Accountability is an integral part of our commitment to providing world-class healthcare. Below you will find information about how we are performing, both financially and operationally, our staff declarations of interests, our efforts to improve our population’s health and the processes we have in place to combat fraud and modern slavery.

Annual reports

Read our 2022/23 annual report, which includes sections on our performance, our work to improve patient care and our independently audited accounts.

Woman sitting at a computer in an office

Royal Free London Annual Report 2022/23 

We monitor our performance against several national targets for urgent and emergency care, cancer assessments and care, elective referral to treatment (RTT) and diagnostic waiting times.

The focus on improving against these standards allows us to fulfil our commitment to delivering safe, consistent, and timely care to both elective and emergency patients. 

Our latest performance data is as follows: 

Emergency care

A total of 67.3% of patients were admitted, transferred or discharged from our emergency departments within four hours in September 2023, down from 71.4% in August. However, this remains on track to achieve the intermediary threshold target of 76% (to be hit by March 2024 — normally 95%).

Individual hospital performance for the same period was:

  • 61.5% at Barnet Hospital
  • 60.4% at Royal Free Hospital
  • 99.8% at Chase Farm Hospital

Ambulance waiting times

Ambulances waiting for under 30 minutes outside our emergency departments was at 68.9% in September 2023 (58.0% at Barnet Hospital and 80.2% at Royal Free Hospital). This is a strong position and performance for quarter two is 74.4% compared to quarter one at 69.8%.

Referral to treatment waiting list

The number of patients waiting less than 18 weeks from referral to treatment in September 2023 was 57.9%, which decreased from 58.8% in August. A total of 119 patients waited longer than 78 weeks and this increased from 55 in August.

Cancer

A total of 47.9% of patients were seen within the 62-day target from GP referral to receiving treatment in August, compared to 47.6% of patients in July.

Individual hospital performance for the same period was:

  • 33.3% at Barnet Hospital
  • 51.4% at Royal Free Hospital

Diagnostics

The number of patients waiting less than six weeks for diagnostic tests was 90.3% in September 2023, an increase from 89.5% in August, against a target of 95%.

Mortality

The number of hospital deaths are lower than expected, with a summary hospital-level mortality indicator (SHMI) of 0.8225 for March 2022 to April 2023 (latest data).

Individual hospital performance for the same period was:

  • 0.8005 for Royal Free Hospital — lower than expected
  • 0.8560 for Barnet Hospital — lower than expected

For our yearly performance data, see our annual reports.

In accordance with NHS England guidance, the Public Register displays declarations of interest made by our decision-making staff. We're committed to being an open and transparent organisation and you can view our staff declarations here

Decision makers are defined as:

  • executive and non-executive directors
  • governors.
  • staff at Agenda for Change band 8d and above
  • non-agenda for change senior staff (including all other very senior managers and all consultants)
  • other administrative and clinical staff who have the power to enter into supply contracts on behalf of the trust, approve invoices or participate in decisions to buy equipment or add drugs to formulary, whether individually or at a trust committee

At the Royal Free London NHS Foundation Trust, we are required by the government to share payment details of our spending greater than £25,000 every month. 

These hospital spending reports include individual invoices, grant payments, expense payments and transactions over £25,000. There may be some occasions where transactions are not published, for example, if sharing our information would contravene legislation.

2023

2022

2021

2017-2020

Fraud in the NHS is thought to cost on average around £5.7 billion every year and takes away money which services should be spending on patient care, funding towards further medical professionals or treatments. The total loss of procurement expenditure is estimated to be £1.05 billion, while the total loss to payroll fraud is estimated to be £0.56 billion.

What is fraud?

Fraud is defined as any dishonest false representation, failure to disclose information or abuse of position (Fraud Act 2006).

Bribery/corruption

Bribery and corruption are where someone is influenced by bribery, payment or benefit-in-kind to unreasonably use their position to give some advantage to another (Bribery Act 2010).

Who commits fraud?

Anyone can commit fraud against the NHS. People investigated include doctors, nurses, administration staff, managers, health care professionals, dentists, opticians, pharmacists, patients, directors, GPs and overseas patients.

Examples of fraud

The types of fraud investigated in the NHS include the following:

  • false time recording (overtime, flexi time, enhanced hours etc)
  • false qualifications/professional registrations
  • working while sick
  • claiming additional or fictitious expenses
  • false charge exemptions
  • ordering/invoices
  • mandate fraud
  • contractor claims
  • employees not having the correct or legitimate right-to-work documents
  • employees having expired right-to-work documents
  • procuring goods and services in a non-transparent and dishonest manner
  • commissioners claiming for services in respect of fictitious or ghost patients
  • false identity.

This list is not exhaustive.

What to do if you suspect a fraud?

  • DO report your suspicions confidentially to someone with the appropriate authority and experience.
  • DO deal with the matter promptly if you feel your concerns are warranted.
  • DO NOT ignore it.
  • DO NOT approach or accuse individuals directly.
  • DO NOT try to investigate the matter yourself. 
  • DO NOT convey your suspicions to anyone other than those with the proper authority.

Who to contact

The trust adopts a zero tolerance approach towards fraud being perpetrated. Therefore, if you have any concerns about fraud, bribery or corruption within the NHS, or need fraud-related advice, you can:

All referrals/discussions will be dealt with sensitively and in a professional and confidential manner.

The Royal Free London has a small public health team whose aim is to improve physical and mental health outcomes, promote wellbeing and reduce health inequalities across the population and communities we serve, within and beyond the hospital walls. We do this by working with our staff, patients, communities and the wider health and care system. 

We have a strong focus on measuring and reporting on inequalities. Routine monitoring of inequalities is important to identify problems, focus on areas to change and monitor the impact of our actions. By taking a data-driven approach, we aim to identify the drivers of ill health and which populations are most affected. We can then use this insight to improve outcomes and patient experience and reduce health inequalities.  

Improving our population’s health

Smoking, alcohol and obesity are major contributors to preventable ill health, such as cancer, respiratory disease and cardiovascular disease. They are also major causes of inequalities in health. We work closely with our colleagues within the trust and with communities and partners outside the hospital to improve lifestyles and make healthy choices the easy choices.  

The team

Joint director of public health, Dr Tamara Djuretic, works across the Royal Free London and the London Borough of Barnet. The Royal Free London deputy director of public health is Dr Judith Stanton. We are an accredited training team and host public health registrars, population health fellows and GP fellows. The public health team sits in the corporate arm of the Royal Free London group and reports to Dr Gillian Smith, group chief medical officer. 

To find out more about the work of the public health team, email: rfl.publichealth@nhs.net.

Public health reports

The Royal Free London NHS Foundation Trust supports the Government’s objectives to eradicate modern slavery and human trafficking and recognises the significant role the NHS has to play in both combatting it and supporting victims. In particular, we are committed to ensuring our supply chains and business activities are free from ethical and labour standards abuses. Steps taken to date include:

People

  • Appropriate pre‐employment checks on directly employed staff and agencies on approved frameworks are audited to provide assurance that pre‐employment clearance has been obtained.
  • A range of controls to protect staff from poor treatment and/or exploitation, which comply with all respective laws and regulations. These include provision of fair pay rates, fair terms and conditions of employment and access to training and development opportunities.
  • Consultation and negotiation with trade unions on proposed changes to employment, work organisation and contractual relations.
  • Established relationships with multiple external agencies and the Local Authority Designated Officer (LADO).

Speaking up at work

  • The Royal Free London believes that every member of staff has a duty to raise concerns at the earliest reasonable opportunity about the provision of care or any other malpractice within the trust where care and/or behaviour/conduct is believed to be inadequate or unacceptable. In addition, staff have duties imposed upon them to raise such concerns by their respective professional regulatory bodies, such as the General Medical Council, Nursing and Midwifery Council, Association of Chartered Certified Accountants, Health and Care Professions Council etc.

Our supply chain

  • We purchase most of our products from UK or EU based firms, who may also be required to comply with the requirements of the UK Modern Slavery Act (2015) or similar legislation in other EU states.
  • We purchase a significant number of products through NHS Supply Chain, whose ‘Supplier Code of Conduct’ includes a provision around forced labour.
  • Where possible and consistent with the public contracts' regulations, we build long‐standing relationships with suppliers.

Training

  • Advice and training about modern slavery and human trafficking is available to staff through our safeguarding children and adults training, our safeguarding policies and procedures and our safeguarding leads.