Agenda Chairs Welcome and Introduction (LS) Minutes from the 27 - - PowerPoint PPT Presentation

• Chair’s Welcome and Introduction (LS)
• Minutes from the 27 September 2018 Annual General

Meeting (LS)

• Review of 2018/19 (WH)…
• …including “What We’ve Delivered for Patients and

Staff” (CP/HY&JB/MS)

• Financial Review including presentation of the 2018/19

Annual Report and Accounts (CP)

• Council of Governors Review of the Year 2018/19 (BD)
• Question and Answer Session (LS)

Agenda

Review of 2018/19

Will Hancock

Chief Executive

We are continuing to grow as an

• rganisation….and operate in an

increasingly complex system(s)!

Our services An integrated approach

Past Future

> Enabling people to access right care, first time > Saving lives and improving outcomes > Supporting people in their own homes

Patient Transport Emergency 999 NHS111 & IUC Service

SCAS

We have a clear strategy……….

….and that strategy is supported by goals and a set of values

• continued to perform well on the Ambulance Response

Programme (ARP) 999 emergency response time standards

• with partners, embedded the Integrated Urgent Care (IUC)

service in the Thames Valley…

• …and continued our co-production work for a new IUC

service in Hampshire

• delivered some good clinical outcomes for patients (e.g.

stroke and STEMI care)

• established ourselves as the leading NHS provider of

Patient Transport Services, with contracts in Thames Valley, Hampshire, Surrey and Sussex

2018/19 was a challenging year for the NHS, but SCAS has:

• continued our work as a Global Digital Exemplar with a

number of key projects underway

• made good progress with the implementation of our OD

Strategy – especially in relation to leadership development and health and well-being

• implemented a new Commercial Transformation Programme
• collaborated

effectively with local systems and

• ther

Ambulance Trusts

• established effective staff processes for ‘Freedom to Speak

Up’

• delivered strong financial outcomes
• maintained our

status as a Segment 1 provider (best possible) under NHS Improvement regulatory approach

And also…..

• Global Digital Exemplar (CP)
• Urgent Care Pathways (HY/JB)
• Staff health and well-being (MS)

“What We’ve Delivered for Patients and Staff” – three examples

EPR Developments –

enhancing electronic patient record functionality

Vehicle as hub –

extended wi-fi for patient care and mapping updates

Resource Optimisation –

using big data to improving demand forecasting and resource planning

Automation

• 999 – control room automation
• PTS – process improvement
• Corporate – e-learning,

procurement .

Livelinks Video – using

video between patients, control staff and road clinicians

Telephony transformation –

latest telephone software to improve resilience, automation, and multi-channel access

EPR Acute Interface –

passing data straight to hospital systems to enhance patient care

Integrated Urgent Care – Connecting

• rganisations and

clinicians to provide better seamless care

Example 1 - Global Digital Exemplar (GDE)

Example 2 - Urgent Care Pathways Programme Aims & Objectives

• Support National & Local Strategies with NHS Constitution at its heart
• Improve quality of Patient Care & Experience
• Improve Patient Safety
• Support Operational Clinical Staff
• Support improvement in the reduction of our key rates for :-
• See & Treat
• See, Treat & Convey to Emergency Departments
• See, Treat & Convey to Non-Emergency Departments
• Efficiency Savings

• 1. Urgent Care Pathways - Access to key services across our footprint for
• ur clinicians to refer our patients to directly
• 2. Digital Software Solution - Visibility of those services for our mobile

clinicians

• 3. Clinical Governance - Safety & Consistency of all Urgent Care Pathways

across SCAS

• 4. Terrafix MDT - Supporting the reporting, data & metrics to understand the

patient journey to improve care

Urgent Care Pathways Programme Projects

Urgent Care Pathways Pathway Development Progress

Pathway doesn’t exist No access to Pathway for SCAS Clinical Staff Potential Pathway exists No current access to Pathway for SCAS Clinical Staff Pathway access under discussion with Service Provider Pathways exists but not in line with SCAS Urgent Care Pathway Plan requirements - e.g. not 24/7 Access available to SCAS Clinical Staff New Pathway in Pilot Phase Pathway available in line with SCAS Urgent Care Pathway Plan requirements Pathway available to SCAS Clinical Staff but service rarely used despite accessibility Pathway access referral restricted to specific SCAS Clinical Cohort Pathway available in line with SCAS Urgent Care Pathway Plan service requirements Available to all SCAS Clinical Staff and used regularly

The programme team have been using a RAG Rating tool to understand the progress made in the development of access to Urgent Care Pathways

Urgent Care Pathways Access to Clinical Pathways

62 6 17 15

SCAS - All Pathways May 2019 RAG Rating Percentage

25 23 24 4 24

SCAS - All Pathways Current RAG Rating Percentage

Urgent Care Pathways Access to Clinical Pathways

• Established & improved access to

25 Pathways

• Reduction in Red RAG Rating by 51
• Large number of pathways being

discussed with our partners

• 37 pathways in pilot phase or need

improvement with access, effectiveness & usage

84 8 23 21 33 31 32 5 32 10 20 30 40 50 60 70 80 90 1 2 3 4 5

• No. of Pathways

RAG Rating

SCAS - All Pathways RAG Rating Comparison

Left - May 2019 Right - Current

Example 3 - Improving the wellbeing of

• ur teams
• SCAS leaders better equipped to support

their teams

• Rosters improved to provide better work-

life balance and reduce fatigue

• Developed our staff support services

SCAS Leader

Module 1

Maximising

Individual

Performance

Module 2

Maximising

Team

Performance

Module 3

Leading

Service Development

Launched SCAS Leader ….

Numbers so far…

• 102 people have started (6 cohorts)
• 85 people have completed
• Cohorts 1-6 line manage a combined total of ~1200 staff
• Managers currently in post should complete by Dec 2020

SCAS Fatigue - Operational Field Trial

Safr Ltd was commissioned to conduct a review as to the level of fatigue experienced by SCAS 999

• perational personnel across 4 sites, over a total period of approximately 5 months.

This included pre-launch activities at each site. (Basingstoke, Didcot, Nursling, Wexham RCs) covering 90 staff. Key Findings The levels of alertness and fatigue within SCAS were found to be broadly in line with the benchmarks for a 24/7 organisation and reasonably consistent across locations and job roles. However, long shifts – especially night shifts of 12 hours or more – were found to cause increased fatigue and therefore higher levels of risk. What we changed

• Reduced the number of 12 hour shifts our 999 teams work
• Reducing the length of night shifts, particularly aiming to avoid night shifts of 12 hours or more and

reducing the number of night shifts in a given period

We have also …

• Improved our control centre environment
• Encouraging healthy mind
• Healthy eating
• Smoking cessation
• Weight management
• Review of bag weights
• Cycle to work scheme
• Promoted health & wellbeing across our Trust

Health & Wellbeing Events

Launching our H&WB Portal

• https://www.sca.nhsbenefits.net/

Leading by example

Charles Porter

Finance Director

Financial Review including presentation of the 2018/19 Annual Report and Accounts

Annual Report and Accounts can be accessed at: http://www.scas.nhs.uk/publications/

• Improving overall and underlying financial position
• Income has increased by £10.5m (5%) due to 999

contract income and Hampshire 111.

• Continuing operations surplus
• f £1,486k (£1,180k surplus

prior year)

• Before STF/land disposal

gains deficit was £1,636k reflecting improving underlying financial position

• £1.5m surplus achieved, with

£3.2m STF (16/17 £3.2m)

Income and Expenditure

2018/19 12 months to March £k 2017/18 12 months to March £k Income 225,989 215,487 (Deficit) before STF and gains on disposal of assets (1,636) (4,412) Surplus/(Deficit) from continuing operations 1,486 1,180 Margin 0.7% 0.5% Discontinued operations

• 131

Surplus 1,486 1,311

• £9.5m capex spend

–

• n new 999 ambulances (£4.1m)

– £2.5m on Estates including Southern House refurbishment, and PTS resource centre (Loverock Road) and Fleet workshop (Milton Park) following Battle sale – £2.4m IT spend including £1.2m Telephony upgrade and GDE

• 1.1x depreciation (£8.3m)

Capital Expenditure £m

2 4 6 8 10 12 14

07_08 08_09 09_10 10_11 11_12 12_13 13_14 14_15 15_16 16_17 17_18 18_19

Estates

Southern House upgrade Milton Park (fleet workshop) Loverock Road (PTS resource centre)

• Major review of Estates and updating strategy
• New sites following sale of Battle site for housing

AFTER BEFORE

Cash position has increased by £4.9m to £22.6m, with the impact of the surplus (+£1.0m), part repayment of capital loan (-£1.7m), working capital (£2.8m) – debtors/provisions, disposals (+£2.6m),and capex less than depreciation (-£0.8m), PDC received (+£1.1m).

Cash £m

5 10 15 20 25 30

07_08 08_09 09_10 10_11 11_12 12_13 13_14 14_15 15_16 16_17 17_18 18_19

• Successfully delivered £8.0m (3.5%) of cost

improvements

• Savings to mitigate inflation, activity and cost

pressures ensuring that quality can be maintained

• Carter review benchmarking Ambulance Trust

efficiency showed SCAS in good light.

• Continuing drive to improve efficiency and value for

money Cost Improvement Plans

Council of Governors (CoG) – Review of 2018 / 19

Bob Duggan

Buckinghamshire Public Governor / Current Lead Governor

The Lead Governor for 2018/19 was Barry Lipscomb

• Contributing at the CoG and Board annual joint strategy workshop

which focused on the development of the Trust’s strategic plans and priorities, in particular the new Long Term NHS Plan.

• Re-appointing two NEDs for a second term
• Providing input into the 2018/19 appraisals for both the Chair and

NEDs

• Partaking in a Governor Development Programme, aimed at

strengthening the effectiveness of the CoG and improving relationships between Governors, Non-Executive Directors and members

• Received the 2018/19 Annual Report and Accounts, and reports from

the Auditors

Again, the CoG delivered the relevant statutory duties, including:

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

More generally the CoG:

The CoG has identified the following priorities for 2019/20: 1. Ensuring that the interests of the Trust’s 17,000 members are suitably represented and that their views are brought to the attention of the Trust. 2. Contributing to the development of the Trust’s future strategic priorities and forward plans - with a strong focus on the newly published NHS Long Term Plan and local systems working together 3. 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 4. Continuing to review the effectiveness of the Council of Governors to ensure that the governors are appropriately supported to deliver their roles, that value is added where appropriate, and the functioning of the CoG is delivered in the most cost effective way and aligned with the values of the Trust.

Priorities for 2019/20

Closure of Annual General Meeting

Lena Samuels

Trust Chair