2016 / 2017 Agenda Agenda Chairs Introduction and Welcome - - PowerPoint PPT Presentation

Annual General Meeting

2016 / 2017

Agenda Agenda

• Chair’s Introduction and Welcome
• Minutes from the 30 September 2016 Annual General Meeting
• SCAS Review of the Year 2016/17
• Clinical Review
• Financial Review including presentation of the 2016/17 Annual

Report and Accounts

• Council of Governors Review of the Year 2016/17
• Question and Answer Session
• Closure of Annual General Meeting

Rev Review iew of the

• f the ye

year ar

Will Hancock – Chief Executive

Our Our ar area ea

• Health & wellbeing
• Blue light pledge
• Recruitment

Impr Improving ving inside inside

• Shaping services with partners
• Delivering more patient care

than ever

• National work
• Listening, engaging, improving our

services - journey to 'Outstanding'

Influenc Influencing ou ing outside tside

I have no doubt that your paramedic saved my life that day so I am very grateful for their professional expertise and care #OPERATIONS Your staff gave my mum the utmost consideration and help #NEPTS They were knowledgeable and caring and quickly handled my call #111 The emergency call taker was ultra-professional and showed real empathy #EOC 2016 = 2,400 followers 2017 = 10,033 followers

Clinical Review John Black, Medical Director and

• Prof. Helen Young, Director of Patient Care

and Service Transformation

Ca Care e Qu Quality ality Co Commiss mmission ion (CQC) (CQC) insp inspec ection tion May May 20 2016 16

• The CQC is an independent health and adult social care regulator
• The CQC ensures health and social care services are safe, effective,

compassionate and deliver high-quality care

• First Ambulance Trust to be rated ‘GOOD’
• Progress with the action plan has been good

Sa Safeg fegua uarding rding 20 2016 16/201 /2017 7 Achiev Achieveme ements nts

• Safeguarding training
• Section 42 processes
• Greater understanding of SCAS by partners
• Development of new technologies
• SCAS has developed very strong links with partner agencies across
• ur whole areas and is now seen as a major NHS organisation

contributing to the safeguarding community

The Work of the Team in 2016/17

• Adult safeguarding/welfare referrals 14,710
• Child safeguarding/welfare referrals 3,093
• Oxfordshire Multi-Agency Safeguarding Hub (MASH) 1,548 enquiries
• Slough MASH (July to March only) 368 enquiries
• Safeguarding forms validated 12,340
• Telephone enquiries 1,691
• Reports and reviews 23

Suicide Prevention. Mental Health Crisis Care Concordat. Dementia.

EDUCATION POLICY/STRATEGY

Elderly Adult Sensory Experience (EASE) and Dementia programme.

• Bespoke programme for all ambulance

staff, aimed at increasing awareness of the challenges associated with the process of ageing for our patients (uses sensory equipment/suit).

• Part of statutory and mandatory training

for 111/999 CCC, Non-Emergency Patient Transport Service and Community First Responder staff. NEW IPAP Suicide Risk Assessment Tool.

• SCAS resources have been shared

with other ambulance Trusts nationally.

• A SCAS self-directed eLearning

resource has been submitted for inclusion on a national NHS eLearning platform. Mental Health Policy implemented.

• Guidance for all staff who are involved

in the care, treatment and support of people who are experiencing a mental disorder, relevant to role. Dementia Strategy.

• SCAS Strategy has been used to produce

a national ambulance service Best Practice Guidance document.

Mental Health Nurses in CCC

• Prompt access to information and care

plans (for patients already known to OHFT), to support shared care approaches.

• Direct access to specialist expertise for

patients known to OHFT.

• Training and advice to call takers, to

support confidence, capability and capacity in managing MH calls.

• Reduction in numbers attending

Emergency Departments (ED) inappropriately.

• Strong partnership work with Oxford

Health NHS Foundation Trust (OHFT).

• OHFT second 3 Band 6 nurses to

SCAS.

• Nurses based in 111 and 999 contact

centres, 7 days/week between 18:00 – 04:30hrs.

• 998 calls during the first year.

Average call length 22 minutes.

• During the year, there was a 14%

reduction in the number of unnecessary journeys to the local Emergency Departments (ED).

Some achievements for Infection, Prevention Control last year;

• Increase in uptake of flu vaccine from 38% to >54%
• Increase in auditing of stations and vehicles
• Review of auditing tool with recommendations for improvements
• Participating in Quality, Governance and Risk Directors Group (QGARD)

project for vehicle cleaning benchmarking

Complaints, Concerns and Healthcare Professional feedback 2883 1311 1403 Compliments 1322 1071 914 Total PE Contacts received 4205 2382 2317

2016/17 PE Total Activity % Year 111 511 1,222,111 0.04 999 Operations 510 562,837 0.09 PTS 1460 543,177 0.27 EOC 399 545,196 0.07 SCAS wide 3 n/a n/a Trust Total 2883 2,873,321

0.10

% refers to Complaints + Concerns + HCP feedback compared with activity of each service

15/16 14/15 16/17

Patient Experience (PE) contacts received

• Number of formal complaints plus informal concerns has remained consistent at around

100 per month

• Largest increase in issues received is in dissatisfaction raised by Healthcare

Professionals (HCPs) regarding the Patient Transport Service (PTS)

• Data was previously recorded locally. Following training/support provided by PE Team,

PTS now manage their HCP feedback using Datix, allowing for clearer oversight of dissatisfaction against activity and clearer reporting and analysis of themes and trends by service and trust wide.

Patient Patient Safety Safety

Long Waits / Delays – Keeping Patients Safe

• Cases reviewed at Long Waits Group
• Closer mapping of rosters to demand
• Escalation policy in times of increased demand
• Meal break policy
• Welfare checks by clinical coordination centre clinicians
• Identify and prioritise vulnerable patients
• Use of the resources we do have, HCP Tier and Co responders
• Innovative pilots including alternative transport

Amb Ambulan ulance ce Clinical Quality Indica Clinical Quality Indicato tors rs (ACQI) (ACQI)

• SCAS finished 2016/17 in the upper quartile for two of the eight ACQI’s

when benchmarked against the other English Ambulance Trusts

• SCAS was above average in four of the eight ACQI’s
• SCAS had the best ‘survival to discharge’ for the all cardiac arrest

patients.

ACQI Full year position 2016/17

Ambulance Clinical Quality Indicators YTD Apr to March 2016/17 Upper Quartile Rating

Clinical Quality Indicator Units

East Midlands East of England Isle of Wight London North East North West South Central South East Coast South Western West Midlands Yorkshire STEMI - Care % 84.02% 91.46% 63.01% 71.66% 84.52% 86.60% 76.26% 66.94% 73.69% 81.52% 85.76% Stroke - Care % 98.76% 99.09% 98.39% 96.77% 97.74% 99.68% 98.78% 95.72% 95.10% 97.19% 98.55% STEMI - 60 %

• STEMI - 150

% 91.07% 91.69% 36.84% 90.30% 92.77% 79.87% 86.84% 89.65% 72.90% 86.54% 84.16% Stroke - 60 % 52.02% 50.59% 67.44% 62.08% 56.39% 52.56% 54.14% 62.40% 36.94% 57.46% 44.38% ROSC % 24.78% 28.49% 17.12% 29.40% 24.99% 35.78% 27.55% 27.88% 25.20% 29.55% 27.82% ROSC - Utstein % 46.83% 56.93% 39.13% 54.46% 59.31% 56.96% 39.76% 52.31% 46.17% 46.23% 55.89% Cardiac - STD % 6.26% 8.45% 10.81% 8.46% 7.12% 8.13% 11.90% 6.40% 8.00% 9.00% 10.07% Cardiac - STD Utstein % 21.30% 31.38% 30.43% 26.04% 34.25% 24.10% 22.84% 22.16% 23.42% 25.47% 36.86% Rag key 1st 2nd 3rd 4th If highlighted represents within upper quartile

National Clinical Performance Indicators (NCPI)

• SCAS finished the last cycle in the upper quartile for three of the four

NCPI’s

• The NCPI cycles were cancelled at the end of cycle 17 due to the

changes being made as part of the Ambulance Response Programme (ARP)

• SCAS have continued to audit 50 records per indicator reported

internally and externally in order to monitor compliance.

NCPI Full year position 2016/17

Clinical Quality Indicator Units

East Midlands East of England Isle of Wight London North East North West South Central South East Coast South Western West Midlands Yorkshire Asthma Care Bundle % 64.9 86.7 66.7 65.7 64.8 77.9 66.4 74.0 59.3 84.7 69.0 Single Limb Fracture Care Bundle % 28.6 51.4 66.7 30.7 67.3 53.5 58.4 54.3 70.0 55.8 44.7 Febrile Convulsion Care Bundle % 69.4 100 40.3 72.7 82.3 92.3 56 86.5 89.3 84.4 Elderly Falls Care Bundle % 17.4 69.3 50.0 48.7 26.5 46.3 89.3 4.0 12.0 10.6 12.3 Mental Health Self harm (Pilot) % Rag key 1st 2nd 3rd 4th National Clinical Performance Indicators Cycle 17 Year to Date Upper Quartile Rating June 2016 to December 2016 If highlighted represents within upper quartile Cancelled

Annual Report and Financial Statements 2016 / 2017 Charles Porter, Finance Director

Annual Report and Accounts can be accessed at: http://www.scas.nhs.uk/wp-content/uploads/SCAS- Annual-Report-2017.pdf

Income and Expenditure Income and Expenditure

• Solid (but deteriorating) financial position
• Income has increased by £9m (5%) from Sustainability and Transformation Funding

(STF) , 999 contracts, and Hants and Thames Valley PTS contracts

• Continuing operations deficit £1,704k (£3,699k deficit prior year)
• Before £2.4m STF deficit was £4,117k reflecting challenging 999 contract settlement

and increasing 999 red demand

• £0.7m surplus achieved, with further £2.4m gain relating to NHS Direct

2016/17 12 months to March £k 2015/16 12 months to March £k Income 183,718 175,061 (Deficit) before STF (4,117) (3,699) (Deficit) from continuing

• perations

(1,704) (3,699) Margin

• 0.9%
• 2.1%

Discontinued operations 2,405 2,505 (Deficit) / Surplus 701 (1,194)

2 4 6 8 10 12 14

07_0808_0909_1010_1111_1212_1313_1414_1515_1616_17

Capital Capital Expenditure £m Expenditure £m

• £4.6m capex spend on new vehicles (£1.3m), £0.9m Newbury Education

and Training centre, and IT (£1.6m)

• 0.6x depreciation (£7.6m)

5 10 15 20 25 30

07_0808_0909_1010_1111_1212_1313_1414_1515_1616_17

Cash Cash £m £m

Cash position has increased by £0.3m to £20.2m, with the impact of the surplus (+£0.7m), part repayment of capital loan (£1.7m), working capital (£1.7m) offset by capex less than depreciation (+£3.0m).

Cost Cost Improvement Plans Improvement Plans

• Successfully delivered £5.7m of cost improvements (3% of total

expenditure budget)

• Savings to mitigate inflation, activity and cost pressures ensuring that

quality can be maintained

• Projects focused on operational efficiency, and non-pay savings from

procurement and eliminating waste.

COUNCIL COUNCIL OF GO OF GOVE VERNORS RNORS (CoG) (CoG) – REV REVIEW IEW OF OF 2016 / 2016 / 17 17 Barry Lipscomb SCAS FT Lead Governor

Again, Again, the C the CoG

• G delivered

delivered the the relevant relevant statut statutory

• ry duties,

duties, including including:

• Appointed a new Chair following a comprehensive recruitment process
• Contributed to the development of the Trust’s strategic priorities

(including through a joint strategy workshop with the Board of Directors)

• Led a competitive procurement process for the appointment of new

External Auditors (Grant Thornton)

• Received the 2016/17 Annual Report and Accounts, and reports from

the Auditors (noted income of £183m and operating surplus of £700k)

More generally More generally the CoG: the CoG:

• Held the Board to account for the performance of the Trust, via the

NEDs:

• through asking questions of the NEDs at formal CoG meetings, governor

attendance at Board meetings, and‘buddying’ arrangements with NEDs

• Represented the interests of the members and public
• through attendance at a range of membership recruitment and engagement

events, and through day-to-day conversations with the general public

• Improved individual and collective knowledge and potential
• through attendance at a range of membership recruitment and engagement

events, and through day-to-day conversations with the general public

Prior Priorities ities for 2017/ for 2017/18 18

• Further developing arrangements for engaging with the Trust’s membership
• Continuing the strong focus that the governors have in terms of holding the

Board to account, via the NEDs, for the performance of the Trust

• Overseeing the appointment processes for the recruitment of new NEDs
• Contributing to the development of the Trust’s future strategic priorities and

forward plans

• Continuing to review the effectiveness of the CoG to ensure that the

governors are appropriately supported to deliver their roles

Question Question and A and Ans nswer er Sessio Session