SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS AND NOTES

Transcription

1 SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS AND NOTES FOR YEAR ENDED 31 MARCH 2013

2 Scottish Ambulance Service Board Annual Accounts CONTENTS Page Directors Report (including interests of Board members) 1 Operating and Financial Review 8 Remuneration Report 16 Statements of Responsibilities 20 Governance Statement 22 Independent Auditors Report 26 Direction by the Scottish Ministers 28 Principal Financial Statements 29 Notes to the Accounts Note 1 (Accounting Policies) 35 Note Scottish Financial Returns 96 Payment Policy 107 Resource and Cash Outturn 108 Sickness Absence 109

3 Scottish Ambulance Service Board Annual Accounts SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS AND NOTES FOR YEAR ENDED 31 MARCH 2013 DIRECTORS REPORT DIRECTORS REPORT 1. NAMING CONVENTION Scottish Ambulance Service is the common name for the Scottish Ambulance Service Board. 2. PRINCIPAL ACTIVITIES AND REVIEW OF THE BUSINESS AND FUTURE DEVELOPMENTS The information that fulfils the requirements of the business review, principal activities and future developments can be found in the Operating and Financial Review, which is incorporated in this report by reference. 3. DATE OF ISSUE Audited Financial Statements were approved and authorised for issue by the Board on 26 June ACCOUNTING CONVENTION The Annual Accounts and Notes have been prepared under the historical cost convention as modified to reflect changes in the value of fixed assets and in accordance with the Scottish Government Financial Reporting Manual (FREM). The Accounts have been prepared under a direction issued by Scottish Ministers, which is included at Page 28 of the accounts. The statement of the accounting policies, which are in line with the International Financial Reporting Standards (IFRS) and have been adopted, are shown at Note APPOINTMENT OF AUDITORS The Public Finance and Accountability (Scotland) Act 2000 places personal responsibility on the Auditor General for Scotland to decide who is to undertake the audit of each health body in Scotland. The Auditor General has appointed Deloitte LLP to undertake the audit of the Scottish Ambulance Service. The general duties of the auditors of health bodies, including their statutory duties, are set out in the Code of Audit Practice issued by Audit Scotland and approved by the Auditor General. 6. BOARD MEMBERSHIP Under the terms of the Scottish Health Plan, the Scottish Ambulance Service Board ( the Board ) is a Board of governance whose membership will be conditioned by the functions of the Board. Members of Health Boards are selected on the basis of their position or the particular expertise which enables them to contribute to the decision making process at a strategic level. The Board has collective responsibility for the performance of the Service as a whole, and reflects the partnership approach, which is essential to improving health and health care. The Scottish Ambulance Service Board comprised during 2012/13: David Garbutt Pauline Howie Councillor David Alexander Moi Ali Neelam Bakshi Suzanne Dawson Edward Frizzell Theresa Houston Andrew Richmond Pamela McLauchlan Shirley Rogers Chairman Chief Executive Non-Executive Director Non-Executive Director Non-Executive Director Non-Executive Director Non-Executive Director Non-Executive Director Non-Executive Director Director of Finance and Logistics Director of Human Resources and Organisational Development 1

4 Matt Bell Prof George Crooks New Appointments (until 30/4/2012) Employee Director Medical Director (part time) Scottish Ambulance Service Board Annual Accounts Shirley Rogers left on secondment on 30 April 2012 to take up a position within Scottish Government. Elinor Mitchell joined the organisation on 1 May 2012 to take up the post of Director of Human Resources and Organisational Development. A new appointment was made of Director Health Professions and Nursing Care and Karen Wilson was appointed to the post from 1 October 2012, both of these positions are as Director of Scottish Ambulance Service. The Board members responsibilities in relation to the accounts are set out in a statement following this report. 7. BOARD MEMBERS AND SENIOR MANAGERS INTERESTS The following interests have been declared by Board members and senior managers: Board Member Directorships Ownerships David Garbutt Chartered fellow of the Chartered Institute of Personnel and Development Fellow Scottish Police College Visiting Fellow Australian Institute of Police Management Self Employed Consultant Pauline Howie None None Councillor David Alexander Depute Convenor Fife and Forth Valley Criminal Justice Authority Member and office bearer Scottish National Party Member CND Scotland Elected Member Falkirk Council Moi Ali Fellow of the RSA Governor, Napier University Neelam Bakshi Judicial Complaints Reviewer Non-Executive Director NHS Education for Scotland Public Appointments Ambassador Cabinet Office Scottish Police Authority Member Chartered Institute of Personnel & Development (Affiliate) Federation of Small Business Co Operative Society National Autistic Society Royal Horticultural Society Member BBC Audience Council Scotland Approved Training Institute American Board NLP Scottish Government, Non-Executive Member Lay Member Employment Tribunals Scotland Reserve Forces Tribunal & Lay Race Equality Assessor to Judiciary Member Scotland Committee of Equality & Human Rights Commission None Self Employed Consultant NB Associates Owner 2

5 Scottish Ambulance Service Board Annual Accounts Suzanne Dawson Lay member of Council of the Law Society of Scotland Member of the Board of Newbattle Abbey College Fellow of Chartered Institute of Marketing Self-employed Marketing Consultant Edward Frizzell Theresa Houston Chair of Court of Abertay University, Dundee Visiting Professor, Queen Margaret University, Edinburgh Non-Executive Director NHS Education for Scotland Andrew Richmond Non-Executive Member of NHS Tayside Chair of Angus CHP Non- Executive Director of Frontier IP Group PLC Trustee Tayside NHS Board Endowment Fund Associate of Society of Investment Professionals (ASIP) Member of Church of Scotland Lay Court member of the University of Dundee Trustee of the University of Dundee Superannuation and Life Assurance scheme Executive Member CIPFA in Scotland Pamela McLauchlan Non-Executive Audit Committee Member National Theatre for Scotland None None None None Shirley Rogers None None Matt Bell None None Prof George Crooks Medical Director NHS24 None Senior Managers Directorships Ownerships Heather Kenney None None Elinor Mitchell None None Daren Mochrie None None Karen Wilson None None 8. PUBLIC SERVICES REFORM (SCOTLAND) ACT 2010 The Public Services Reform (Scotland) Act came into being in October In Sections 31 and 32 it placed a duty on all public bodies to publish information on expenditure and certain other matters as soon as is reasonably practicable after the end of each financial year. These items include: Overseas Travel; Public Relations ; Hospitality and Entertainment; and External Consultancy. In order to comply with this Act, the Scottish Ambulance Service places on its external website the information relating to the expenditure incurred under these headings since 1 April In addition, public bodies are required to publish cash payments made to external parties that exceed 25,000 on a monthly basis, as soon as the monthly accounts are available. A list of these payments is also placed on our External Website. The following link will take readers to the relevant information: 3

6 Scottish Ambulance Service Board Annual Accounts Payments made to staff that exceed 100k per annum should also be disclosed. This information is contained in the Directors remuneration report. No other members of staff currently earn more than 100k per annum. 9. PENSION LIABILITIES The accounting policy note for pensions is provided in Note 1 and disclosure of the costs is shown within Note 24 and the Remuneration Report. 10. REMUNERATION FOR NON-AUDIT WORK Deloitte LLP, the Service s current External Auditor, have only undertaken audit related work during 2012/13 for the Scottish Ambulance Service Board. 11. RELATED PARTY TRANSACTIONS During the year, no Board member, key manager or other related parties have undertaken any material transactions with any body. All Board members are also Trustees of the Scottish Ambulance Service Endowment (charity) funds. 12. PAYMENT POLICY The Scottish Ambulance Service is committed to supporting the Scottish Government in helping businesses during the current economic situation by paying bills more quickly. The intention is to achieve payment of all undisputed invoices within 10 working days across all public bodies. The target has been communicated to all non-departmental public bodies, who are working towards the accelerated payment target of 10 working days. The Scottish Ambulance Service has endeavoured to work towards this target and does ensure that invoices received that have been correctly checked are processed within 7 working days of date of receipt. However those that require further investigation result in delays to the achievement of the target, this is required to ensure sound financial management of public funds. In 2012/13 the Board paid 28% of invoices by value and 37% by volume within 10 days (2011/12= 24% by value & 17% by volume ) In 2012/13 average credit taken was 25 Days (2011/12 = 28 Days) In 2012/13 the Board paid 71% of invoices by value and 81% by volume within 30 days (2011/12 = 73% by value & 77% by volume ) 13. CORPORATE GOVERNANCE The Board meets regularly during the year to progress the business of the Scottish Ambulance Service Board. This includes reviewing of performance against the key targets for the organisation. Considering the key strategies and policies the organisation wishes to develop. Seeking assurance that principal decisions are governed and implemented, as planned. In order to support the work of the Board and to provide a framework of assurance the following governance committees report to the Board: Clinical Governance; Audit; Staff Governance; and Remuneration. 4

7 Clinical Governance Committee 5 Scottish Ambulance Service Board Annual Accounts The Clinical Governance Committee of the Board has two key roles: - Systems assurance to ensure that clinical governance mechanisms are in place and operate effectively throughout the Scottish Ambulance Service System; and - Public health governance to ensure that the principles and standards of clinical governance are applied to the health improvement activities of the NHS Board. The Clinical Governance Committee currently comprises four Non-Executive Directors: Ms Suzanne Dawson (Chair); Mr Andrew Richmond; Ms Neelam Bakshi; and Ms Theresa Houston. Mr David Nelson is the Public/Patient Representative. The Committee meets approximately four times per year to monitor standards of care and measure the effectiveness of pre-hospital treatment. Audit Committee The Audit Committee currently comprises four Non-Executive Directors: Mr Edward Frizzell (Chair); Ms Moi Ali; Mr Andrew Richmond and Councillor David Alexander. Mr Frizzell took up the post of Chair from Mr Richmond from the 1 July The Audit Committee meets four times per year to consider the various reports from both internal and external auditors to assess the risks that may arise in the Service. Staff Governance Committee The Staff Governance Committee comprises four Non-Executive Directors: Mr Matt Bell, (Employee Director and Chair), Ms Moi Ali, Councillor David Alexander, Ms Neelam Bakshi and the Chairman, Mr David Garbutt. The Committee meets four times per year to ensure effective monitoring of staff governance within the organisation. Remuneration Committee At the start of the year, the Remuneration Committee comprised the Chairman and three Non-Executive Directors: Mr Edward Frizzell; Ms Suzanne Dawson and Councillor David Alexander. In compliance with the membership arrangements set out in the 4 th edition of the Staff Governance Standard, Matt Bell, Employee Director joined the membership of the Committee in November The Committee is chaired by the Chairman, Mr David Garbutt. It meets at least twice per year to consider the evaluation of performance and pay awards for Executive Directors. The committee has an important role in ensuring consistency of policy and equity of treatment of staff across the local NHS system, including remuneration issues, where they are not already covered by existing arrangements at national level. The Board Members responsibilities in respect of internal control are set out in a statement following this report. 14. DISCLOSURE OF INFORMATION TO AUDITORS The directors who held office at the date of approval of this directors report confirm that, so far as they are each aware, there is no relevant audit information of which the Board s auditors are unaware; and each director has taken all the steps that he/she ought reasonably to have taken as a director to make himself/herself aware of any relevant audit information and to establish that the Board s auditors are aware of that information. 15. HUMAN RESOURCES Human Resources and Organisational Development Structure In early 2012/13 a new Director of HR and OD was appointed and subsequently, towards the end of the financial year, the post of Head of HR and Staff Governance was filled. Work also began this year to review the HR and OD structure and it is envisaged that a new structure will be agreed and in place by the summer of Partnership Working and Staff Governance Throughout 2012/13, and in the face of difficult economic challenges, we have continued to live out the values and principles of partnership working, ensuring that effective staff governance exists across the Service. Work began in the latter part of 2012 looking at the partnership model within the Service and a new model was agreed, in partnership, which will be in place as of 1 June This new model brings the Service in line with other NHS Boards and has a focus on ensuring the new Staff Governance Standards are understood and embedded within the organisation.

8 Scottish Ambulance Service Board Annual Accounts During 2012/13 Staff Governance standard audits were conducted in all of the Divisions. The purpose of these audits was to asses the extent to which the 5 standards of staff governance were being met within each Division. During the course of these audits, a number of areas of good practice, as well as some areas for improvement were identified. Each Division received written feedback on their audit and these are published on the SAS internal website. Workforce and Recruitment 2012/13 was a challenging year for staff as we continued to take forward our Working together for better patient care strategy and the development of Emergency, Unscheduled and Scheduled Care Services. As our Strategy moved forward, we continued to work on the development of new roles and models of service and recognise the opportunities and challenges this presents for staff. Partnership and staff across the Service have and will continue to be involved at all stages in the development and implementation of plans and we have developed our engagement and communication with staff through visible leadership, using innovative mechanisms for communication and introducing a team briefing system to improve face to face communication. We implemented our Clinical Strategy which maintains a continued focus on Patient Safety, testing and evaluating new roles and enhanced clinical practice for ambulance staff (e.g. our specialist paramedics). We will also continue to involve staff in improving the efficiency and effectiveness of our Service and embed the improvements identified in our 2011/12 Learn and Improve Programme around Workforce, Scheduled Care, EMDC and administration services. We have continued to implement the recommendations from our Learn & Improve review of Scheduled Care specifically aiming to improve the way we manage and organise the Patient Transport Service and have introduced mobile technology to our PTS fleet to support this improvement. We aim to ensure those with a medical need for ambulance transport get the best patient care and, for those who are not eligible; we will continue to work with our partners to signpost alternative transport. This is part of the 5 year development programme. We are also progressing through Learn and Improve changes to the way we function administratively by ensuring the administrative service is as efficient as it can be. We will look to improve the efficiency, effectiveness and quality of our Scheduled Care, administrative, support functions and workforce planning arrangements. In January 2012 we reached agreement over the management of rest breaks. The immediate focus has been on implementing the new arrangements across the Service. In moving to these agreed new arrangements, the Service was required to recruit and train additional staff to fill the gaps in operational cover that would inevitably result from a move to a 37.5 hour working week. This resulted in 150 additional staff being recruited over the last 12 months, with 110 being in post by 31 March 2013 and the remainder due to commence the April 2013 course. Having now recruited the additional posts we will look to review our skills mix in order to provide the most appropriate clinical care for our patients at all times. This work will be further developed and refined through the Optima modelling work. Ambulance Control Structure Over the past year, a major review of the Ambulance Control Centres (ACC) operating model has been completed resulting in the introduction of a fundamentally new management structure and the introduction of an operational performance hub based in Cardonald. The new structure includes a new 24 hour National Operations Senior Management role and the introduction of 5 specialised development managers responsible for systems, emergency planning, workforce and clinical performance. The recruitment, management of change and communication processes have been conducted over the last 6 months and required significant and crucial input from the HR team. The new structure is due to go live over the summer months. The pilot to include the new clinical advisor role has been conducted throughout This new role is fundamental to improving operational performance, by improving clinical decision making within the ACC. The pilot has been extended until December 2012 to enable further evaluation of outcomes. 6

9 Scottish Ambulance Service Board Annual Accounts Phase 1 of the Scheduled Care Programme has now been completed and all scheduled care co-ordinators have transferred from regional ASO offices into the three regional control rooms. Ambulance Control has taken responsibility for the scheduled care co-coordinator teams with effect from April Human Resources Scorecard We are continuing to develop an HR Scorecard that reports on various HR statistical indicators including sickness absence, turnover, vacancies, Occupational Health/Health and Safety statistics and other workforce information. The scorecard ensures that this data is reported in one report and can be used to identify and track trends or compare different sets of statistics to establish any relationship between them. e:ess (electronic Employee Support System) Over the latter part of 2012/13 we have been preparing to implement our new NHSS HR system called e:ess. We are ahead of schedule, having brought forward our participation in this project by several months and have been busy setting up a project team, ensuring project governance is in place, and planning ahead for the business process changes that will occur as a result in 2013/14. The new system will benefit our workforce greatly by allowing staff greater access to their personal data and will streamline our HR business transactions, cutting the amount of time spent on administrative tasks. Organisational Development We are now midway through our HR/OD Strategy Doing the Right Thing and can now assess our progress to date. A review of the Action Plan by Doing the Right Thing Programme Board highlighted that we have made considerable progress in what we initially set out to achieve with many of the actions complete or seen as business as usual. Any outstanding actions will be incorporated into the Staff Governance Action Plan going forward. A number of innovative Culture discussion workshops have been run across the Service initially to a Divisional Management Team and Partnership audience. These workshops have stimulated excellent discussion and debate around a number of organisational issues encompassing culture, values, behaviours, staff engagement, patient safety and managing adverse incidents and they have received very positive feedback. It is our intention to keep the momentum of these workshops going with a view to developing a sustainable model that can be delivered in house. Keeping staff well informed of developments is an important aspect of our leadership and management roles and one of the key tenets of our Staff Governance Standards. One of the ways we are improving communication in our organisation is to introduce a team briefing model we have named Team Talk that is initially being piloted in the North Division EVENTS AFTER THE END OF THE REPORTING PERIOD There have been no significant events after the end of the financial year that would materially impact on the information contained within the accounts. 17. FINANCIAL INSTRUMENTS Information in respect of the financial risk management objectives and policies of the Board and the exposure of the Scottish Ambulance Service to price risk, credit risk, liquidity risk and cash flow risk is disclosed in note 27. The Accounting Officer (Chief Executive) of the Scottish Ambulance Service has authorised these financial statements for issue on the 26 June Signed: Date: 26 June 2013 Mrs Pauline Howie Chief Executive 7

10 OPERATING AND FINANCIAL REVIEW Scottish Ambulance Service Board Annual Accounts NHS Boards are required to prepare an Operating and Financial Review under section 7.2 of the FReM. This provides a narrative explanation of the main trends and factors underlying the development, performance and position of the Board during the financial year covered by the financial statements, and those which are likely to affect its future development, performance and position as defined in the Accounting Standards Board Reporting Statement objectives. The operating and financial review has been prepared in accordance with the FReM and complies with best practice. 1 Principal Activities and Review of the Year The Scottish Ambulance Service was established in 1999 under The Scottish Ambulance Service Board Order 1999 which amended the National Health Service (Scotland) Act 1978 and is responsible for the provision of Accident & Emergency Response, Patient Transportation Service and Air Ambulance services for the residents of Scotland, including the islands communities. This covers a total population of over 5.2 million. The role of the Scottish Ambulance Service is to: provide accident and emergency, patient transport and air ambulance services to the people of Scotland; improve and protect the health of people; improve health services for local people; focus clearly on health outcomes and people s experience of their local NHS system; and promote integrated health and community planning by working closely with other local organisations. The functions of the Scottish Ambulance Service Board comprise: strategy development; implementation of strategic framework; resource allocations; implementation of its Delivery Plan; and performance management. During this year the Organisation has delivered the following: Realigned all A&E rosters and moved A&E staff across to a 37.5hr week inclusive of rest period almost all staff were on their new rosters by 31 March with a small number moving during April and early May 2013; Progressed design and development of Single Clinical Triage System (SCTS) in partnership with NHS 24, jointly developing clinical content and pathways to route patients more effectively to definitive care; Increased levels of clinical paramedic advisors on a 24/7 basis across the three Ambulance Control Centres (ACC) sites investing 1.3 million; Developed a national framework and care pathways for elderly patients who have fallen in partnership with the Long Term Conditions Collaborative and Reshaping Older Peoples Care; Invested 100k in testing various professional to professional decisions support systems for crews to reduce avoidable attendances at hospital; With NHS Fife, developed pilot SEPSIS warning tool for crews through the mobile data e-prf system, with real time transfer of patient record to receiving hospital ahead of ambulance arrival, to pre-alert for potential SEPSIS; Established national patient booking service offering direct patient booking for Patient Transport Service and relocated 29 local offices into 3 regional centres to manage all booking, planning & day control across Scotland; Introduced mobile data technology across the PTS fleet to support dynamic deployment, more efficient use of resources and electronic capture and transfer of data; Continued to work in partnership with NHS Boards, local authorities and community transport partners to establish alternative integrated hubs. This is for patients not requiring ambulance transport to hospital appointments. We now have two pilot sites operating in Grampian and Lochaber; Continued to grow community First Responder schemes across Scotland to strengthen community resilience, including the launch of a higher skilled Emergency Responder scheme in West Ardnamurchan supported by telehealth links to Aberdeen Royal Infirmary; 8

11 Scottish Ambulance Service Board Annual Accounts Continued to work with partners such as British Heart Foundation and British Red Cross to strengthen community based life-saving skills. Also supported the expansion of community based public access defibrillators, including across the Caledonian MacBrayne ferry fleet, and initiated the mapping of these defibrillators onto the C3 command and control system to highlight their proximity to a caller, where this is relevant, which is proven to save lives; Completed business case for the development of the ScotSTAR National Specialist Retrieval Service to be co-ordinated by the Scottish Ambulance Service; Progressed preparation for the new contract for Air Ambulance Service in 2013 and worked in partnership to extend air ambulance capacity with the launch of Scotland s first charitable Air Ambulance Service; Reviewed frontline leadership and management roles and designed specific development programme for this cohort of managers to be delivered in 2013, focussing the role on strengthening clinical leadership and patient safety; Established a national Quality Hub and Collaborative to build capacity for quality improvement across SAS to drive forward service change and improvement and patient safety; Undertaken extensive planning and preparation for the Commonwealth Games in Glasgow in Financial Performance and Position The Scottish Government Health Directorate (SGHD) sets three financial targets at NHS Board level on an annual basis. These limits are: revenue resource limit - a resource budget for ongoing operations; capital resource limit - a resource budget for new capital investment; and cash requirement - a financial requirement to fund the cash consequences of the ongoing operations and the new capital investment. NHS Boards are expected to contain their net expenditure within these limits, and to report on any variation from the limits set. The Scottish Ambulance Service achieved each of the targets set and the table below indicates the financial performance against each target. Revenue resource limit Core Revenue resource limit Non Core (1) Limit as set by SGHD 000 (2) Actual Outturn 000 (3) Variance (over)/under (1)-(2) , , ,311 14,311 0 Capital resource limit 17,150 17,146 4 Cash requirement 220, , / / (46) Brought forward (surplus) from previous financial year (23) 5 (Savings)/excess against in year revenue resource limit (9) (41) TOTAL (Surplus) / Excess for year (32) 18 Non Core Surplus returned to government 0 (23) Brought forward Core (surplus) to current year (32) 9

12 Scottish Ambulance Service Board Annual Accounts In respect of financial position and performance: The Scottish Ambulance Service achieved a breakeven position against Non-Core Revenue Resource Limit at the year end, and generated a surplus against Core Revenue Resource Limit at the year end of 32k, resulting in an overall saving of 32k; The Scottish Ambulance Service contained its costs within the revenue and capital resource limits; The closing bank balance as at 31 March 2013 was 60k; Provisions for bad and doubtful debts of 73k were made; Provision for legal obligations of 227k were made, of which 136k relates to medical and clinical claims, 66k relates to employers liability claims and 25k relates to third party claims; Land and buildings were fully revalued by the Valuation Office Agency at 31 March 2013 on the basis of fair value (market value or depreciated replacement cost where appropriate). Other Property Plant and Equipment were revalued on the basis of indices at 31 March 2013; o The net impact was a decrease in value of 699k (2011/12: 382k increase), of which 153k (2011/12: 374k) was credited to the revaluation reserve and 852k (2011/12: 8k credit) charged to the Statement of Comprehensive Net Expenditure. The net charge of 852k to the Statement of Comprehensive Net Expenditure was comprised of 1,281k (2011/12: 512k) impairment losses and 429k (2011/12: 520k) reversal of previous impairment losses; Total outstanding liabilities are m; All of the five operating divisions returned deficits against budget in the year. This was due to high utilisation of overtime and an additional cost pressure from the new on call arrangements which were implemented from 1 October Improvements in overtime utilisation have been made; however, further work is required in 2013/14; and In addition, there was a high usage of medical consumables and drugs due to activity demands which also contributed to the overspend position in the divisions. There were four incidents during the year of theft of laptops. None of these laptops had personal data on them and in addition the Service has an encryption policy and this therefore mitigated the risk around the loss of Service data. 10

13 3 Key Performance Indicators (KPIs) Scottish Ambulance Service Board Annual Accounts Health Boards are required to report on their Key Performance Indicators, as agreed with the Scottish Government Health Directorate, shown below. Examples of KPIs include financial break-even targets, waiting times targets, delayed discharges, absences and suicide rates, which are all examples of the main NHS objectives. These objectives can be classified under four categories: Health improvement for people in Scotland; Efficiency improvements; Access more quickly to service; and Treatment appropriate for patient (HEAT). NHS Scotland Objective 1: Health Improvement for the people of Scotland improving life expectancy and healthy life expectancy Target No. H1 H2 H3 H4 H5 Target Save more lives: Achieve a return of spontaneous circulation on arrival at hospital of 12% to 20% Actual 17.5% - Improved on previous year Cardiac Arrest Cardiac Arrest patients responded to in 8 minutes Target 80% Actual 79.1% - Improved on previous year % of Cat A incidents responded to within 8 minutes Target 75% Actual 74.7% - Improved on previous year % of Cat B incidents responded to within 19 minutes Target 95% Actual 91.8% - decrease on previous year % emergency incidents responded to within 8 minutes in Island Boards Target 55% Actual 53.0% - decrease on previous year NHS Scotland Objective 2: Efficiency and Governance Improvements continually improve the efficiency and effectiveness of the NHS Target No. E1 E 3 E5 E6 Reduce Sickness absence to a target of 5% Actual 6.3% - increase from previous year PTS journeys with CHI recorded Target 85% Actual 93.4% - not recorded previous year Target NHS Boards to operate within their Revenue Resource Limit and Capital Resource Limit; and to meet their cash requirement. Target achieved Consistent with last year Deliver a 3% Cash Releasing Efficiency Saving per annum Target achieved Consistent with last year 11

14 Scottish Ambulance Service Board Annual Accounts NHS Scotland Objective 3: Access to Services recognising patients need for quicker and easier use of NHS services Target No. A1 A2 A3 A4 Target % of 1 hour urgent calls responded to within an hour target 91% Actual = 87.6% - Improved on previous year Improve punctuality for appointment for all PTS patients target 72% Actual = 53.7% - decrease on previous year see note Improve punctuality for pick up for all PTS patients target - 90% Actual = 74% - decrease on previous year see note % of PTS journeys cancelled by SAS target < 0.5% Actual = 0.5% - Improved on previous year NOTE: previously A2 and A3 only measured Priority 1 patients now it measures all patients NHS Scotland Objective 4: Treatment Appropriate to Individuals: ensure patients receive high quality services that meet their needs Target No. Target T1 T2 T10 Reduce Hospital admissions. Increase % of calls treated at scene target - 12% Actual = 16.5% - Improved on previous year % of Hyper Acute Stroke patients taken to hospital in 55 minutes target 80% Actual = 78.8% - Improved on previous year Reduce the % of patients conveyed to hospital Actual = 75.7% - Not measured previously 12

15 Scottish Ambulance Service Board Annual Accounts Sustainability and Environmental Reporting Significant work has been ongoing during 2012/13 in relation to sustainability and environmental reporting. Our National Headquarters is continuing to lead the Service in waste management and energy conservation. The organisation achieved a 2.02% reduction in energy consumption which meets the government 2% target of year on year energy reduction.this equates to an efficiency saving of 24k. Fleet continues to follow its action plan to reduce carbon emissions by purchasing vehicles with reduced carbon emissions. Waste Minimisation and Recycling The Scottish Ambulance Service has located its National Headquarters function within a shared NHS premises at Gyle Square, Edinburgh. A recycling area is set up within the National Headquarters which is proving to be extremely popular. Recycling will be monitored and measured and target figures have been set for 2013/14. Two new stations have also been identified to act as pilot stations for waste minimisation within the South East Division. Energy Efficiency As part of our property strategy, we are continuing to install energy saving devices in our upgrades/new builds; in particular, thermostatic valves to all radiators; time clocks to all heating systems; automatic devices for lighting and - within the actual build - energy saving insulation. The Service is also trialling a new gas heating system that incorporates air-source heat pumps (air to water system). These pumps absorb heat from the outside air, and can extract heat even at low temperatures, which reduces the amount of energy required to heat radiators and hot water. Transport Vehicle Emissions The Scottish Ambulance Service is committed to reducing vehicle emissions within the constraints of operating a blue light fleet. Emissions are recorded and reported on a monthly basis, with month to year trend analysis. With the reduction in vehicle numbers, the introduction of lower emission vehicles and focus on emission reduction, the Scottish Ambulance Service is now showing a slight reduction in its overall annual emissions footprint of 3.6% on the previous level of emissions. The leased vehicle essential-user car scheme was suspended late in 2012 to allow a full review which has now been completed and is being introduced. The emission limits have been reduced further with choice restricted to a small set of low emission vehicles. There is still an operational requirement for the resilience provided by a 4x4 vehicle but the emissions of these vehicles is now restricted to below 150g/km. Vehicle & Equipment Selection The procurement process recognises the requirement to consider the environmental impact of vehicles and the opportunities for reduced emissions. All vehicle manufacturers have to meet stringent environmental standards resulting in Scottish Ambulance Service vehicles replaced in recent years already complying with Euro V standards. Vehicles registered in the next calendar year will have to comply with Euro VI standards. In addition to these controls, the Scottish Ambulance Service has assessed individual vehicles identifying new models and technology to help reduce emissions while still meeting operational needs. New 4x4 Paramedic Response Units are now being converted from a base vehicle with emissions below 150g/km. During the year, 200 van conversion A&E vehicles with lower weights, improved fuel economy and reduced emissions were brought into service. During the design of our vehicles, consideration is given to reducing energy both in whole life and operational use. There has been a transition across to LED lighting for emergency warning lights, functional vehicle marker lighting and interior/exterior work lighting. This uses reduced energy and offers extended operational life. Intelligent plug in charging systems allow vehicle electrical systems to have optimum charging ensuring all vehicle based equipment is ready for use but also resulting in extended battery life, reduced battery requirement and removing the requirement to have the vehicle engine running unnecessarily. During the year, an electric Patient Transport Ambulance was brought into service and is currently being evaluated in operational use in the central Glasgow area. Electric vehicles are seen as one potential option to help reduce emissions while maintaining patient service. 13

16 Scottish Ambulance Service Board Annual Accounts Waste Management The Scottish Ambulance Service vehicle workshops continue to implement a waste management process which separates waste to be recycled appropriately, through the shared waste services with other departments, and separately for workshop specific waste. This allows segregation and recycling of the majority of workshop waste e.g. oils, metals, paper, plastics, glass etc. All waste and recycling is facilitated through appropriately registered partners and records are retained for audit purposes. Water Efficiency The constant use of water at all of our sites for vehicle cleaning does mean that our water consumption is high. Unfortunately, unless we undertake vehicle cleaning off site, there is very little latitude to reduce water consumption. However, 85% of our sites now have water meters in operation. This does allow us to closely monitor the consumption and although we may not be able to reduce the consumption because of our vehicle cleaning, it will alert us quicker to any leaks or problems with the water supply. We continue to concentrate on installing water-saving devices such as touch-sensitive taps within certain areas of the station as part of our upgrades and new builds. A new initiative is being trialled at a new build Ambulance Station for the use of recycled water for vehicle washing. This will be monitored during 2013/14 and if successful will be incorporated into all upgrades and new builds. Green Purchasing The Service has in place an environmental procurement policy which supports the Service s environmental policy and the Scottish Executive s policy on Public Procurement and Sustainable Development. As a national public service, the Scottish Ambulance Service is committed to investing in Green Procurement practices and recycling initiatives that will have a positive impact on sustainability of the environment. 5 Equality & Diversity Our Strategic Framework Working Together for Better Patient Care establishes our vision, to deliver the best patient care for people in Scotland, when they need us, where they need us. Our goals to improve patient access and referral to the most appropriate care, to deliver the best service for patients and to engage with all our partners and communities to deliver improved health care cannot be achieved without a firm commitment to continue to progress our equalities work, now and in the future. During the last number of months we have developed our equality outcomes after considering a wide range of input across a number of sources including our patients, members of the public, senior managers, staff and staff side colleagues. We have also taken cognisance of the greater equality and health inequality context and Scottish Government and National NHS policy priorities. We are working hard to ensure that equality and diversity is firmly embedded in all that we do and we recognise the significant impact this has on the service we provide to our patients and the experience of the workforce for all our staff. Our mainstreaming report highlights some of our equalities work and outlines the actions we are taking to progress this further. We have published our equality outcomes, mainstreaming report, equal pay statement and gender pay gap information on 30 April This work ensures that we are compliant with the requirements of the Equality Act 2010 and Equality Act (Specific Duties) (Scotland) Regulations 2012 and the need to have due regard to eliminating discrimination, advancing equality of opportunity and fostering good relations. We continue to monitor the Service Anti-Bullying and Harassment Campaign. The aim of this campaign is to raise awareness of unacceptable behaviour and encourage staff to raise any concerns/issues at the earliest opportunity in order to resolve problems as soon as possible. The Equality and Diversity Steering Group continues to meet bi-monthly to take some of the key areas of work forward. Membership includes representatives from across the Divisions. 14

17 Scottish Ambulance Service Board Annual Accounts Equal Pay The Scottish Ambulance Service has received one claim under the Equal Pay Act 1970 from a woman seeking compensation for past inequalities with male colleagues, under their pay arrangements. The basis of the claim is as follows: The claimant s job has been rated as being of equivalent to that of their comparator using a valid Job Evaluation Study, and/or is of equal value to that of their comparator; Their comparator is currently paid or has been paid more than them; and They claim equal pay, back pay and interest (back pay is claimed for the statutory maximum of five years). The current position and recent developments are summarised below. Comparator Information Comparators have still not been identified, with the exception of a small number of cases. Work is still ongoing by both claimants and respondents in this regard. Until comparators are identified it is not possible to identify the term which is said to breach the equality clause. Period of Claim The period over which back pay for any established breach would have to be calculated is the period between dissolution of their employing Trust and 30 September For the Scottish Ambulance Service this means that the period of the claim is limited to 6 months. The limited scope of these claims was upheld by the Employment Appeal Tribunal in the test case of Foley and Ors v Greater Glasgow Health Board (August 2012). Unequal Contract Term The issue of the basis of claims was considered at the Case Management Discussion on 22 January 2013, which centred on Emmanual v City and Hackney Primary Care Trust. This was a national test case to establish, where claimant and comparators carried out work of equal value, whether there was a genuine material factor defence for different terms relating to pay. The Tribunal decided that the Trust had failed to demonstrate a justification in the respect of different weekend overtime rates, but had done so in relation to basic pay.. Signed: Date: 26 June 2013 Mrs Pauline Howie Chief Executive 15

18 Scottish Ambulance Service Board Annual Accounts SCOTTISH AMBULANCE SERVICE ANNUAL ACCOUNTS AND NOTES FOR YEAR ENDED 31 MARCH 2013 ANNUAL REPORT REMUNERATION REPORT BOARD MEMBERS AND SENIOR MANAGERS REMUNERATION The remuneration of Board members and senior employees is determined in accordance with the NHS MEL(2000)25 Pay and Conditions of Service. This document sets out the pay arrangements for Board members and senior employees of NHS Boards. The arrangements referred to in this document are mandatory from 1 April Performance appraisal for Board members and senior employees is conducted in accordance with HDL(2002)64 Appraisal arrangements for staff on Executive pay ranges. As stated above, the Remuneration Committee meets at least three times per year to consider the evaluation of performance and pay awards for Executive Directors. This committee comprises the Chairman and three Non- Executive Directors: Mr Edward Frizzell, Ms Suzanne Dawson, and Councillor David Alexander. The Committee is chaired by the Chairman, Mr David Garbutt. 16

19 SCOTTISH AMBULANCE SERVICE REMUNERATION REPORT FOR THE YEAR ENDED MARCH 2013 CURRENT YEAR 2012/13 Scottish Ambulance Service Board Annual Accounts Remuneration (Bands of 5,000) Performance Related Bonus (Bands of 5,000) Real increase in pension at pensionable age (Bands of 2,500) Total accrued pension at pensionable age at 31 March (bands of 5,000) Cash Equivalent Transfer Value (CETV) at 31 March 2012 Cash Equivalent Transfer Value (CETV) at 31 March 2013 Real increase in CETV in year Benefits in kind Remuneration of: '000 '000 '000 '000 Executive Members Chief Executive: Pauline Howie (11) 4.3 Director of Finance & Logistics: Pamela McLauchlan (6) 4.0 Director of HR and Organisational Development: Shirley Rogers (3) 0.5 (Outward Secondee from 30/04/12 to Scottish Government) Part Time Medical Director : Prof George Crooks (a) (a) (a) (a) (a) (a) Non Executive Members Chairman: David Garbutt Suzanne Dawson Andrew Richmond David Alexander Theressa Houston Moi Ali Neelam Bakshi Edward Frizzell Employee Director : Matt Bell (b) (b) (b) (b) (b) (b) Other Senior Employees Director of Service Delivery: Daren Mochrie Director of Strategic and Planning and Quality Improvement: Heather Kenney (8) 4.3 Director of Nursing : Karen Wilson (Started 01/10/12) Director of HR and Organisational Development : Elinor Mitchell (Inward Secondee from 01/05/12 from Scottish Government) (c) (c) (c) (c) (c) (c) 2,219 2,373 (19 ) 24.7 Notes (a) (b) (c) George Crooks' Director's pension information is included within NHS24 information. The Employee Director, Matt Bell's Salary is entirely in respect of board duties. Elinor Mitchell's pension information is included within Scottish Government Information. These salary costs stated above include Employers Contributions to National Insurance and NHS Pension Scheme plus On Call Allowances where applicable. 17

20 Scottish Ambulance Service Board Annual Accounts SCOTTISH AMBULANCE SERVICE REMUNERATION REPORT FOR THE YEAR ENDED MARCH 2013 PRIOR YEAR 2011/12 Remuneration (Bands of 5,000) Performance Related Bonus (Bands of 5,000) Real increase in pension at pensionable age (bands of 2,500) Total accrued pension at pensionable age at 31 March (bands of 5,000) Cash Equivalent Transfer Value (CETV) at 31 March 2011 Cash Equivalent Transfer Value (CETV) at 31 March 2012 Real increase in CETV in year Benefits in kind Remuneration of: '000 '000 '000 '000 Executive Members Chief Executive: Pauline Howie Director of Finance & Logistics: Pamela McLauchlan Director of HR and Organisational Development: Shirley Rogers Part Time Medical Director : Prof George Crooks (a) (a) (a) (a) (a) (a) Non Executive Members Chairman: David Garbutt Suzanne Dawson Andrew Richmond David Alexander Theressa Houston Moi Ali Douglas Marr (Left 30/06/11) Christine Humphries (Left 30/06/11) Neelam Bakshi (Started 01/07/11) Edward Frizzell (Started 01/07/11) Other Senior Employees Director of Service Delivery: Peter Ripley (Left 05/08/11) (b) (b) (b) (b) (b) (b) Director of Service Delivery: Daren Mochrie (Started 08/08/11) Director of Strategic and Planning and Quality Improvement: Heather Kenney Total 1,816 2, Note (a) (b) George Crooks' Director's pension information is included within NHS24 information. Peter Ripley's Pension information is included within East Midlands Ambulance Service NHS Trust The salary costs stated above include Employers Contributions to National Insurance and NHS Pension Scheme plus On Call Allowances where applicable. 18