Agenda • Chair’s Welcome and Introduction (LS) • Minutes from the 27 September 2018 Annual General Meeting (LS) • Review of 2018/19 (WH )… • …including “What We’ve Delivered for Patients and Staff” (CP/HY&JB/MS) • Financial Review including presentation of the 2018/19 Annual Report and Accounts (CP) • Council of Governors Review of the Year 2018/19 (BD) • Question and Answer Session (LS)
Review of 2018/19 Will Hancock Chief Executive
We are continuing to grow as an organisation….and operate in an increasingly complex system(s)!
We have a clear strategy………. Our services An integrated approach > Enabling people to access right care, first time Patient > Saving lives and improving outcomes Transport > Supporting people in their own homes SCAS NHS111 & Emergency IUC Service 999 Past Future
….and that strategy is supported by goals and a set of values
2018/19 was a challenging year for the NHS, but SCAS has: • continued to perform well on the Ambulance Response Programme (ARP) 999 emergency response time standards • with partners, embedded the Integrated Urgent Care (IUC) service in the Thames Valley… • …and continued our co-production work for a new IUC service in Hampshire • delivered some good clinical outcomes for patients (e.g. stroke and STEMI care) • established ourselves as the leading NHS provider of Patient Transport Services, with contracts in Thames Valley, Hampshire, Surrey and Sussex
And also….. • continued our work as a Global Digital Exemplar with a number of key projects underway • made good progress with the implementation of our OD Strategy – especially in relation to leadership development and health and well-being • implemented a new Commercial Transformation Programme • collaborated effectively with local systems and other Ambulance Trusts • established effective staff processes for ‘Freedom to Speak Up’ • delivered strong financial outcomes • maintained our status as a Segment 1 provider (best possible) under NHS Improvement regulatory approach
“What We’ve Delivered for Patients and Staff” – three examples • Global Digital Exemplar (CP) • Urgent Care Pathways (HY/JB) • Staff health and well-being (MS)
Example 1 - Global Digital Exemplar (GDE) EPR Developments – enhancing electronic patient record functionality EPR Acute Interface – passing data straight to hospital systems to Vehicle as hub – enhance patient care extended wi-fi for patient care and mapping updates Telephony transformation – latest telephone software to improve resilience, automation, and multi-channel access Resource Optimisation – using big data to improving demand forecasting and resource planning Livelinks Video – using video between patients, control staff and road clinicians Automation Integrated Urgent Care • 999 – control room automation – Connecting • PTS – process improvement organisations and • Corporate – e-learning, clinicians to provide better procurement . seamless care
Example 2 - Urgent Care Pathways Programme Aims & Objectives Support National & Local Strategies with NHS Constitution at its heart Improve quality of Patient Care & Experience Improve Patient Safety Support Operational Clinical Staff Support improvement in the reduction of our key rates for :- - See & Treat - See, Treat & Convey to Emergency Departments - See, Treat & Convey to Non-Emergency Departments Efficiency Savings
Urgent Care Pathways Programme Projects 1. Urgent Care Pathways - Access to key services across our footprint for our clinicians to refer our patients to directly 2. Digital Software Solution - Visibility of those services for our mobile clinicians 3. Clinical Governance - Safety & Consistency of all Urgent Care Pathways across SCAS 4. Terrafix MDT - Supporting the reporting, data & metrics to understand the patient journey to improve care
Urgent Care Pathways Pathway Development Progress Pathway doesn’t exist No access to Pathway for SCAS Clinical Staff The programme team have been using a RAG Rating tool to Potential Pathway exists No current access to Pathway for SCAS Clinical Staff Pathway access under discussion with Service Provider understand the progress made Pathways exists but not in line with SCAS Urgent Care Pathway Plan requirements - e.g. not 24/7 in the development of access to Access available to SCAS Clinical Staff New Pathway in Pilot Phase Urgent Care Pathways Pathway available in line with SCAS Urgent Care Pathway Plan requirements Pathway available to SCAS Clinical Staff but service rarely used despite accessibility Pathway access referral restricted to specific SCAS Clinical Cohort Pathway available in line with SCAS Urgent Care Pathway Plan service requirements Available to all SCAS Clinical Staff and used regularly
Urgent Care Pathways Access to Clinical Pathways SCAS - All Pathways SCAS - All Pathways Current RAG Rating Percentage May 2019 RAG Rating Percentage 15 24 25 0 17 4 62 6 23 24
Urgent Care Pathways Access to Clinical Pathways Established & improved access to SCAS - All Pathways 25 Pathways RAG Rating Comparison Reduction in Red RAG Rating by 51 90 84 80 Large number of pathways being 70 discussed with our partners 60 No. of Pathways 50 37 pathways in pilot phase or need Left - May 2019 40 33 32 32 31 Right - Current improvement with access, 30 23 21 20 effectiveness & usage 8 10 5 0 0 1 2 3 4 5 RAG Rating
Example 3 - Improving the wellbeing of our teams • SCAS leaders better equipped to support their teams • Rosters improved to provide better work- life balance and reduce fatigue • Developed our staff support services
Launched SCAS Leader …. SCAS Leader Module 1 Module 3 Module 2 Maximising Leading Maximising Individual Service Team Performance Development Performance
Numbers so far… • 102 people have started (6 cohorts) • 85 people have completed • Cohorts 1-6 line manage a combined total of ~1200 staff • Managers currently in post should complete by Dec 2020
SCAS Fatigue - Operational Field Trial Safr Ltd was commissioned to conduct a review as to the level of fatigue experienced by SCAS 999 operational personnel across 4 sites, over a total period of approximately 5 months. This included pre-launch activities at each site. (Basingstoke, Didcot, Nursling, Wexham RCs) covering 90 staff. Key Findings The levels of alertness and fatigue within SCAS were found to be broadly in line with the benchmarks for a 24/7 organisation and reasonably consistent across locations and job roles. However, long shifts – especially night shifts of 12 hours or more – were found to cause increased fatigue and therefore higher levels of risk . What we changed Reduced the number of 12 hour shifts our 999 teams work Reducing the length of night shifts, particularly aiming to avoid night shifts of 12 hours or more and reducing the number of night shifts in a given period
We have also … • Improved our control centre environment • Encouraging healthy mind • Healthy eating • Smoking cessation • Weight management • Review of bag weights • Cycle to work scheme • Promoted health & wellbeing across our Trust
Health & Wellbeing Events
Launching our H&WB Portal • https://www.sca.nhsbenefits.net/
Leading by example
Financial Review including presentation of the 2018/19 Annual Report and Accounts Charles Porter Finance Director Annual Report and Accounts can be accessed at: http://www.scas.nhs.uk/publications/
Income and Expenditure • Improving overall and underlying financial position • Income has increased by £10.5m (5%) due to 999 contract income and Hampshire 111. 2018/19 2017/18 • Continuing operations surplus 12 months to 12 months to of £1,486k (£1,180k surplus March £k March £k prior year) Income 225,989 215,487 • Before STF/land disposal (Deficit) before STF and (1,636) (4,412) gains deficit was £1,636k gains on disposal of assets Surplus/(Deficit) from reflecting improving 1,486 1,180 continuing operations underlying financial position Margin 0.7% 0.5% • £1.5m surplus achieved, with £3.2m STF (16/17 £3.2m) Discontinued operations - 131 Surplus 1,486 1,311
Capital Expenditure £m 14 12 10 8 6 4 2 0 07_08 08_09 09_10 10_11 11_12 12_13 13_14 14_15 15_16 16_17 17_18 18_19 • £9.5m capex spend – on new 999 ambulances (£4.1m) – £2.5m on Estates including Southern House refurbishment, and PTS resource centre (Loverock Road) and Fleet workshop (Milton Park) following Battle sale – £2.4m IT spend including £1.2m Telephony upgrade and GDE • 1.1x depreciation ( £8.3m )
Estates BEFORE AFTER Loverock Road (PTS Southern House Milton Park (fleet workshop) resource centre) upgrade • Major review of Estates and updating strategy • New sites following sale of Battle site for housing
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