Agenda item

Purpose: To review the progress of the Improvement Programme and services in West Berkshire.

Kirsten Willis-Drewett (Assistant Director of Operation) and Caroline Morris (Transformation Programme Director) presented the report from the South Central Ambulance Service NHS Foundation Trust (SCAS).

During the presentation the following points were highlighted:

·       SCAS remained in the NHS Recovery Support Programme following the 2022 Care Quality Commission (CQC) rating of inadequate. However, significant improvements had been made across the organisation and they were focussed on longer term strategic and cultural change.

·       In terms of patient safety and experience, significant improvements had been made to safeguarding, training in the approach to the Mental Capacity Act and in learning from patient safety incidents.

·       An overview of operational performance was shared. This included reduced handover times at hospitals leading to faster call response times. This was in response to their Release to Respond initiative to reduce handover delays and had resulted in SCAS being the fastest responding ambulance service in the country in January 2025. There had also been improvements in ensuring patients got the right care as quickly as possible. It was highlighted that SCAS were responding to Category 2 and Category 3 calls better than the England average. Category 1 calls were not meeting target and so would be an area of focus for SCAS.

·       It was advised that SCAS also provided the 111 call service. The demand for that had increased significantly. 111 used various pathways to direct patients to. The target was for less than 10% to be directed to 999 services.

·       It was highlighted that SCAS had a strong working relationship with Royal Berkshire NHS Foundation Trust.

The following points were raised in the debate:

·       It was noted how successful the Release to Respond initiative had been for ambulance response times and in reducing the queues of ambulances at hospitals across the SCAS operating area. It was noted that at peak times there were 25 ambulances operating in Berkshire West and about 15 during the night. If there were long queues at hospitals it was not viable for the ambulance service.

·       Members noted there had been immense improvements since the CQC inspection and that the work undertaken was impressive. In particular, the work around culture and wellbeing was highlighted. It was confirmed that there was good evidence that an engaged workforce improved performance. SCAS had used evidence-based ways of making improvements.

·       It was noted that there was a particular challenge around resourcing vehicles. There was a national procurement process, and the government mandate was for only two types of vehicles. They had to replace vehicles every five years and with only two products it was a challenge to get vehicles. A third provider would be beneficial, and it was a long process to acquire new vehicles. In addition, there were only two workshops in the SCAS area and so they were looking for a third workshop. Ambulances needed servicing every six weeks. Particularly during winter, there were fleet challenges.

·       It was confirmed that the non-emergency patient transport service would no longer be provided by SCAS. A new provider had been commissioned by the BOB ICB starting from 1 April^t 2025. The new provider was EMBED and they were the largest provider of non-emergency patient transport services in the UK. SCAS were working to ensure a smooth transition to the new provider.

·       It was advised that the South East Ambulance transformation would involve the creation of a group model across six ICBs. SCAS currently covered four ICBs and was fairly small compared to other NHS organisations. This model worked along county boundaries and was built on current infrastructure, local accountability and local relationships. The South East Ambulance transformation would benefit from similar geographies and working together where it made sense to.

·       It was advised by SCAS that they would be implementing Quality Improvement (QI) methodology and a continuous improvement approach to the transformation programme. SECamb had a great QI programme which would benefit SCAS as part of the South East Ambulance transformation. They would look at what each other did and compare to get collective improvements and to drive efficiency.

·       It was highlighted that 5% of patients would never access digital services and asked how SCAS would ensure individuals were not excluded. It was advised that the use of artificial intelligence to support call handlers would benefit all through streamlining processes. They could also collect demographic data to reduce repetition for patients sharing information. Artificial intelligence could also be used to assist with training of call handlers and in particular the transition between the training environment and taking real calls. By improving the training environment, they were less likely to lose staff during that transition. 

·       It was noted that the Hampshire and IOW ICB were the lead commissioners of SCAS. It was advised that SCAS also met with the other three ICB’s including the BOB ICB as well as working on specific programmes of work with each ICB.

·       It was confirmed that SCAS were not in a rush to be reinspected by the CQC because although they had completed an enormous amount of work and made improvements, there was more work to be done. There was a new senior leadership team which needed time to settle. A reinspection would be better after a stable team was in place. However, it was noted that the CQC would visit when they would visit and that it could be at any time. It was advised that they were cautious to promote the improvements through communications at this time until they had the data and evidence to show that.

·       It was asked that SCAS return to the Health Scrutiny Committee in 12 months times with an update and include information on their communications.

Action: Vicky Phoenix to add an update to the work programme for March 2026.

RESOLVED to note the report.