REPORT OF THE VICE-CHAIRMAN OF JOINT CITY AND COUNTY HEALTH SCRUTINY COMMITTEE

Transcription

1 Report to Joint City and County Health Scrutiny Committee 14 January 2013 Agenda Item: REPORT OF THE VICE-CHAIRMAN OF JOINT CITY AND COUNTY HEALTH SCRUTINY COMMITTEE EAST MIDLANDS AMBULANCE SERVICE BETTER PATIENT CARE PROGRAMME PROGRESS REPORT Purpose of the Report 1. To allow Members the opportunity to consider information regarding the range of activity within the East Midland Ambulance Service (EMAS) Quality Improvement Programme Better Patient Care. Information and Advice 2. Members may recall the previous iteration of the EMAS change programme Being the Best which was examined by a sub-committee of the Joint Health Committee in November The sub-committee s recommendations as ratified by the Joint Health Committee are as follows. There should be another hub in the North of the County to cover the Bassetlaw and Newark areas There should be proper provision of maintenance resources (i.e. mechanics) once the changes have been implemented across all areas There should be adequate numbers of ambulances and crews in rural areas EMAS should carefully review all existing arrangements and protocols for crossboundary working to ensure that the greatest possible benefits are secured for people in the North of Nottinghamshire. All issues relating to ambulance stocking governance and accountability should be carefully reviewed practitioners picking up vehicles should not be held accountable for equipment and medication that is missing The facility to transport patients should be available all through the night The fines levied against Ambulance Trusts for not meeting targets are unfair and counter to the interests of the local people and health service Members recommend that EMAS campaigns hard to have the regime of fines lifted. In addition, the Chairman of the Joint Health Committee will write to the Secretary of State for Health regarding this issue 4. The following response was received from Alan Schofield, Assistant to the Chief Executive, Corporate Affairs, EMAS in relation to the EMAS estate in January

2 On the EMAS estate, in particular, it means carrying out further analysis to make sure the final proposals work operationally and financially. Options include to do nothing ; recruit more staff and have more vehicles; run with the 13 hub and 118 community ambulance posts model (as described before and during the consultation); or to have more than 13 hubs/stations (this option includes the possibility of having 27 hubs supported by 108 Community Ambulance Posts). 5. The issue of hubs and was considered by the EMAS Board on 25 March The final decision was to go with 28 hubs and 108 Community Ambulance Posts. 6. Further to this, the latest position is that the estates plan is currently on hiatus over the winter period so EMAS can concentrate on meeting the activity demands. Work is still ongoing to identify suitable locations for Community Ambulance Stations, but the closure of stations and moving of staff to other locations has not yet taken place. 7. A briefing from EMAS on the Better Patient Care Programme is attached as an appendix to this report. 8. Alan Schofield will attend this meeting of the Joint Health Scrutiny Committee to brief the committee and answer questions as necessary. 9. Members may wish to schedule further consideration of the Better Patient Care programme for when plans in relation to the estate are more advanced and/or select additional elements from within the programme for closer scrutiny. RECOMMENDATION That the Joint City and County Health Scrutiny Committee:-. 1) receive the briefing and ask questions as necessary 2) identify additional elements from within the Better Patient Care programme for scrutiny Councillor Parry Tsimbirdis Vice-Chairman of Joint City and County Health Scrutiny Committee For any enquiries about this report please contact: Martin Gately Background Papers None Electoral Division(s) and Member(s) Affected All 2

3 1. Overview BETTER PATIENT CARE PROGRAMME PROGRESS REPORT On 8 October 2013, EMAS was requested to attend a risk summit by the Local Area Team for Derbyshire and Nottinghamshire, on behalf of the regulators and other key stakeholders. Since the risk summit, the trust has been working on a Quality Improvement Programme (Better Patient Care), which sets the direction of the organisation for our staff; raising our clinical quality; and responding to patients. 2. Overall Progress Progress has been made in following areas: Implementation of the plan has now commenced using a programme management approach through the Trust Programme Management Office (PMO). This will ensure: o core processes are in place to give the Board and stakeholders confidence and assurance that the plans will be delivered on time and to a very high standard with exceptions highlighted o robust governance arrangements are in place to ensure staff are not burdened by excessive bureaucracy but are easily able to communicate progress and exceptions that require action o co-ordination with other major projects and ensure conflicts and constraints are managed Workstream leads have been identified and meetings have been held to agree actions to develop detailed plans for each workstream contained in the plan Project toolkits have been generated for the worksteams of the plan which will monitor the progress against the project plan, risks, issues and benefits Project toolkits have been created for each workstream Key performance indicators to be agreed against each workstream of the Better Patient Care plan which will help the trust define and measure progress towards the organisational goals and success criteria. 3. Update on Governance Arrangements The following governance arrangements have been agreed: The Better Patient Care Board will meet twice a month and will be chaired by the Chief Executive Better Patient Care Delivery Group has been established and will meet weekly to review progress with the workstream leads Better Patient Care Delivery Groups will also be replicated in each county Additional support will be provided to the workstream leads EMAS Oversight Group (attendees EMAS, CCG, TDA and CQC) to meet fortnightly-this will be the forum where the trust is held to account regarding the implementation of the plan Escalation of any issues will be through the PMO to the workstream Executive leads and/or Better Patient Care Board 1

4 4. Workstream Progress Responding to Patients Additional Private Ambulance Services has been commissioned to support performance delivery elements of the plan. In addition Voluntary Ambulance Services will continue to provide additional resources on a daily basis. A GP has been assigned to the Emergency Operations Centre to provide additional support during weekends. Our People The Trust has confirmed its intentions to go forward with Listening into Action. Executive Directors are now aligned to each county including attendance at Urgent Care Boards. An engagement meeting has also been held with staff to go through the Better Patient Care plan and to obtain feedback Our Leadership An offer has been received from the Local Education and Training Board in terms of what they can do to support the trust around individual and team development Clinical Safety A Task and finish group has been established to review the future governance process for reviewing quality standards. At the first meeting the terms of reference for the Clinical Governance Group were reviewed and revised (including addition of lay representation, ensuring duties and relationships with other groups clearly defined). It was also agreed that a further sub group looking at clinical effectiveness will be established, that a work plan for the CGG would be developed to provide clarity regarding what reports are required on a regular basis for assurance. The terms of reference of the serious incident review have been agreed and the external body to undertake the review has been identified. Our Money: Financial Governance has been strengthened including revised terms of reference for the Investment Committee to focus on Finance and Performance; finance restructure which includes dedicated financial support to Operational Divisions including the Emergency Operations Centre. An activity forecast for 2013/14 based on actual figures to end October has been prepared and shared with Commissioners. A workshop has been set up to review activity growth forecasts for 2014/15 and 2015/16. Our Communications: A staff engagement group has met and spent time talking with frontline and support service colleagues about Better Patient Care. Valuable feedback was gained on the Our Communications work stream. It led to the addition of a new action: to ensure EMAS colleagues who deliver engagement and public education work in addition to their day job are captured on a central database and supported by being able to access newly created resources, held centrally, to support EMAS community engagement work i.e. school talks, short educational videos, hot topic and key messages one-side etc. 2

5 Recording this work centrally allows for identification of colleagues who are suited to different styles of engagement (i.e. school talks, Women s Institute, faith groups etc.) and allows EMAS to recognise and reward colleagues who go above and beyond what they are employed to do. Being held to Account Revised Board and committee arrangements which will assist in addressing issues identified at the recent risk summit to strengthen current corporate governance arrangements have been proposed and will be agreed by the Trust Board. Estates Activity has focused on identifying sites and partners for Community Ambulance Stations (CAS), with focus on Lincolnshire as a first phase. Melton ambulance station, where the Trust s lease expires, is due to close on the 6 January 2014 and staff will move to Oakham. As a result of feedback and suggestions from staff at Melton, a premises owned by Melton Borough Council (Phoenix House, Melton Mowbray), will be used as a CAS. 5. Next Steps for Better Patient Care: The Better Patient Care programme will be supported to deliver the required benefits through a robust programme management framework. There has been a rapid period of readjusting existing programme management and governance arrangements to absorb the developing Better Patient Care plan. It is intended that this work will be finalised in line with the QIP submission in order to support implementation. The following next steps will be taken: Governance arrangements to be implemented and regular reporting established to provide assurance through the organisation and out to stakeholders Key Performance Indicators will be agreed to define and measure progress to ensure that planned activity delivers outcomes to improve the care we provide to our patients. 3