civil Rights in Israel, the World Health Organization and
UNRWA.
3
Socioeconomic Impact of
Blindness in the oPt
• The rate of blindness is ten times
higher than in the West
• 80% of blindness is preventable
• Social stigmatisation especially
for girls
• Impact on GDP –USD 202 billion/
year (vs. treatment would cost
USD 28 billion) - WHO study on
refractive errors
• Blindness - very high
dependency (blind person
requires average of 2 carers)
4
St John Eye Hospital Group:
Providing key basic health
services
• 128,000 patients (increasing by
approx. 5,000 annually) treated in
Jerusalem, West Bank and Gaza
per year
• Includes:
– Over 5,000 major operations
– Mobile Outreach: 16,700 patients
checked and health education
delivered to their families
– Leading on preventative health and
screening programmes
5
Staff at St John
• Employed 235 people in
total, including 148 medical
staff
• Trained 5 ophthalmic nurses
• One medical resident entered
his final year, two more
residents continued on the
course and two new
residents joined the course
School of Nursing Graduates, 2015
6
Wide reach in
Palestine:
•East Jerusalem
•Gaza
•West Bank
7
Quality of Care
• SJEHG services offer the highest
standards of care, notwithstanding the
difficult climate in which we operate
• JCI accreditation is the gold standard in
health care and its consultants are the most
experienced in the industry
• In 2016 SJEHG had its three yearly review
achieving 96% overall
8
Strategic Plan 2013-2017
Capacity
Patients
Research
Gaza
Finance
Reputation
Partnership
9
Growing Reach
Outpatients Numbers 2007-2015
130,000
120,000
110,000
100,000
90,000
80,000
70,000
2007
2008
2009
2010
2011
2012
2013
2014
2015
10
Growing Reach
Major Surgeries 2006-2015
5500
5000
4500
4000
3500
3000
2500
2000
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Decrease in 2013 due to refurbishment of our theatre in Jerusalem (and
increase for 2014 to catch up backlog of patients)
11
SJEHG 2015
Unit
Patient Numbers
(2015)
Running Costs
(2015)
Staff Numbers
(2015)
Jerusalem Hospital
46,498 (including
3,795 major
surgeries)
£6,057,269
170 (including 98
medical staff)
Gaza Hospital
31,419 (including 911 £522,877
major surgeries)
17 (including 14
medical staff)
Hebron Hospital
11,451 (including 338
major surgeries)
£353,397
14 (including 9
medical staff)
Anabta Clinic
22,026
£366,749
17 (including 11
medical staff)
Mobile Outreach Unit
16,760
£336,776
11 (including 8
medical staff)
Total
128,154
£7,375,341*
235
*excludes London office costs
12
Jerusalem Hospital
• Covers all ophthalmic specialties and is the
base for our doctor and nursing specialist
training courses
• In 2015 vital updates to the building’s
infrastructure began
• Patient pathways were also introduced to help
the visually impaired find their way to their
clinics
13
Hebron and Anabta Facilities
• The new Hebron Hospital opened at the
end of 2015 – purpose-built, located in the
city centre and will treat many more
patients
• The Anabta Clinic is easily accessible
from the bigger towns of Nablus, Tulkarem
and Jenin, where many of their residents
are refugees from Gaza
• In 2015 these facilities combined treated
over 33,000 people
14
Gaza Hospital
• Main provider of charitable eye care in Gaza
NEW HOSPITAL
• New hospital to open in May 2016:
– Conflict preparedness: e.g reinforced
basement and shatterproof glass to
ensure safety of patients and staff
– Double operating capacity
• Only new build by an NGO since last conflict
(2014)
OLD CLINIC
15
Mobile Outreach Programme
• Brings eye care to isolated
communities in the West Bank (e.g.
Bedouins, small refugee
communities…)
• A second outreach team was
relaunched in 2015
Mobile Outreach Growth
Patients Reached
18,000
16,000
14,000
12,000
10,000
8,000
6,000
2010
2011
2012
2013
2014
2015
Drop in numbers due to reduced funding allowing for only one van to be
utilised
16
Diabetic Retinopathy Programme
•
•
•
Under the programme the unit:
– Travels to remote villages to screen
patients
– Refers patients for further treatment in our
centres
– Educates on ways to prevent diabetes from
developing
Since 2012:
– 21,236 people have benefited from our
awareness sessions
– 44,572 have been screened for diabetes
– 13,607 have been diagnosed with diabetic
retinopathy and referred to our Hebron
Hospital
We are expanding to refugee camps in
northern Jordan, the first time our services
have been projected into a neighbouring
country
17
Jerusalem Old City:
Muristan
•
•
•
A hospital has existed at this site since at
least 700 AD and knights from the First
Crusade in 1099 formed the Order of St
John there in the early 12th century
Soldier monks looking after recuperating
pilgrims and became known as the Knights
Hospitaller of the Order of St John
The building was used by the Eye Hospital
as a temporary eye clinic following the
1948 war but has been abandoned since
1961
18
Future of Muristan
• St John wants to preserve the
endangered building whilst providing an
invaluable walk-in clinic which will
provide a primary and emergency eye
care clinic, treating an estimated 5,500
patients every year
• A small museum on the history of the
Order with a resource/knowledge centre
will also be included along with an entire
garden area and an outlook with one of
the best views of Jerusalem
19
Partnerships
• We have developed partnerships that
promote peace and result in constructive
relationships between Palestinians and
Israelis
• Some examples of our partnerships
include:
• Tel Aviv University – certifies St
John’s Orthoptic Assistants
• Palestinian Red Crescent Society, AlQuds University medical centres;
• Medical Relief Society –
implementation partners for Diabetic
Retinopathy Screening Programme in
the West Bank
• Help to treat premature babies at the
Holy Family and Caritas Baby
Hospitals in Bethlehem
20
Hadassah - St John Partnership
•
The Hadassah Medical Center in Jerusalem is one of the largest and most
progressive hospitals in the region
•
Hadassah was nominated for a Nobel Peace Prize in 2005 for its equal treatment
of all patients, an ethos St John shares
•
•
Since 1998, Prof Jacob Pe’er, head of the
ophthalmology department at Hadassah,
has worked with St John on complex
clinical cases
The ‘Peres Center for Peace’ funded a
Joint Teaching Programme
21
Joint Teaching Programme
•
•
•
Palestinian ophthalmologists
undertake further training in
specialisations at Hadassah that
they would not otherwise be able to
access
In 2014, all ophthalmic specialties
were covered at St John’s hospital
by Palestinian doctors for the first
time ever
Of our 34 doctors, seven have
undertaken formal training and
qualifications at Hadassah
22
Sovereign Military Order of
Malta
• St John screens and treats
premature babies at the
Order of Malta’s Holy
Family Hospital in
Bethlehem
• The Order of Malta will
jointly run our Muristan
Clinic
23
The Palestinian Authority (PA)
•
•
In 2014 St John signed an MOU with
the Palestinian Ministry of Health.
St John:
– Examines and treats diabetic
patients in PA run clinics
– Provides free surgical services for
many patients who are referred to
our services by the PA
– Trains medical personnel in order
to increase the efficiency of
surgical specialties
– Provides experienced doctors to
perform surgeries in PA hospitals
24
European Union:
‘Partnership for Peace’ Project
• In 2015, secured funding for a genetic research project with
Hadassah from the EU’s Partnership for Peace Programme
• The collaboration will include training:
– Geneticist
– Epidemiologist
– Ocular Ultrasonagraphist
• A dedicated genetic research laboratory will be established in our
Jerusalem Hospital
• First major research project undertaken by St John in over 20 years
25
Actual 2015 (GBP / ILS = 5.94)
Budget 2016 (GBP / ILS =
5.85)
Patient Related Income
£'000
3,776
£'000
3,736
Voluntary Income
Other Income
4,598
147
5,436
321
Total Incoming
Resources
8,521
9,494
Payroll costs
Medical costs
Other costs
Depreciation
4,987
1,284
1,228
700
5,333
1,463
1,322
832
Total Resources
Expended
8,199
8,950
322
544
Net Income
Finance
27
Finance 2015
INCOMING RESOURCES 2015
44%
PATIENT RELATED INCOME
26%
PRIORY INCOME
28%
OTHER VOLUNTARY INCOME
OTHER INCOME
2%
Total Incoming Resources: £8,521,000
Capital Donations: £564,000
COST ALLOCATIONS 2015
61%
PAYROLL
MEDICAL COSTS
DEPRECIATION
OTHER
16%
9%
14%
Total Cost Allocations: £8,199,000
27
Voluntary Income Split
CAPITAL/OPERATING DONATIONS SPLIT 2015
CAPITAL/OPERATING DONATIONS SPLIT 2016
14%
12%
86%
88%
Operating Donations
Capital Donations
Operating Donations
Capital Donations
Operating Donations
2015 (£'000) 2016 (£'000)
7,983
8,720
564
774
Capital Donations
28
Balance Sheet - December 31st 2015
Fixed Assets
Actual
31st Dec 2015
Budget
31st Dec 2016
£’000
£’000
14,469
15,766
5,163
4,019
Current Liabilities
-1,462
-1,020
Longterm Liabilities
-3,453
-3,504
TOTAL
14,717
15,261
Current Assets
29
Assets
Fixed assets
Tangible assets at written down
value
Actual
Budget
31-Dec-15
31-Dec-16
£’000
£’000
4,232
5,276
Investments at market value
10,237
10,490
Total
14,469
15,766
364
400
1,135
1,650
595
550
Bank accounts
3,009
1,419
Total
5,103
4,019
Current assets
Stock
Debtors
Sundry debtors & prepayments
30
Priory Income 2012-2015
Priory Income 2015
Australia
£85,000
Canada
£50,000
England
£468,000
New Zealand
£113,000
Scotland
£195,000
United States
£1,318,000
Wales
£15,000
Total
£2,244,000
31
Priory Income: Trend
Income From Priories 2001-2015 (£)
2,000,000
1,800,000
1,600,000
1,400,000
1,200,000
1,000,000
800,000
600,000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
32
GBP / NIS
Year, to 20/01/16
6.2028
6.0917
5.9806
NIS
5.8695
5.7584
5.6473
5.5362
5.4251
5.314
33
USD / NIS
Year, to 20/01/16
4.1
4.05
4
NIS
3.95
3.9
3.85
3.8
3.75
3.7
34
SJEHG Trustees
Mr Nicholas Woolf
Mr Nick Goulding
Ms Nicki Shaw
Dr Maged AbuRamadan
Mr John Pelly
Dr Alistair McPhail
Dr Anne L. Coleman
Mr Guy Morton
Ms Susan Dingwall
Mr Herbert von Bose
35
Governance
SJEHG’s Board meets three times a year, including once in
Jerusalem. The Steering Committee meets three times a year,
between Board meetings
Committees of the Board:
• Finance Committee
• Clinical Governance Committee
• Steering Committee
• Fundraising Committee
• Strategy & Planning Committee
• Investment Committee
• Audit Committee
• Honours & Awards Committee
36
Competition
• SJEHG has increasing competition across the oPt;
• Private practices across the West Bank provide care for patients who
live in areas where we do not provide eye care and for those who can
afford it. Our doctors themselves also carry out private practice at
other clinics
• Government hospitals also provide limited ophthalmic services, mostly
cataract surgeries
• In Gaza, we receive corneal graft and retinal surgery referrals from the
Palestinian Authority. Cataract patients are referred from them to
government hospitals. UNRWA refer many ophthalmic cases to us but
not cataract patients, who are now being sent to the Eye Specialty
Hospital (run by the Public Aid Society)
37
Risks
• SJEHG’s risk register analysis is based on UK National
Patient Safety approach
• Each committee reviews risk in its own area every
meeting
• Board and Steering committee review major risks each
meeting. Board signs off annually for the annual
accounts
• Only two red risks, after mitigation: political and war,
which are beyond our control
38
Plans for 2016
Research:
Installing a laboratory to begin researching hereditary eye diseases and publishing
research in recognised journals
Training:
Alongside regular training programmes, one doctor will begin Fellowship in Glaucoma
to enable our Gaza Hospital to provide treatment for the most complicated cases, one
doctor’s Fellowship in herediary eye diseases will continue
Infrastructure:
• Official openings the new Gaza and Hebron Hospitals and restoration of the ancient
site of Muristan
• Jerusalem Hospital- update of outdated pipe work and hydrants and a separation of
our paediatric and retinal clinical areas
Information:
A roll out of the new Hospital Management Information System
Community Healthcare:
Expanding our Diabetic Retinopathy Screening Programme
to northern Jordan
Media:
• Releasing ‘Eyes of St John’ on an international stage
39
• Launching a new interactive website & online shop
Layla (an Anabta cataract patient) and her
father had this to say:
‘Thank you so much to all at St John,
from Anabta, to London to Jerusalem,
from myself, my family and all the city
of Jenin - we are so grateful to have
your services’
Radwan (Mobile Outreach Patient)
trying glasses on for the first time
40
Alice, a nursing school graduate from
2015, who now works in our services:
“The best thing about St John is the
teamwork in the hospital. Here it’s
like one big family!”
Omar (ruptured retina patient from Gaza).
His mother had this to say:
“Your doctor was the first person to
give us a thread of hope and wanted
only the best for us all. He brought us
to life again. Thank you to St John,
thanks to you all!”
41
Eyes of St John
42