CATEGORY OF PAPER Specific action required: Provides … · 2017-07-25 · Operations Centre Headlines 3.1. All call taking service levels have been achieved in June 2017 with both

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CATEGORY OF PAPER

Specific action required: Provides Assurance: For Information:

Trust Board – 27/07/2017

Report title: Integrated Quality and Performance Report – July 2017

Purpose of report: To provide the Board with an overview of key performance metrics for June 2017

Key issues: (key points of the paper, how this supports the achievement of the Trust’s corporate objectives, overview of risk implications, main risk details on page 2)

Red 1 performance increased to above 75% at 75.45% in June 2017, achieving the national target. Red 2 performance decreased slightly to 56.95%. Decreases were also seen in performance against most Green and Urgent priorities, with Green 2 and Urgent 4 hour the only areas to see improvement. It is the first time since July 2015 that NEAS has achieved monthly Red 1 performance above the target of 75%.

Overall the Trust-wide absence rate has risen slightly by 0.26% in comparison to last month and is now 6.49%.

All call taking service levels were achieved in June 2017.

Issue previously considered by:

Recommended actions:

Board members are asked to note:

monthly performance in June 2017.

the ongoing actions being undertaken to improve response performance

Sponsor / approving director: Graham Tebbutt, Head of Strategy and Transformation

Report author: Hannah Winney, Planning and Performance Manager

Governance and assurance

Link to Trust Priorities: (please tick)

Organisational

Sustainability

Improving

Quality &

Safety

Workforce

& Investors

in People

Clinical Care

& Transport

NHS 111 &

Clinical

Assessment

Service

Comms &

Engagement

Link to CQC / KLOE: (please tick)

Caring Responsive Effective Well Led Safe

Link to Trust values: (please tick) (Please explain how this paper supports the application of the Trust’s values in practice)

Pride Strive for

excellence Respect Compassion

Take

responsibility

& be

accountable

Make a

difference –

day in & day

out

Any relevant legal / statutory issues? (Such as relevant acts, regulations, national guidelines or constitutional issues to consider)

Equality analysis completed

Yes No Not Relevant

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If this is not relevant please explain why:

An equality analysis is a review of a policy, function or significant service change which establishes whether there is a positive or negative impact on particular social groups

Key considerations Details

Confirm whether any risks that have been identified have been recognized on a risk register and provide the reference number:

Please specify any Financial Implications

Please explain whether there are any associated efficiency savings or increased productivity opportunities?

Are any additional resources required e.g. staff capacity?

Is there any current or expected impact on patient outcomes/experience/quality?

Specify whether appropriate clinical and/or stakeholder engagement has been undertaken:

(stakeholders could include staff, other Trust departments, providers, CCGs, patients, carers or the general public)

Are there any aspects of this paper which need to be communicated to our stakeholders (internal or external)?

(Please tick – if ‘yes’ then please complete all boxes. Please briefly specify the key points for communication and ensure the Comms team are informed via mailto:[email protected])

Yes No Positive Negative

Proactive Reactive Internal External

mailto:[email protected]

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Trust Board

Integrated Quality and Performance Report – June 2017

27th July 2017

1. Executive Summary

1.1. Red 1 performance increased to above 75% at 75.45% in June 2017, achieving the national target. Red 2 performance decreased slightly to 56.95%. Decreases were also seen in performance against most Green and Urgent priorities, with Green 2 and Urgent 4 hour the only areas to see improvement. It is the first time since July 2015 that NEAS has achieved monthly Red 1 performance above the target of 75%.

1.2. Overall the Trust-wide absence rate has risen slightly by 0.26% in comparison to last month and is now 6.49%.

1.3. All call taking service levels were achieved in June 2017.

2. Workforce Headlines

2.1. Overall the Trust-wide absence rate has risen slightly by 0.26% in comparison to last month and is now 6.49%. This reflects a 0.49% increase compared with June 2016. The FirstCare data warehouse has now been refreshed and is operating on new logic which has resulted in a very slight increase of 0.04% in the absence rate.

2.2. The frontline FTE turnover rate remains within target at 0.56% for front line staff.

2.3. Statutory and Mandatory compliance and Performance Appraisal Completion has reduced slightly in June 2017 to 89.55% and 79.02%.

3. Operations Centre Headlines

3.1. All call taking service levels have been achieved in June 2017 with both 999 and 111 service levels seeing an improved performance. Call levels for 111 service have started to reduce following the increase in demand resulting from service changes in the south of the region, however calls answered for June 2017 are still over 30% higher than seen in June 2016.

3.2. Hear and Treat rates have continued to reduce based on AQI definitions dropping to 7.02% for June 2017, almost 1% lower than in June 2016. The rate of incidents managed without the need to transport to A&E was 36.5% in June 2017. Clinical call audits are being used to identify learning and improvement opportunities to improve hear and treat rates amongst clinicians. This will be monitored and reviewed to reduce variation amongst clinicians in the clinical hub.

3.3. Referrals from 111 to Emergency Department continues to meet the 5% target, however has started to increase slightly. This increase is being addressed through individual performance management and targeted training for clinicians.

3.4. 111 calls referred to 999 has increased slightly in June 2017 reaching 14.34%, with the proportion of 111 calls referred to 999 which received an ambulance response at 11.78%.

3.5. Friends and Family Test results have exceeded the target of 80% however show a reducing trend since March 2017.

4. Emergency Care Headlines

4.1. June 2017 saw similar levels in overall Red 8 and Red 19 performance. Red 2 performance decreased slightly to 56.95%, whereas Red 1 performance increased to above 75% at 75.45%, achieving the national target. Of the local CCGs, all were below

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75% in June 2017 for overall Red performance. Decreases were also seen in performance against most Green and Urgent priorities, with Green 2 and Urgent 4 hour the only areas to see improvement, with G2 reaching 40.45% remaining relatively static compared with June 2016 performance. It is the first time since July 2015 that NEAS has achieved monthly Red 1 performance above the target of 75%. Red 1 performance as at 19th July 2017 was 73.60%.

4.2. National benchmarking data for May 2017 shows that NEAS is above the national average for Red 1 performance that month. Of the eight trusts that are currently reporting performance against the three national standards, South Central Ambulance Service reported performance above the Red 1 national standard and London Ambulance Service were above the Red 19 standard. They were the only two services to have achieved any of the three national standards.

4.3. In June 2017 22 patients waited longer than 60 minutes for a Red response, of these 4 were attributable to data recording issues. This represents a reduction compared with May 2017, however remains above the number recorded for June 2016 when 5 patients waited more than 60 minutes. Patients waiting longer than 8 hours for a Green response and longer than 12 hours for an Urgent response also reduced in June 2017 compared with May 2017, falling from 17 to 8 for Green incidents, and 23 to 0 for Urgent incidents.

4.4. The table below provides the current forecast performance figures against the three national performance standards, as set out in our Operational Plan 2017-19. They are subject to review as additional analysis is undertaken, and discussions continue with our commissioners regarding system improvement. Performance is highlighted blue where it has been above the forecast and orange where it is below.

4.5. NEAS continues to achieve its Red 1 forecast, but has failed to achieve either R2 or R19, missing the forecast position by 9.43% and 0.71% respectively. An RPIW is planned for August 2017 to review in depth Red 2 performance.

Table 1 – Performance Forecasts 2017/18

4.6. Overall incident volumes are higher than last year, with NEAS responding to 4.07% more incidents for the year to date than in 2016/17. There remains a high volume of Red demand in June 2017 of 550 per day, which is +3.33% (532 incidents) higher than the June 2016 volumes.

4.7. See and Treat rates continue to show improvement compared with the previous year. June 2017 achieved 26.47% See and Treat rate an improvement of 3.51% compared with June 2016.

4.8. Handover delays have reduced in June 2017, with only 346 hours lost to handovers over 15 minutes. This is at the lowest level since September 2015, with 74.6% of handovers completed within the 15 minute target. Overall turnaround times at hospital remains low with only 35.8% within the 30 minute target for June 2017. Work is on-going to improve the accuracy of handover and turnaround times through use of the EPCR data, this will also ensure that recording processes are consistent across the region.

4.9. The volume of late finishes has reduced to 3,037 hours, a reduction of 16% compared with May 2017.

4.10. The number of official diverts between hospitals was 8 in June 2017, down significantly from 25 in May 2017. This impacted on 40 patient journeys.

4.11. NEAS was below the national average for 4 of the 8 National Clinical Indicators (current reporting month is February 2017), including 100% achievement of PPCI treatment within 150 minutes, reflecting the best position nationally. Local increases from January 2016 were seen in 5 indicators. ROSC and Survival to Discharge performance remain the key challenges for the Trust.

Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Qtr 1 Qtr 2 Qtr 3 Qtr 4 Year end

Original Forecast 68.93% 66.91% 65.82% 65.34% 68.49% 63.56% 66.49% 73.92% 69.33% 72.14% 72.10% 70.04% 70.24% 68.81% 70.61% 76.25% 71.55%

Actual 73.14% 72.11% 75.45% 73.48% - - - 72.32%


Actual 60.69% 57.06% 56.95% 58.21% - - - 61.49%


Actual 90.05% 87.59% 87.51% 88.37% - - - 88.78%

Red 1

Red 2

Red 19

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5. Patient Transport Headlines

5.1. PTS performance against key indicators continues to be maintained, with only on time arrival at treatment centre, marginally below target at 79.65% (80% target).

5.2. Patient satisfaction has remained high in June 2017 at 98.5%, the highest rate in the 13 month reporting period.

6. Fitness to practice statistics

6.1. The HCPC registration date for all paramedics is 1 September 2017. For frontline paramedic roles (Allied Health Professionals) is currently 98% matched (7 EU paramedic are currently going through the HCPC registration process and 4 newly qualified students). Nursing NMC and Medical staffing GMC are both showing as 100% match and in-date this month.

6.2. ESR is reporting 100% compliance level for all employees who require a DBS check based on the position their currently hold within ESR system.

7. Assurances

7.1. All call handling service levels have been achieved.

7.2. R1 national response target has been achieved.

7.3. Continued increasing trend in See and Treat rates.

7.4. Reduction in number of hours relating to late finishes.

7.5. 100% compliance with DBS.

8. Risks and Issues

8.1. R2 and R19 national response targets and forecasts not achieved.

8.2. Continuing high levels of call volumes experienced by NHS111 services.

8.3. Continued low rate of turnarounds completed within 30 minute target, leading to reduced availability to respond.

9. Recommendations

9.1. The Trust Board members are asked to note the following:

month and quarter position, and performance for year end.

the ongoing actions being undertaken to improve response performance.

Document Information

Author Name: Hannah Winney

Author Title: Planning and Performance Manager

Sponsor Name: Graham Tebbutt

Sponsor Title: Head of Strategy and Transformation

Last Saved 2017-07-21 15:55:00

Save Location N:\Public\Performance Management & Business Planning\IQPR Board Reports\15 - June 2017\IQPR Cover Report July 17.docx

Word Count 1795

Document Title

Company Name

Department

Financial Year

Reporting Month

Content

Strategic Aims

Performance at a Glance

Workforce Headlines

NEAS Operations Centre

ECS Operations

PTS

Note

Jun-17

IQPR Report - Correct as 17 July 2017

IQPR Report

North East Ambulance Service NHS Foundation Trust

Strategy, Transformation and Workforce

2017/2018

The IQPR uses the Data warehouse, ESR and Quality Dashboard as data sources.

Comments

As of October we have moved to reporting against the 5 themes of the NHS Improvement's Single Oversight Framework in place of the

Monitor Governance and Financial Sustainability Risk Rating.

Performance against control total metric - replaces the 'I&E Margin Variance from Plan' metric reported last year as of May 17. This metric

shows bottom line financial performance against plan, but excludes any STF funding received from the calculation

Due to ESR reconfigurations linked to the restructure it has not been possible to report on all Workforce metrics. Updates will be provided in

next month's report.

Statutory and Mandatory compliance reporting from April 17 has been updated to report on competencies rather than course completion.

This provides a more accurate picture of compliance rates.

The IQPR uses the Data warehouse, 111 Balance Scorecard and service line Operations Dashboards as data sources

Hear and Treat rates reflect the national AQI definition.

Appreciations and complaints figures are being reviewed for data quality.

111 Calls referred to 999 follows exisitng guidance and does not reflect whether an ambulance was dispatched.

The IQPR uses the Data warehouse, Validated Performance Reports, Ambulance Quality Indicators Report, Quality Dashboard and ESR as

data sources.

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Values Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17

No reduction in cumulative position

on last year

Cumulative reduction greater than

last year, <=2%

Growth in cumulative position on

last year by >2%Increase Hear and Treat Rates

No reduction in cumulative position

on last year

Cumulative reduction greater than

last year, <=2%

Growth in cumulative position on

last year by >2%Strategic Aim - Increase See and Treat Rates

Reduce Red 1 Variability (Quarterly Figures)*

Reduce Red 2 Variability (Quarterly Figures)*

Deterioration on previous month No change from previous monthAggregate improvement on previous

monthReduce Overall Attrition*

>8% >5-8% <=5%Reduce Sickness Absence to Below 5% Cumulative

YTD*

Area of Concern, Missed Deadline,

Overspend

Area of Increased Focus, Potential

area of Concern

All items are up to date

All metrics are indicating correctlyAchieve Establishment levels by September 2016

Qtr. targets breachedQtr. position behind target but still

recoverableQtr. position on target

Performance Against Strategic Aims

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Category Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17

Formal Action Likely

Emerging concerns/ persistently

failing Operational targets/

financial issues/ breach or likely

breach

No Evident Concerns Monitor/NHSI - Governance Rating

Red 1 (Quarterly RAF Indicator)*

Red 2 (Quarterly RAF Indicator)*

<95%Either <95% & Recoverable OR

>95% & forecast to fail>95% Red 19 (Quarterly RAF Indicator)*

1 2 to 3 3.5+NHSI - Financial Sustainability Risk Rating (Reporting change as of Oct

16) 4 4 4 4 4 4 4 4 4 1 1

1 (<1.25x) 2* (1.25-1.75x) Capital service capacity (times)

1 (<14 days) 2* (14-7 days) 3> (7-0 days) Liquidity days

1 (-1%) 2* (-1-0%) 3> (>0%) I&E margin*

<=-1% <-1%, <1% >=1% Variance in I&E margin as a % of income*

<3 above national

performance

>3<5 above national

performance

>5 above national

performanceNational Clinical Indicators

PPCI 150

STEMI Care Bundle

ROSC

ROSC UTSTEIN

Survival to Discharge

UTSTEIN Survival to Discharge

Fast 60

Stroke Bundle

2+ RedAll Amber OR 1 Green 2 Amber

OR 2 Green 1 Red3 Green National Standards

<75% >=75% Category Red 1*



3+ RedAll Amber OR

50% Green 50% Amber/Red>=50% Green Operational Performance

<60% >60%, <75% >75% Green 1 in 20*

<60% >60%, <75% >75% Green 2 in 30*

<60% >60%, <75% >75% Green 3 in 60*

<40% >40%, <60% >60% Urgent in 60*

<50% >50%, <70% >70% Urgent in 120*

<60% >60%, <80% >80% Urgent in 240*

4+ RedAll Amber OR 2/3 Green 3/2

Amber OR 3 Green 2 Red4+ Green Safe and Caring

Decreasing No change Increasing Incident Reporting Trend

>5% 1 - 4.9% <1% Incidents Reported Moderate or Higher

>0 NA 0 Serious Incidents

1 NA 0 Assaults on Staff Actual

Increasing NA Decreasing Assaults on Staff Trend

Decreasing NA Increasing Patient FFT

3+ RedAll Amber OR 2/3 Green 3/2

Amber OR 3 Green 2 Red4+ Green NHS 111

<90% >=90%, <95% >=95% Call Answer Performance*

>10% >5%, <10% <5% ED Referrals*

>15% >10%, <15% <10% 111 - Ambulance Dispatch

<90% >=90%, <98% >=98% 111 Warm Transfers*

Delayed due

to end of

year

reporting

NA

Limited

reporting

due to year

end

Performance At A Glance

As of October we have moved to reporting against the 5 themes of the NHS Improvement's Single Oversight

Framework. No formal submission has been requested for the Performance theme.

March 2017 Quarterly Review Meeting with NHSI confirmed NEAS is within Segment 2 of the Single Oversight

Framework.

<75%Either <75% & Recoverable OR

>75% & forecast to fail>75%

N/A Below National Average Above National Average

<95% >=95%, <100% 100% 111 Call Back Within 10*

2+ Red

All Amber OR 1

Green 2 Amber OR 2

Green 1 Red

3 Green Human Resources

>8% >5-8% <=5% Sickness Absence Rate*

<90% <=90%, <95% >=95% Occupied Rate

>=15% <15%, >=10%, <10% Turnover Rate

Target Trend Overarching theme Service Line Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Grand Total

Operations Centre 101.13% 103.58% 97.36% 98.05% 98.07% 99.57% 99.31% 99.49% 99.51% 100.36% 93.21% 99.06%

ECS 94.04% 92.93% 92.69% 94.19% 95.27% 97.94% 96.87% 99.78% 98.01% 98.19% 96.50% 96.04%

PTS 95.74% 95.74% 93.81% 93.97% 93.51% 92.80% 91.85% 91.36% 91.59% 91.93% 92.64% 93.18%

Operations Centre 6.78% 6.87% 8.84% 8.37% 7.65% 7.40% 8.14% 7.64% 6.78% 6.72% 7.15% 6.41% 6.94% 7.36%

Operations North & South 6.84% 6.84%

ECS 6.16% 7.48% 7.50% 7.60% 7.43% 7.40% 8.44% 8.52% 7.45% 5.34% 5.91% 6.61% 7.15%

PTS 6.56% 8.39% 8.48% 8.85% 9.59% 10.13% 9.23% 9.76% 10.87% 11.19% 8.21% 11.04% 9.36%


Operations North & South 0.36% 0.36%

ECS 0.68% 0.98% 0.77% 0.37% 0.35% 0.35% 0.20% 0.53% 0.27% 0.65% 0.55% 0.36% 0.51%

PTS 0.99% 0.23% 0.00% 2.75% 0.71% 0.68% 0.47% 0.00% 0.47% 1.05% 0.83% 0.24% 0.70%

Operations Centre 68.00% 73.00% 72.00% 73.00% 79.00% 80.00% 83.00% 84.15% 86.99% 85.57% 81.89% 82.83% 79.12%

Operations North & South 90.97% 88.63% 89.80%

ECS 82.00% 81.00% 82.00% 84.00% 87.00% 89.00% 91.00% 90.00% 95.00% 94.97% 87.60%

PTS 72.00% 75.00% 81.00% 82.00% 85.00% 86.00% 87.00% 84.15% 91.00% 92.18% 83.53%


ECS 99.62% 99.62% 99.74% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 99.95%

PTS 99.98% 99.82% 99.82% 99.82% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 99.96%

100-105% 95.54% 95.42% 93.61% 94.65% 95.12% 96.89% 96.05% 97.61% 96.75% 96.89% 94.67% 95.77%

<=5% 5.74% 6.64% 7.17% 7.00% 7.19% 7.22% 7.47% 7.54% 7.28% 6.32% 6.18% 6.19% 6.49% 6.89%

<=1.25% 0.84% 0.99% 1.38% 1.41% 0.58% 0.85% 0.68% 0.66% 0.51% 0.96% 0.92% 0.53% 0.56% 0.84%

>=95% 77.00% 78.00% 80.00% 81.00% 85.00% 86.00% 88.00% 88.00% 93.00% 93.89% 91.26% 89.55% 85.89%

57.20% 62.65% 62.43% 66.48% 66.48% 77.02% 70.34% 77.84% 79.77% 79.84% 79.02% 70.82%

100% 99.70% 99.60% 99.78% 99.90% 99.90% 99.74% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 100.00% 99.91%

<=1.25% Front Line Turnover Rate (FTE)

Workforce Headlines

100-105% Front Line Occupied Rate

<=5%Front Line Sickness

Absence Rate (% FTE Days)

Total Front Line DBS Compliance

Workforce AnalysisOverall the Trust-wide absence rate has risen slightly by 0.26% in comparison to last month and is now 6.49%. This reflects a 0.49% increase compared with June 2016. The FirstCare data warehouse has now been refreshed and is operating on

new logic which has resulted in a very slight increase of 0.04% in the absence rate. The frontline FTE turnover rate remains within target at 0.56% for front line staff. Statutory and Mandatory compliance and Performance Appraisal Completion

has reduced slightly in June 2017 to 89.55% and 79.02%.

The HCPC registration date for all paramedics is 1 September 2017. For frontline paramedic roles (Allied Health Professionals) is currently 98% matched (7 EU paramedic are currently going through the HCPC registration process and 4 newly

qualified students). Nursing NMC and Medical staffing GMC are both showing as 100% match and in-date this month.

ESR is reporting 100% compliance level for all employees who require a DBS check based on the position their currently hold within ESR system.

100% Front Line DBS Compliance

Total Front Line Occupied Rate

Trust-wide Sickness Absence Rate (% FTE Days)

Total Front Line Turnover Rate (FTE)

Total Front Line Stat & Mand Compliance

Total Trust Wide Appraisal Completion Rate (Rolling 12 Month)

>=95% Front Line Stat & Mand Compliance

0.00%

0.50%

1.00%

1.50%

2.00%

2.50%

3.00%

3.50%

4.00%

4.50%

Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17

Frontline Turnover Rate %

EC PTS Operations Centre Target Ops North and South

0%

1%

2%

3%

4%

5%

6%

7%

8%


Sickness Absence Rate (% FTE Days Lost)

Sickness Absence Rate (% Calendar Days Trust Wide) Target

Value Target Trend Jun 16 Jul 16 Aug 16 Sep 16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Grand Total

>=80% FFT (% Recommending) 90.00% 88.00% 82.20% 90.70% 83.70% 87.30% 88.60% 84.20% 89.40% 90.90% 88.10% 86.70% 84.00% 87.22%

FFT Responses 68 59 73 43 49 111 79 95 123 93 67 83 82 1025

Duty of Candour 1 1 2 7 6 0 3 1 0 1 0 0 5 27

Number of Assaults/Aggression on Staff Reported 0 2 0 0 0 2 0 3 3 1 0 0 0 11

Number of Incidents Reported 96 68 89 48 47 76 79 87 69 74 96 59 98 986

Number of Serious Incidents 2 0 1 2 1 2 1 1 0 0 3 2 1 16

Incidents Reported Moderate or Higher 1 1 3 3 3 3 3 3 3 3 3 3 5 37

Value Target Trend Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Grand Total

Calls Answered 40,247 42,528 40,377 40,357 42,610 39,409 44,111 40,919 36,461 37,165 35,624 40,736 39,045 519,589

ETA Calls 4,373 4,684 4,331 4,656 5,272 4,624 5,758 4,887 4,336 3,508 4,265 3,689 4,432 58,815

95% % 999 Calls Answered Within Target 97.13 % 95.48 % 98.85 % 95.68 % 96.06 % 96.60 % 94.45 % 94.49 % 95.47 % 97.17 % 95.45 % 93.30 % 95.31 % 95.80 %

<1% % Calls Abandoned 999 0.46 % 0.48 % 0.49 % 0.46 % 0.44 % 0.46 % 0.46 % 0.41 % 0.33 % 0.43 % 0.57 % 0.80 % 0.40 % 0.48 %

R1 % of Total Incidents MTD 3.08 % 3.26 % 3.08 % 3.10 % 3.39 % 3.21 % 3.34 % 3.33 % 3.51 % 3.02 % 3.09 % 3.35 % 2.98 % 3.21 %

R2 % of Total Incidents MTD 49.46 % 49.48 % 49.16 % 49.39 % 49.61 % 49.51 % 48.86 % 50.86 % 49.93 % 46.26 % 48.28 % 49.98 % 49.17 % 49.23 %

HCP Red Rate 16.32 % 16.32 %

111 Red Rate 27.51% 25.88% 25.78% 23.27% 21.61% 22.06% 23.04% 15.88% 25.74% 22.51% 23.54% 23.81% 23.10% 23.36 %

Hear and Treat (AQI) 8.1% 8.2% 9.1% 8.4% 8.8% 9.1% 9.7% 8.7% 8.8% 7.2% 7.3% 7.7% 7.02% 8.32 %

999 Contact Centre Appreciations 2 5 3 3 1 8 4 7 2 8 2 3 2 50

999 Contact Centre Complaints 36 31 40 36 34 28 26 22 18 15 11 8 17 322

999 Safeguarding Alerts 56 82 61 38 61 82 145 45 26 94 49 106 71 916

999 Patient Safety Incidents 16 7 13 13 15 16 18 13 9 9 17 10 71 227

Value Target Trend Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Grand Total

Calls Answered 52,515 56,839 81,781 50,041 57,951 55,252 69,457 65,372 57,387 61,894 79,920 75,613 68,490 832,512

95% Calls Answered within 60 Seconds 96.30 % 95.00 % 96.20 % 95.40 % 94.80 % 95.80 % 92.50 % 93.20 % 93.80 % 95.82 % 91.93 % 92.03 % 95.90 % 94.5%

>60% 111 Call Triage Rate 88.00 % 87.90 % 87.00 % 87.10 % 87.60 % 88.60 % 88.00 % 88.00 % 87.40 % 87.96 % 87.53 % 87.70 % 87.97 % 87.8%

>95% 111 Warm Transfer Rate 55.51 % 52.76 % 51.97 % 48.37 % 47.31 % 61.69 % 57.58 % 65.22 % 62.86 % 46.10 % 41.22 % 43.27 % 39.36 % 51.8%

>95% 111 Call Back in 10 Performance 39.63 % 37.72 % 39.96 % 40.37 % 36.68 % 39.46 % 47.24 % 50.03 % 46.37 % 44.40 % 36.78 % 39.57 % 46.87 % 41.9%

<5% 111 Calls Referred to ED 6.43 % 6.22 % 5.57 % 5.73 % 5.48 % 5.74 % 5.06 % 5.14 % 4.88 % 4.74 % 3.68 % 3.98 % 4.14 % 5.1%

<10% 111 Calls Referred to 999 15.02 % 14.51 % 14.26 % 14.70 % 15.18 % 16.38 % 15.45 % 16.19 % 15.27 % 15.37 % 13.28 % 13.81 % 14.34 % 14.9%

111 Appreciations 5 4 2 1 1 0 1 7 2 6 0 3 0 32

111 Complaints 4 6 7 3 2 3 2 3 0 3 0 0 0 33

111 Safeguarding Alerts 141 137 143 134 118 132 121 112 85 57 68 78 110 1436

Safe 111 Patient Safety Incidents 11 11 11 11 8 20 9 14 5 36 31 11 16 194

Value Target Trend Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct-16 Nov-16 Dec-16 Jan - 17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Grand Total

70% % PTS Calls Answered Within 60 seconds 93.74 % 93.50 % 96.49 % 96.28 % 90.66 % 88.11 % 90.26 % 93.70 % 90.52 % 94.38 % 94.97 % 88.38 % 85.32 % 92.02 %

% Calls Abandoned PTS 1.00 % 0.95 % 0.90 % 1.08 % 1.80 % 1.58 % 1.21 % 0.52 % 0.94 % 0.46 % 0.21 % 1.21 % 1.65 % 1.04 %

PTS Contact Centre Appreciations 3 1 2 1 2 1 1 0 0 0 4 0 1 16PTS Contact Centre Complaints 13 12 8 14 11 9 6 8 3 3 0 0 0 87

Caring

Effective

Caring

Safe

NHS 111

Responsive

Effective

In Development

Patient Transport Service

Responsive

Caring

Operations Centre

Caring

Safe

999 Contact Centre

Responsive

All call taking service levels have been achieved in June 2017 with both 999 and 111 service levels seeing an improved performance. Call levels for 111 service have started to reduce following the increase in demand resulting from service changes in

the south of the region, however calls answered for June 2017 are still over 30% higher than seen in June 2016.

Hear and Treat rates have continued to reduce based on AQI definitions dropping to 7.02% for June 2017, almost 1% lower than in June 2016. The rate of incidents managed without the need to transport to A&E was 36.5% in June 2017. Clinical call

audits are being used to identify learning and improvement opportunities to improve hear and treat rates amongst clinicians. This will be monitored and reviewed to reduce variation amongst clinicians in the clinical hub.

Referrals from 111 to Emergency Department continues to meet the 5% target, however has started to increase slightly. This increase is being addressed through individual performance management and targeted training for clinicians.

111 calls referred to 999 has increased slightly in June 2017 reaching 14.34%, with the proportion of 111 calls referred to 999 which received an ambulance response at 11.78%.

Friends and Family Test results have exceeded the target of 80% however show a reducing trend since March 2017.

Operations Centre Analysis

1

19

72

7.08

27.11

47.45

1

33

85

7.77

27.57

50.97

0102030405060708090

100110120130140150160

Time to answer call (inseconds) (Median)

Time to answer call (inseconds) (95th percentile)

Time to answer call (inseconds) (99th percentile)

Time to treatment for Cat Acalls (in minutes) (median)

Time to treatment for Cat Acalls (in minutes) (95th

percentile)

Time to treatment for Cat Acalls (in minutes) (99th

percentile)

999 Operational Ambulance Quality Indicators - May 2017

Previous Month Best Trust Worst Trust Current month NEAS

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%

10.00%


Operations Centre Sickness Rate

Operations Centre % Target %

0.80%

13.42%

5.24%7.65%

36.78%

0.57%

13.11%

4.73%7.31%

36.09%

0%

10%

20%

30%

40%

50%

60%

Percentage of calls abandoned beforebeing answered

Re-contact occurs within 24 hoursfollowing Hear & Treat

Re-contact occurs within 24 hoursfollowing See & Treat

Calls resolved by telephone advice Patients treated without conveyance toA&E

Operational Ambulance Quality Indicators - May 2017

Current month NEAS Previous Month England Average Best Trust Worst Trust

Value Target Trend Jun 16 Jul 16 Aug 16 Sep 16 Oct-16 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Grand Total

75% R1 Performance % MTD 65.74 % 65.23 % 68.07 % 63.29 % 64.94 % 64.86 % 67.40 % 69.36 % 72.01 % 72.16 % 73.14 % 72.11 % 75.42 % 68.75 %



75% G1 in 20 Performance % MTD 28.64 % 32.80 % 29.04 % 29.45 % 26.53 % 28.08 % 23.42 % 23.70 % 27.10 % 36.01 % 36.59 % 30.13 % 29.77 % 29.33 %

75% G2 in 30 Performance %: MTD 39.58 % 36.57 % 40.87 % 39.11 % 33.59 % 36.77 % 30.72 % 34.91 % 38.10 % 47.43 % 46.82 % 37.91 % 40.45 % 38.68 %

75% G3 in 60 Performance % MTD 62.53 % 61.00 % 65.81 % 66.81 % 62.90 % 59.94 % 54.85 % 60.27 % 57.57 % 66.67 % 64.75 % 62.30 % 60.70 % 62.01 %

60% Urgent in 60 Performance % MTD 37.91 % 34.62 % 37.77 % 32.23 % 33.45 % 33.86 % 29.91 % 33.60 % 34.94 % 40.22 % 36.14 % 35.78 % 32.42 % 34.83 %



Handover Delays Hours Lost (>15mins) 611:12:00 491:47:00 488:57:00 492:07:00 458:44:00 543:08:00 983:49:00 1384:09:00 834:57:00 424:37:00 477:39:00 599:23 346:43:00 7537:49:00

Handover < 15 Mins % 66.4% 66.8% 67.0% 67.7% 66.2% 68.1% 64.8% 61.3% 66.3% 73.6% 72.5% 63.2% 74.6% 67.57 %

Handover 15 to 30 Mins % 9.2% 10.0% 10.4% 9.3% 10.5% 9.6% 13.0% 12.9% 12.3% 10.0% 10.5% 10.4% 9.5% 10.58 %

Handover 30 to 60 Mins % 2.5% 2.5% 2.6% 2.2% 2.6% 2.3% 3.0% 5.2% 4.1% 2.0% 2.7% 2.9% 1.8% 2.80 %

Handover 60 to 120 Mins % 0.6% 0.4% 0.5% 0.5% 0.5% 0.5% 1.2% 1.9% 1.0% 0.3% 0.3% 0.7% 0.3% 0.67 %

See and Treat Incidents % 22.96 % 24.20 % 24.11 % 24.70 % 23.11 % 22.98 % 23.75 % 23.46 % 24.03 % 24.58 % 25.48 % 26.27 % 26.47 % 24.3%

Average Job Cycle Time 01:31:39 01:29:45 01:29:49 01:31:23 01:32:25 01:31:00 01:44:47 01:46:10 01:42:38 01:37:13 01:38:38 01:40:54 01:39:50 01:36:38

Late Finishes (Hours) 3,331.57 3,466.67 3,353.83 3,149.30 3,349.03 3,461.07 4,281.67 4,228.00 3,577.00 3,383.00 3,470.00 3,615.00 3,037.00 45703.14

80% FFT (% Recommending) 100.00% 96.70% 100.00% 100.00% 98.80% 95.70% 96.60% 93.80% 97.40% 96.80% 98.60% 97.00% 96.90% 97.56%

FFT Responses 20 30 43 44 80 92 58 160 117 126 147 132 160 1209

Appreciation 48 51 47 60 44 56 47 85 63 61 65 66 44 737

Complaint 9 21 16 15 14 11 13 11 10 16 14 13 16 179

Safeguarding Alerts 655 677 655 688 693 665 685 750 741 756 844 791 792 9392

Assaults/Aggression on Staff Reported 25 23 15 26 35 30 38 31 28 39 36 31 28 385

Duty of Candour 2 2 2 1 1 2 6 4 0 2 1 2 1 26

Patient Safety Incidents 37 34 28 34 32 28 60 69 36 46 39 54 46 543

Incidents Reported* 190 184 197 204 185 180 229 227 150 200 203 183 190 2522

Serious Incidents 3 1 1 0 0 0 1 1 0 2 1 0 1 11

Incidents Reported Moderate or Higher* 11 14 13 12 10 10 10 10 10 12 10 10 12 144

Emergency Care Services

Effective

Caring

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

5,000

10,000

15,000

20,000

25,000

Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb - 17 Mar - 17 Apr - 17 May-17 Jun-17

Red Volume and Performance

R1 Incident R2 Incident R1 Performance % R2 Performance % R19 Performance % Red 8 Target Red 19 Target

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb - 17 Mar - 17 Apr - 17 May-17 Jun-17

Green Volume and Performance

G1 Incident G2 Incident G3 Incident G1 in 20 Performance % G2 in 30 Performance % G3 in 60 Performance % Green Target

June 2017 saw similar levels in overall Red 8 and Red 19 performance. Red 2 performance decreased slightly to 56.95%, whereas Red 1 performance increased to above 75% at 75.45%, achieving the national target. Of the local CCGs, all were below 75% in June 2017 for overall Red performance.

Decreases were also seen in performance against most Green and Urgent priorities, with Green 2 and Urgent 4 hour the only areas to see improvement. It is the first time since July 2015 that NEAS has achieved monthly Red 1 performance above the target of 75%. Red 1 performance as at 19th July

2017 was 73.60%.

National benchmarking data for May 2017 shows that NEAS is above the national average for Red 1 performance that month. Of the eight trusts that are currently reporting performance against the three national standards, South Central Ambulance Service reported performance above the Red 1

national standard and London Ambulance Service were above the Red 19 standard. They were the only two services to have achieved any of the three national standards.

In June 2017 22 patients waited longer than 60 minutes for a Red response, of these 4 were attributable to data recording issues. This represents a reduction compared with May 2017, however remains above the number recorded for June 2016 when 5 patients waited more than 60 minutes. Patients

waiting longer than 8 hours for a Green response and longer than 12 hours for an Urgent response also reduced in June 2017 compared with May 2017, falling from 17 to 8 for Green incidents, and 23 to 0 for Urgent incidents.

NEAS continues to achieve its Red 1 forecast, but has failed to achieve either R2 or R19, missing the forecast position by 9.43% and 0.71% respectively. An RPIW is planned for August 2017 to review in depth Red 2 performance.

Overall incident volumes are higher than last year, with NEAS responding to 4.07% more incidents for the year to date than in 2016/17. There remains a high volume of Red demand in June 2017 of 550 per day, which is +3.33% (532 incidents) higher than the June 2016 volumes.

See and Treat rates continue to show improvement compared with the previous year. June 2017 achieved 26.47% See and Treat rate an improvement of 3.51% compared with June 2016.

Handover delays have reduced in June 2017, with only 346 hours lost to handovers over 15 minutes. This is at the lowest level since September 2015, with 74.6% of handovers completed within the 15 minute target. Overall turnaround times at hospital remains low with only 35.8% within the 30

minute target for June 2017. Work is on-going to improve the accuracy of handover and turnaround times through use of the EPCR data, this will also ensure that recording processes are consistent across the region.

The volume of late finishes has reduced to 3,037 hours, a reduction of 16% compared with May 2017.

The number of official diverts between hospitals was 8 in June 2017, down significantly from 25 in May 2017. This impacted on 40 patient journeys.

NEAS was below the national average for 4 of the 8 National Clinical Indicators (current reporting month is February 2017), including 100% achievement of PPCI treatment within 150 minutes, reflecting the best position nationally. Local increases from January 2016 were seen in 5 indicators. ROSC and

Survival to Discharge performance remain the key challenges for the Trust.

Emergency Care Service Analysis

100.00%

86.57%

22.34%

47.83%

7.45%

34.78%

53.28%

98.17%

81.82%

88.16%

26.04%

50.00%

6.91%

32.00%

49.26%

96.25%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

PPCI treatment within 150 minutes STEMi Care Bundle ROSC ROSC [Utstein] Survival to discharge Survival to discharge [Utstein] FAST positive within 60 minutes Stroke Care Bundle

Clinical Ambulance Quality Indicators - February 2017

Current month NEAS Previous Month England Average Best Trust Worst Trust

19645 20339 19020 19539 20584 20136 21627 21479 18766 20693 20192 20320 19221

492.25 489.1 492.07458.36

543.08495.39

983.49

1384.15

834.57

424.37477.39

599.23

346.43

0

200

400

600

800

1000

1200

1400

0

5000

10000

15000

20000

25000

Jun/2016 Jul/2016 Aug/2016 Sep/2016 Oct/2016 Nov/2016 Dec/2016 Jan/2017 Feb/2017 Mar/2017 Apr/2017 May/2017 Jun/2017

Ho

urs

Lo

st

Arr

ival

s

Arrivals and Time Lost to Handovers

Arrivals Hours Lost to Handover Linear (Hours Lost to Handover)

0.00%

1.00%

2.00%

3.00%

4.00%

5.00%

6.00%

7.00%

8.00%

9.00%

10.00%


ECS Sickness Rate %

Sickness Absence Rate Target %

Value Target Trend Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Grand Total

Effective 90% Time On Vehicle < 60 % 94.39% 94.66% 94.57% 94.10% 93.99% 93.32% 94.01% 94.52% 94.29% 93.80% 94.17% 93.15% 93.51% 94.04%

80% On Time Arrival At Treatment Centre % 80.45% 80.30% 79.98% 80.13% 80.08% 79.96% 79.12% 78.61% 79.33% 79.09% 79.78% 79.16% 79.65% 79.66%

85% Treatment Centre Collection Within 60 % 87.06% 88.15% 87.95% 87.59% 87.92% 85.75% 86.33% 87.29% 86.89% 87.57% 88.63% 88.30% 86.57% 87.38%

95% Treatment Centre Collection Within 90 % 96.78% 97.13% 97.15% 97.22% 97.25% 96.42% 96.76% 97.19% 96.56% 97.24% 97.50% 97.54% 97.21% 97.07%

80% PTS FFT (% Recommending) 93.80% 87.20% 94.50% 90.90% 95.20% 93.00% 92.90% 94.90% 97.10% 94.40% 97.40% 98.50% 98.50% 94.48%

PTS FFT Responses 385 474 384 263 333 341 169 494 102 337 153 68 68 3,571

PTS Appreciation 11 5 5 9 4 7 10 9 2 12 11 8 12 105

PTS Complaint 3 0 7 3 6 6 5 4 8 0 4 4 4 54

Number of Assaults/Aggression on Staff Reported - PTS 5 4 3 1 3 3 3 1 4 6 8 4 4 49

Duty of Candour 2 1 0 0 0 0 0 0 0 0 0 0 1 4

PTS Safeguarding Alerts 17 11 17 8 15 7 10 7 11 11 6 11 4 135

Number of Incidents Reported - PTS 39 40 34 34 38 38 33 54 51 51 29 37 54 532

Number of Incidents Reported Moderate or Higher - PTS 3 3 0 5 2 2 2 1 5 2 0 1 4 30

Patient Transport Service Analysis

PTS performance against key indicators continues to be maintained, with only on time arrival at treatment centre, marginally below target at 79.65% (80% target).

Patient satisfaction has remained high in June 2017 at 98.5%, the highest rate in the 13 month reporting period.

Patient Transport Service

Responsive

Caring

Safe

0

10000

20000

30000

40000

50000

60000

Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb - 17 Mar - 17 Apr - 17 May - 17 Jun - 17

PTS Activity By Vehicle

Ambulance Third Party Providers Unknown Winter Pressure Vehicles

0

10000

20000

30000

40000

50000

60000

70000

Jun - 16 Jul - 16 Aug - 16 Sep - 16 Oct - 16 Nov - 16 Dec - 16 Jan - 17 Feb - 17 Mar - 17 Apr - 17 May - 17 Jun - 17

PTS Journeys by Contract

Planned Bookings Same Day Bookings

Our badge stands for unmatched quality of care for every life we touch.

NEAS Performance Improvement Plan 2017/18

Not achieved and now overdue

Risk of non-achievement

On track for achievement

Completed

NEAS: Performance Improvement Plan 2017/18

Page 2 of 17

Contributors

Change Record

Project title: NEAS Performance Improvement Plan

Author: Victoria Court

Owner: Paul Liversidge

Customer:

Date: 12/05/17

Version: V1

Name Position

Alison Kimber Clinical Services Manager

Gilliam McArthur Strategic Head operations Centre

Hannah Winney Performance Lead

Paul Liversidge COO

Date Version Name Change

Our badge stands for unmatched quality of care for every life we touch.

1. INTRODUCTION ............................................................................................................................................................................... 4

1. RECRUIT TO NEW ESTABLISHMENT 2017/18 .............................................................................................................................. 5

2. MAXIMISE CLINICAL STAFF ON FRONTLINE VEHICLES ............................................................................................................ 6

3. REDUCE DEMAND........................................................................................................................................................................... 7

4. FOCUS ROBUST MANAGEMENT ON FRONTLINE DELIVERY .................................................................................................... 8

5. ADDITIONAL OBJECTIVES ............................................................................................................................................................. 9

6. RESPONSE PERFORMANCE TRAJECTORIES 2017/18 ............................................................................................................. 10


Page 4 of 17

1. Introduction

The NEAS Performance Improvement Plan sets out the key actions to be undertaken which will ensure achievement of our response time performance trajectory as set out in our Operational Plan 2017/19. Our approach to improving response performance covers four key areas: 1) recruitment to increased establishment, 2) alignment of demand and capacity, 3) managing demand and 4) providing managers with the tools and information to improve performance.

Following investment from commissioners for additional Paramedics and building on the success of achieving full establishment of paramedics in April 17, continued recruitment of frontline staff remains a key part of our Improvement Plan. This work reflects NEAS’ low ratio of paramedics per square mile and per 10,000 of the population, that impacts on our ability to meet the needs of the population as well as national response targets and also delivery of the new see and treat requirements.

Maximising time spent caring for patients will further improve our response performance through increased availability and efficiencies by releasing time to care. These activities focus on reviewing our rota lines and abstraction processes as well as developing improvement solutions to reduce ‘waste’ and increase time available for patient care.

Managing the demand into the service and specifically reducing ambulance responses will further support improvement of response times. Over recent years we have experienced an increase in red demand, the most serious life-threatening cases, which has put additional pressure on our service and contributed to deteriorating response performance. Through enhanced clinical triage through the Clinical Hub, increased Hear and Treat and See and Treat rates we aim to release some of the pressure felt by not only crews on the road but also the whole urgent and emergency care pathway. We are working with our partners also to ensure avoidable health care professional red requests and GP urgent requests are more appropriately managed.

Finally, we need to ensure that our staff and managers have access the right information and the most appropriate tools to manage our resources effectively. We are developing reports, dashboards and agile solutions to ensure we can make best use of the resources we have available, identify training needs quickly and improve systems to ensure they meet the needs of our crews.

We are also doing some work internally to ensure our that we can calculate resources available match that required from our demand profile taking into consideration service reconfigurations, both historic and planned, which have increased our overall cycle time and therefore subsequent resource requirements e.g. stroke.


Page 5 of 17

1. Recruit to New Establishment 2017/18

Ref Objective Actions Lead Target Date

Status Notes

1.1 Recruit 42 Paramedics new staff 1.1.1 Review International recruitment campaigns for

paramedics

Neil Gatenby

Jan 18

3/7/17 – 12 2/10/17 – 6 13/11/17 – 20 15/01/18 - 8

1.1.2 Develop proposal on nurse conversion scheme

options

Elaine Mcdonald/Debra

Stephen

Sep 17

1.2 Review the role of the ECA 1.2.1 Agree the future role of ECAs within the Trust C Black/Paul Aitken Fell

Aug 17

1.2.2 Review historic training of ECAs to ensure ECAs are fit for future purpose i.e. frontline deployment under all previous training provided.

C Black/Paul

Aitken fell

Aug 17

1.3 Recruit 42 ECAs 1.3.1 Actively recruit and train to full ECA establishment

Neil Gatenby Feb 18

15/5/17 – 6 12/6/17 – 15 21/8/17 – 6 18/9/17- 9 8/1/18 – 6 5/2/18 - 12

1.4 Target Degree paramedics to come to NEAS

1.4.1 Visit Teeside and assess and give conditional offers to all students

Neil Gatenby PAF

June 17

1.5 Recruit 12 APPs 1.5.1 Recruit to fill all APP vacancies. To ensure we meet the staffing requirement cover is currently being provided by a third party agency (Amber) as we recruit this will be reduced

Neil Gatenby/Steve

Adams

July 17


Page 6 of 17

2. Maximise Clinical Staff on frontline vehicles

Ref Objective Actions Lead Target Status Notes/update

2.1 Maximise DCA capacity 2.1.1 Return all clinically trained staff to front-line patient facing duties by reducing abstractions

V Court

Ongoing

Monitoring against Targets

2.1.2 Create a tool to identify staffing shortfalls

V Court April 2017

2.1.3 Create a dynamic staffing plan based on

predicted shortfalls

V Court September

2017

2.2 Attendance management 2.2.1 Roll out management training to increase skills of management team in sickness management

G Hunter

August

2017

2.2.2 Review Sickness Policy K Forsyth

August

2017

2.2.3 Undertake monthly sickness audits

V Court

Ongoing

2.3 Review late finishes of

operational staff

2.3.1 Review current rosters/shift profilesto ensure maximum overlap where possible

V Court

June 2017

2.3.2 Review dispatch procedures for calls that require a dispatch during the last hour of a crews shift

L Pyburn

July 2017

2.3.3 Ensure that new rosters/shift profiles allow/ incorporate staggered start/finish times

V Court

September

2017

2.4 Focus on downtime 2.4.1 Develop Trust level and individual level downtime reporting

H Winney

April 2017

2.4.2 Identify priority downtime categories and set appropriate targets

H Winney

April 2017


Page 7 of 17


2.4.3 Provide training / coaching to ECCMs to support employees to reduce downtime to targets set

V Court

June 2017

2.6 Reduce Handover to Clear 2.6.1 Using individual Performance data manage staff to reduce average Handover to Clear to 15 minutes

V Court

Ongoing

2.6.2 Develop Individual Performance Management Policy

V Court

August

2017

2.7 Pro-active Management 2.7.1 Train on-call managers who will be positioned in EOC in the relevant systems to assist with pro-active management

V Court

August

2017

2.8 Performance and situation reporting

2.8.1 Review current performance reporting – Create an Agile Operational LIVE Dashboard for Managers

Z Phipps

July 2017

3. Reduce Demand


3.1 Analysis of HCP Red Calls 3.1.1 Create a process to allow HCP calls to be

identified by source to assist with future analysis

H Winney

July 2017

3.2 Increase See and Treat 3.2.1 Complete options appraisal to review alternative

models for delivering improved see and Treat rate

V Court/Dan

Haworth

July 2017

3.3 Increase Hear and treat 3.3.1 Clinical Call Audits performed monthly. Action

plans for staff with lower than required rates

G

McArthur/Mathew Beattie

August

2017


Page 8 of 17

3.4 Team based performance

metrics

3.4.1 Team based data on Call to dispatch, Red 1 and Red 2 performance, Cancellations and rest break allocation

G McArthur

August

2017

3.4.2 Action Plans for Teams not meeting the required performance metrics

G McArthur

August

2017

4. Focus robust management on frontline delivery


4.1 Private and volunteer ambulance provision

4.1.1 Review current PAS usage V Court

Ongoing

4.1.2 Fluctuate Pas usage in line with staffing

projections

V Court

Ongoing

4.2 Review the organisational structure to maximise local decision making, empowerment and ownership

4.2.1 Review and agree new organisational structure

V Court

April 2017

4.2.2 Review Operational Manager portfolios and ensure fitness for purpose

V Court

June 2017

4.2.3 Recruit to vacant Operational Management roles

V Court

June 2017

4.2.4 Set up a short-life working group to oversee the implementation of new organisation structure

V Court

June 2017


Page 9 of 17

5. Additional Objectives


5.1 Review stakeholder engagements and strengthen relationships particularly with other emergency services

5.1.1 Ensure new management structure encourages improved stakeholder relationships with a specific focus on other emergency services, HOSCs, commissioners, CCGs, acute Trusts and Health Watch groups

V Court

July 2017

5.1.2 Review arrangements for liaison/ meeting structure with other emergency services

S Swallow

July 2017

5.1.3 Implement improved joint working with other emergency services

S Swallow

July 2017

5.1.7 Review internal communication arrangements

M Cotton

Ongoing

5.2

Understand the reasons for the poor Red 2 Performance

5.2.1 Hold an Improvement Event to map out the Red 2 Call process and identify key action points

G McArthur

July 2017

5.3 Create a culture of accountability, delivery and patient-service centred organisation

5.3.1 Annual CPD courses to include a focus on customer care / positive relationships and discussion on implications of new vision and values

E McDonald

August

2017

5.3.2 Corporate induction of new staff and internal courses will all receive a Trust brief from Band 7 or above

V Court

June 2017

5.4 Review the Trust’s branding 5.4.1 Undertake a review of the Trust’s branding to reflect integration of PTS & EC

C Knowles

September

2017

5.5 Improve engagement and support for volunteers and Community First Responders (CFRs)

5.5.1 Review current arrangements for management of CFR groups

G Campbell

June 2017

5.6 Review major emergency responses capabilities and managerial on-call arrangements

5.6.1 Undertake a review of the Trust’s major emergency response capabilities through an external audit

S Swallow

May 2017


Page 10 of 17


5.6.2 Review managerial on-call arrangements to ensure alignment of new operational structure

S Swallow

June 2017

6. Response Performance Trajectories 2017/18

Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Qtr 1 Qtr 2 Qtr 3 Qtr 4 Year end


Actual 73.14% 72.11% 75.45% 73.48% - - - 72.32%


Actual 60.69% 57.06% 56.95% 58.21% - - - 61.49%


Actual 90.05% 87.59% 87.51% 88.37% - - - 88.78%

Red 1

Red 2

Red 19


Page 11 of 17

Monthly Updates

1. Recruit to New Establishment 2017/18

Ref Objective Actions Lead Notes/update

1.1 Recruit 42 Paramedics new staff 1.1.1 Review International recruitment

campaigns for paramedics

Neil Gatenby

June 2017

Paper submitted proposing recruitment from Australia. Poland is no longer delivering as pool is exhausted and Brexit is having an impact.

1.1.2 Develop proposal on nurse conversion

scheme options

Elaine Mcdonald/

Debra Stephen

June 2017

Elaine McDonald - A discussion has taken place with the University of Cumbria and they can offer Nurse Conversation over one year. This has been overtaken by events as a bigger meeting Chaired by Jo Baxter has identified a wider more joined up approach is required not just looking at nurses but other health care professionals.

1.2 Review the role of the ECA 1.2.1 Agree the future role of ECAs within the Trust

C Black/Paul Aitken Fell

June 2017 Under discussion with ET

1.2.2 Review historic training of ECAs to ensure ECAs are fit for future purpose i.e. frontline deployment under all previous training provided.

C

Black/Paul

Aitken fell

June 2017 Elaine McDonald – the ECA course has been reviewed and revised to ensure it is fit for purpose. A meeting is due to take place with Victoria Court to ensure that the Apprenticeship is embedded within the ECA course from September 2017 to support the Trust with the Apprenticeship Levy

1.3 Recruit 42 ECAs 1.3.1 Actively recruit and train to full ECA establishment

Neil Gatenby

June 2017 90 ECAs assessed to date. Pre-employment checks turnaround is tight due to operational capacity to provide assessors.

1.4 Target Degree paramedics to come to NEAS

1.4.1 Visit Teeside and assess and give conditional offers to all students

Neil Gatenby

PAF

June 2017 Speed Assessments held for next year’s Teesside Paramedic Grad’s and will be sending conditional offer letters to 40WTE of them subject to final assessment closer to graduation date.

1.5 Recruit 12 APPs 1.5.1 Recruit to fill all APP vacancies. To ensure we meet the staffing requirement cover is currently being provided by a third party agency (Amber) as we recruit this will be reduced

Neil Gatenby/S

teve Adams

June 2017 App recruitment is ongoing and is currently on target


Page 12 of 17

2. Maximise Clinical Staff on frontline vehicles


2.1 Maximise DCA capacity 2.1.1 Return all clinically trained staff to front-line patient facing duties by reducing abstractions

V Court

2.1.2 Create a tool to identify staffing

shortfalls

V Court June 2017

GRS rebuild will provide this capability in September.

2.1.3 Create a dynamic staffing plan based

on predicted shortfalls

V Court June 2017

Rebuild of GRS will provide the planning tool to identify shortfalls

in staffing aligned to demand.

2.2 Attendance management 2.2.1 Roll out management training to increase skills of management team in sickness management

G Hunter

June 2017

Recruiting additional HR partner to design and deliver training.

2.2.2 Review Sickness Policy K Forsyth

2.2.3 Undertake monthly sickness audits

V Court

2.3 Review late finishes of

operational staff

2.3.1 Review current rosters/shift profiles to ensure maximum overlap where possible

V Court

June 2017 Modelling will be undertaken by ORH to identify the staffing requirements to ensure adequate staffing at changeover and reduce late finishes. This modelling will not be available until November

2.3.2 Review dispatch procedures for calls that require a dispatch during the last hour of a crews shift

L Pyburn

2.3.3 Ensure that new rosters/shift profiles allow/ incorporate staggered start/finish times

V Court

June 2017

Will be addressed in the rota review

2.4 Focus on downtime 2.4.1 Develop Trust level and individual level downtime reporting

H Winney

June 2017

A Trust level downtime report has been developed and is produced on a monthly basis. Individual level reports have been developed with operational managers. These reports are


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now available for managers to access.

2.4.2 Identify priority downtime categories and set appropriate targets

H Winney

June 2017

Downtime categories have been reviewed and revised to ensure consistent application and meaningful analysis. Downtime targets have been set for those categories where operational efficiencies could be made. These targets are included within the individual level reports to allow managers to review team performance.

2.4.3 Provide training / coaching to ECCMs to support employees to reduce downtime to targets set

V Court

June 2017

ECCM Meetings being used to train staff

2.6 Reduce Handover to Clear 2.6.1 Using individual Performance data manage staff to reduce average Handover to Clear to 15 minutes

V Court

June 2017

Individual Performance data now available. Comms issued regarding the importance of logging in to Terrafix.

2.6.2 Develop Individual Performance Management Policy

V Court

June 2017

Will start on this Policy when the Rostering Policy and associated procedures are signed off in July

2.7 Pro-active Management 2.7.1 Train on-call managers who will be positioned in EOC in the relevant systems to assist with pro-active management

V Court

June 2017

Familiarisation sessions undertaken. Session held on Roles and responsibilities and a Scope of Practice developed. Go live in August

2.8 Performance and situation reporting

2.8.1 Review current performance reporting – Create an Agile Operational LIVE Dashboard for Managers

Z Phipps

3. Reduce Demand



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3.1 Analysis of HCP Red Calls 3.1.1 Create a process to allow HCP calls to

be identified by source to assist with future

analysis

H Winney

June 2017

A Cleric development is being requested to allow improved analysis of HCP calls. The next Cleric development will be in place in April 2018.

3.2 Increase See and Treat 3.2.1 Complete options appraisal to review

alternative models for delivering improved see

and Treat rate

V Court/

Dan Haworth

June 2017 Task and Finish Group established to analyse best use of Funding for See and Treat.

3.3 Increase Hear and treat 3.3.1 Clinical Call Audits performed monthly. Action plans for staff with lower than required rates

G

McArthur/Mathew Beattie

June 2017

Current hear and treat rate for June 2017 was 7.1%. Clinical Auditor is focusing an element of call audit reviews on those staff with below standard hear and treat rates to identify any educational needs and provide face to face support. The staff will be monitored on this element for the next three months to understand what, if any, improvements are made their performance. There is wide variation across the team with some staff having an above average performance of between 10-15% and only a minority that perform poorly that lowers the team average.

3.4 Team based performance

metrics

3.4.1 Team based data on Call to dispatch, Red 1 and Red 2 performance, Cancellations and rest break allocation

G

McArthur

June 2017

1) Rest break allocation is reviewed weekly by LC and monthly in the DM 1-1 meetings.

2) Dispatch performance for R1 and R2 is monitored on an individual basis through the dashboard and fed back to the team

3.4.2 Action Plans for Teams not meeting the required performance metrics

G

McArthur

June 2017

1) Fully auditable process in place for call handling compliance with metrics

2) Data now available for individual clinician performance and this is managed at the 1-1 meeting with line manager

3) Duty manager metrics and plan being reviewed on the Duty managers away day on the 30th August


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4. Focus robust management on frontline delivery


4.1 Private and volunteer ambulance provision

4.1.1 Review current PAS usage V Court

June 2017 Meeting booked with S Darrie to understand the process to monitor staffing going forward

4.1.2 Fluctuate Pas usage in line with staffing

projections

V Court

June 2017 Process established to align PAS to staffing shortfalls

4.2 Review the organisational structure to maximise local decision making, empowerment and ownership

4.2.1 Review and agree new organisational

structure

V Court

June 2017 Phase 2 now agreed. Communication to staff and consultation process started.

4.2.2 Review Operational Manager portfolios and ensure fitness for purpose

V Court

June 2017

Individual Objectives issued. To be monitored at monthly 121s

4.2.3 Recruit to vacant Operational

Management roles

V Court

June 2017 Remaining Band 7 posts in the Ops Centre on hold until at risk staff resolved

4.2.4 Set up a short-life working group to oversee the implementation of new organisation structure

V Court

June 2017

Complete – all new managers in post with all required equipment and access.

5. Additional Objectives


5.1 Review stakeholder engagements and strengthen relationships particularly with other emergency services

5.1.1 Ensure new management structure encourages improved stakeholder relationships with a specific focus on other emergency services, HOSCs, commissioners, CCGs, acute Trusts and Health Watch groups

V Court

June 2017

Mapping process undertaken of all current meeting requests and engagement events. Individuals identified to attend each meeting

5.1.2 Review arrangements for liaison/ meeting structure with other emergency

S Swallow June 2017

Regular meetings attended with other emergency services i.e.


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services

Safety Advisory Groups, Local Resilience Forums. Third party providers are invited once annually to the Trusts Emergency Preparedness Resilience & Response Group as part of the Civil Contingency Act (2004) cycle of business

5.1.3 Implement improved joint working with other emergency services

S Swallow June 2017

Joint working with other emergency services conducted regularly whereby debriefs take place to ensure good practice and lessons learnt can be captured to improve joint working. Furthermore, exercises are held with other emergency services whereby different scenarios are put in place to test practices in place whilst working together.

5.1.7 Review internal communication

arrangements

M Cotton

June 2017 Communication is a Strategic Objective and as such will be addressed through the monitoring of progress in that forum

5.2

Understand the reasons for the poor Red 2 Performance

5.2.1 Hold an Improvement Event to map out the Red 2 Call process and identify key action points

G McArthur

June 2017

RPIW booked for August 2017. Report and action plan will be shared once complete

5.3 Create a culture of accountability, delivery and patient-service centered organisation

5.3.1 Annual CPD courses to include a focus on customer care / positive relationships and discussion on implications of new vision and values

E

McDonald

June 2017

Mission, Vision and Values are now embedded within Statutory and Mandatory Training and all Core Courses. Staff receive the video on the Trust’s Values on these courses as well.

5.3.2 Corporate induction of new staff and internal courses will all receive a Trust brief from Band 7 or above

V Court

June 2017

Complete

5.4 Review the Trust’s branding 5.4.1 Undertake a review of the Trust’s branding to reflect integration of PTS & EC

C Knowles

July 2017

Clinical Care and Transport launched. Comms plan formulated.

5.5 Improve engagement and support for volunteers and Community First Responders (CFRs)

5.5.1 Review current arrangements for management of CFR groups

G

Campbell

June 2017

CFR Cluster created with clear line management structure

5.6 Review major emergency responses capabilities and managerial on-call arrangements

5.6.1 Undertake a review of the Trust’s major emergency response capabilities through an external audit

S Swallow

June 2017

Recently undertaken a full audit of capabilities with NARU. Action plan formulated and In Progress


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5.6.2 Review managerial on-call arrangements to ensure alignment of new operational structure

S Swallow

June 2017 In line with the new operational structure, the on-call arrangements for various on-call roles within the Trust have been reviewed and development programmes in place to ensure competency of individuals. Furthermore, an internal continual professional development for on-call officers is being developed and will be implemented in line with the NARU commander framework.

Documents

CATEGORY OF PAPER Specific action required: Provides … · 2017-07-25 · Operations Centre Headlines 3.1. All call taking service levels have been achieved in June 2017 with both