CQC and Performance Update Mark Cotton Assistant Director

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CQC and Performance Update Mark Cotton Assistant Director

CQC and Performance Update Mark Cotton Assistant Director

Care Quality Commission rating 1 November 2016 “The North East Ambulance Service has a

Care Quality Commission rating 1 November 2016 “The North East Ambulance Service has a lot of to be proud of and there were clearly many areas of good practice. We found a general culture of passion and enthusiasm at the trust and it was clear that everyone’s first priority was the patient. ” Professor Sir Mike Richards Chief Inspector of Hospitals Care Quality Commission.

What we do well The CQC highlighted – Outstanding Practice üCulture of compassion and

What we do well The CQC highlighted – Outstanding Practice üCulture of compassion and commitment üClear Vision and Strategy üShift in patient engagement and staff wellbeing üImproved relationships between Executives and Unions üFront line clinical leadership improved

What we do well The CQC highlighted – Outstanding Practice ü Good infection prevention

What we do well The CQC highlighted – Outstanding Practice ü Good infection prevention control management practices ü High patient satisfaction ü Introduced Advanced Practitioners ü Active in Research ü Strong relationships with Sports Ground Safety Authority ü The “flight deck” system which monitors hospital capacity and demand in real-time to manage pressures in the system and divert patients to alternative care when necessary ü Enrolled in the Mind Blue Light Project

CQC Rating - Good

CQC Rating - Good

Where we need to improve Must do – Regulation 17 – Good Governance Must

Where we need to improve Must do – Regulation 17 – Good Governance Must Do Action Taken and Planned Improve resilience of dispatch Ø Requires a dispatch desk at Russell House Line management and clinical oversight of CFR’s ü Identified a specific clinical line manager/robust recruitment and development programme now in place Safe storage of paper records ü Improved the policy, SOP and audit process around storage and transfer of paper records – compliance 98%. Introduced new EPCR July 16

Where we need to improve Must do – Regulation 17 – Good Governance Must

Where we need to improve Must do – Regulation 17 – Good Governance Must Do Action Taken and Planned Management of Clinical risk in EOC when dispatch stack increasing Ø Ring back process, increased hub clinicians, use of REAP. Requires additional resources Business continuity plans for EOC require improvement ü BCP reviewed and testing plans underway Learning from incidents and complaints is shared ü Introduced a quarterly learning bulletin and developed a ‘learning from listening’ intranet page Continue to reduce complaint and incident backlog ü Marked improvement and being sustained

Where we need to improve – Should do Should Do Actions Taken Improve major

Where we need to improve – Should do Should Do Actions Taken Improve major incident training ü Now included in EAT with further training programmes planned Staff are further encouraged and supported to report incidents ü Signed up to Safety Campaign, feedback when reporting, learning bulletin, developing an open and honest supportive culture, improved RCA process Improve the system for monitoring cleanliness of PTS vehicles ü PTS manager audit all vehicles and staff quarterly. The first quarter saw 80% of vehicles audited with 97% compliance. Improve training for dementia and mental health ü Introduced training on mental health, DOLS and dementia to EAT – developed handbooks for staff

Dementia work Equality NE award We won the Equality NE award for “Larger Organisations

Dementia work Equality NE award We won the Equality NE award for “Larger Organisations Making a Difference in the Community” for our work around Dementia Awareness and becoming a Dementia Friendly organisation.

Our performance -2. 95% Emergency Care Services +19. 9% 2016/17 * Data provided shows

Our performance -2. 95% Emergency Care Services +19. 9% 2016/17 * Data provided shows actual volumes for the full financial year 2

The time taken to complete an average job has increased by 19% since 2013

The time taken to complete an average job has increased by 19% since 2013 Average Job Cycle Times (minutes) 92 91 90 89 88 86 84 80 78 Our crews spend on average 11 minutes longer on each job. 84 82 80 Based on 380, 000 incidents per year this equates to 2902 days, or an extra 16 shifts a day for a year. 76 74 2013/14 The time it takes crews to complete a job has increased by 19% between August 2013 and August 2016. The yearly average is likely to be higher once the winter months have been included. 2014/15 2015/16 Apr - Aug 16

Our performance Emergency Care Services * Data provided shows actual performance for the full

Our performance Emergency Care Services * Data provided shows actual performance for the full financial year 3

Our performance * Data provided shows actual volumes for the full financial year +0.

Our performance * Data provided shows actual volumes for the full financial year +0. 96% +25. 09% +7. 06% -0. 64% Improving call handling 6

Our performance Managing 999 calls 87% of callers would recommend our service * Data

Our performance Managing 999 calls 87% of callers would recommend our service * Data provided shows actual volumes for the full financial year 7

Our performance Patient Transport Services 94% of PTS patients rated their experience as very/fairly

Our performance Patient Transport Services 94% of PTS patients rated their experience as very/fairly good * Data provided shows actual volumes for the full financial year 8

Our performance National Benchmarking Category R 1 Performance 2016/17 YTD, as at Feb-17 Category

Our performance National Benchmarking Category R 1 Performance 2016/17 YTD, as at Feb-17 Category R 2 Performance 2016/17 YTD, as at Feb-17 16

Our performance End of Life care • Over 95% of End of Life requests

Our performance End of Life care • Over 95% of End of Life requests are fulfilled. • Over 90% of transport requests are met within 3 hours, with over 50% now met within 1 hour. 10

NHS Improvement – Quarterly Ratings Quarter 3 2016/17 Quarter 4 2016/17 Key targets: NHS

NHS Improvement – Quarterly Ratings Quarter 3 2016/17 Quarter 4 2016/17 Key targets: NHS Improvement R 1: 65. 81% R 1: 71. 12% R 2: 59. 13% R 2: 56. 24% R: 59. 55% 57. 18% R 19: 87. 79% R 19: 86. 24% Fully registered with CQC for the essential standards of quality and safety. We have been provided with a shadow segment rating, measured under the Single Oversight Framework. We fall within segment 2 (on a scale of 1 to 4, with 1 being the best rating). This means that we would receive targeted support. 18

Patient Experience Actual (aggregate complaints) 16 -17 Actual (aggregate appreciations) 16 -17 Actual (aggregate

Patient Experience Actual (aggregate complaints) 16 -17 Actual (aggregate appreciations) 16 -17 Actual (aggregate complaints) 15 -16 Actual (aggregate appreciations) 15 -16 Threshold 0. 80 0. 60 0. 70 0. 50 0. 60 0. 40 0. 50 0. 40 0. 30 0. 20 0. 10 received per 1, 000 calls answered) Mar Feb Jan Dec Nov Oct Sep Aug Jul Jun May Apr Rate of complaints (new complaints Apr 0. 00 Appreciations (new appreciations received per 1, 000 calls answered) 19

Serious Incidents 13 Mar-17 Feb-17 Jan-17 Dec-16 Nov-16 Oct-16 Sep-16 Aug-16 Jul-16 Jun-16 May-16

Serious Incidents 13 Mar-17 Feb-17 Jan-17 Dec-16 Nov-16 Oct-16 Sep-16 Aug-16 Jul-16 Jun-16 May-16 Apr-16 Mar-16 Feb-16 Jan-16 Dec-15 Nov-15 Oct-15 Sep-15 Aug-15 Jul-15 Jun-15 May-15 Apr-15 0 Sep-15 Aug-15 Jul-15 Jun-15 May-15 Apr-15 Patient & Staff Safety 60 50 40 30 20 10 Assaults on Staff 7 6 5 4 3 2 1 0

Handover Time lost to handovers over 15 minutes have reduced between March 2016 and

Handover Time lost to handovers over 15 minutes have reduced between March 2016 and March 2017 by 66%. The hospitals with the greatest amount of time lost to handover for December are NSEC (337 hours), Sunderland Royal (234 hours) and UHND (117 hours). 16

A new journey – operating environment Adapting to changing needs National response Care closer

A new journey – operating environment Adapting to changing needs National response Care closer to home Reduce hospital admissions An integrated solution Demand Organisational change Increase in Red rate More complex conditions More demand for NHS 111 Embrace change Develop quicker Improve staff welfare Innovate More same day discharge transport

A new model of working… Integrating care and transport

A new model of working… Integrating care and transport

www. neas. nhs. uk /North East Ambulance Service @NEAmbulance © Copyright 2015 North East

www. neas. nhs. uk /North East Ambulance Service @NEAmbulance © Copyright 2015 North East Ambulance Service Trust