Agenda item

Purpose: To provide an update on the Improvement Programme, current demand and response times.

 Kevin Tallett, Improvement Programme Director, South Central Ambulance Service NHS Foundation Trust (SCAS) presented the report on the South Central Ambulance Service (Agenda Item 6) and highlighted a few key items in the report. He advised that 96% of the 900 immediate actions required following the CQC report were completed. Of the 11 must-do’s, 10 had been cleared. The 1 remaining item was regarding governance. 14 of the 20 should-do’s had also been completed. They were now moving into the next phase with a target to have all remaining actions cleared by September 2023. They were currently in National oversight Framework 4 with mandated support from NHS England. They were working closely to make improvements by the September deadline.

The Chairman asked for further information on how SCAS had performed over the previous winter, how staff were coping and if there was any up to date data. He noted the delays at hospitals and news items over the winter months. Kevin Tallett responded that it was a very difficult winter. Ben Voller, Clinical Operations Manager, SCAS, advised the Committee that there had been extreme levels of pressure in December 2022. It had improved in January. There were concerns regarding the industrial action and its impact on patient safety but fortunately the strikes were not as large as expected. However, future strikes would have more of an impact. They were doing all they could internally to maximise response for the 20 March 2023 strike. Ben Voller advised it had been a very difficult time but there was a brief respite currently and morale was on the up. Sarah Webster added that the teamwork between SCAS and the Royal Berkshire Hospital (RBH) had been excellent over the winter. They created different ways of working to speed up handovers.

Councillor Macro noted the report stated 14 out of the 16 should do’s had been completed and asked what the two items remaining were. He also noted that whilst response times had improved they were still slightly below target. He asked when they were likely to be on target. Kevin Tallett advised the remaining items were largely regarding capturing evidence and planning. These were very large pieces of work. He highlighted that the actions being taken needed to be sustainable and embedded, and it was important to not be overly optimistic in terms of turnaround. Ben Voller answered the question regarding response time targets. He advised that it was very complicated. There were a number of issues to drive down the utilisation matrix to ensure vehicles were available to respond rather than vehicles waiting for jobs. Resourcing continued to be a challenge. The paramedic profession was more desirable in different areas of health which affected their clinical resourcing. Ben Voller also highlighted the impact of hospital delays. They could not put a finite time on when SCAS would meet nationally mandated performance targets but advised that SCAS were working very hard with other areas of health to meet the targets as quickly as possible. Kevin Tallett added that it was all about people and so recruitment and retention was key.

Councillor Linden asked how SCAS were assessing their recovery. Were staff surveys completed and was patient and family feedback obtained? He asked how this was shaping services. Kevin Tallett advised that the CQC met with them monthly to observe the assurance meeting. There was positive feedback that they were making good progress. Regarding staff, they had held a series of listening events in addition to the annual staff survey. Staff were also involved in delivering the plan. There were a number of themes including silo working, bureaucracy and slow decision making. The CQC report had an impact on everybody within the Trust and so there was almost a grieving process. Now the focus was to make improvements. Regarding the culture, this was a longer term piece of work. The Freedom to Speak Up work was ongoing. They would share the friends and family data with the Committee outside of the meeting.

Councillor Andy Moore noted that performance in January was an improvement and asked what the targets were. Ben Voller confirmed that Category 1 response was 7 minutes and so they were 30 seconds adrift. This was the most urgent call needing a clinical response and a transportation service. For Category 2 the mean was 18 minutes and so they were quite a way adrift. The target for 90^th percentile was 40 but would be reducing to 30. For Category 3 and 4 they did not have the mean average figures however it was 120 minutes for Category 3 and 180 minutes for Category 4. The highest percentage of calls were Category 2 and there were spikes in Category 1 calls as well. These impacted on Category 3 and 4 calls as they worked a triage system. Councillor Moore asked how things were looking since January. Ben Voller advised that they would provide the data when it was available but noted that following some respite, they were now back up at Resource Escalation Action Plan (REAP) 3 due to some increased demand pressure. Councillor Moore noted the data was regarding Berkshire West and asked how the performance compared between urban Reading and rural West Berkshire. Ben Voller advised they had the data available by postcode and so would make that available.

RESOLVED that: the report be noted.