North East Ambulance Service NHS Trust North East Ambulance Service Annual report 2009/2010 Contents 3 Chairman’s introduction 04 Chief executive’s end-of-year statement 06 Ambulance operations 08 Foundation trust 15 s nt Community involvement 18 nte o C Complaints and letters of appreciation 20 Workforce 24 Clinical care and patient safety 35 Operating and financial review 46 Financial performance 48 Trust board 64 Past, present and future 69 1 Chairman’s introduction 1 5 It gives me great pleasure to introduce our annual Providing equal opportunities is very important to report, for the seventh time. As I look back over us, both in the services we deliver and the way n the years of my chairmanship, I take a lot of pride we employ people. I am proud to report that we o cti in the improvements we have made to our services, achieved 70th place in Stonewall’s workplace u d o as we show in this report. We can say honestly that equality index and we are an ‘Equality and diversity ntr we provide high-quality services (whether speaking partner with NHS employers’ for 2010/2011. These n’s i to customers on the phone, in our contact centres, are very significant achievements and demonstrate a m in our ambulances when we assess patients, provide our strong commitment to achieving a fair society. air h necessary treatment and take them to hospital C or in our training and activities to prepare for We reviewed our business plan and long-term 1 emergencies, which the public are often not aware financial plan this year. We are very keen to involve of). staff and stakeholders (people with an interest in our organisation) in developing our main aims for Since last year’s annual report, we have focused on the future. These aims are to: monitoring the quality of our services to make sure we continue to provide high standards of care as we • set a good example to other ambulance services prepare for foundation trust status. By becoming a in the way we provide emergency care; foundation trust, people would have more of a say • help to make significant changes in the way on the decisions we make within the ambulance urgent and emergency care is provided in the service. We would also have more funding. To help North East; with this, I reorganised the board to make sure • improve patient transport services; that we had the right mix of experience and skills • be an outstanding employer; so that we would be fit for the future – not only as • be successful financially; and a foundation trust but also because of the current • be well-organised and responsible for everything demanding financial environment. As a result, I we do. am pleased to welcome five new colleagues. On the executive team, Ann Fox, a qualified nurse, has We want to achieve these aims by: joined us as Director of Clinical Care and Patient Safety, working alongside Mr Kyee Han, a consultant • being committed, professional and responsible; in emergency medicine, as Medical Director. On • working well as a trust; the non-executive side, I welcome Chris Suddes, • always delivering a high-quality service; Wendy Lawson and Jeff Fitzpatrick, who bring to the • shaping the future; and board considerable skills in areas such as arranging • showing we care. transport, managing call centres and commercial insight. I am grateful to all my colleagues on the board for their support and hard work during the last year. I We have been very busy preparing for our would like to thank all our staff and stakeholders foundation status. We held a three-month public who have done so much to improve the lives of our consultation during the summer of 2009 and patients – your dedication to the job in hand always received comments on our plans from a wide range inspires me. of people and organisations who were interested in the ambulance service. During this time, over 4200 people became members of the trust – far more than we had originally hoped. As I write this, we have well over 7000 members and are working hard to keep them updated on our plans for the future. We want our members, and future governors when we appoint them, to help us deliver services that people in the North East need and want, whatever their race, religion, age, disability, sexuality or sex. 2 Chief Executive’s end of year statement 2 7 nt e m at In 2009/10 we worked very hard to successfully As we move closer to foundation trust status, we ar st improve our services, as I will go on to explain. will need to take a more business-like approach to ye how we arrange the funding and monitoring of NHS d of n Despite the swine-flu pandemic and the coldest services. For example, we have been working with e winter for many years, we met our target to our commissioning partners and other primary care e’s v respond to 75% of life-threatening calls within eight trusts (PCTs) to develop a new model of funding for uti c e minutes. This achievement was a real team effort by our ambulances. We will try out this system next x e our directorates at the trust and our commissioners year to see whether it gives patients the best results ef hi across the North East. in terms of quality of care. Again, the results are C influencing national policy on ‘payment-by-results’ 2 After almost three years of consultation and for ambulance services. planning, we finally opened our new contact centre in South Tyneside. This is a state-of-the-art facility We are confident we can build upon the hard- that has really improved how well our ambulance earned improvements we have made over the last service can respond to the 2.65 million people who few years and can continue to give the taxpayer live in the North East. The centre is named Russell the best possible value for money for our services. House, in memory of an estates adviser who was I am pleased to report that we are well on our way much respected and worked for us for a long time. to doing this. Last year, the costs of running our The building also houses a new ambulance station emergency ambulance services were 83% of what for the Hebburn area, our emergency planning the average English ambulance services spent – the department and our new hazardous area response lowest in the country. This is a trend which we team (HART). expect to continue this year. After setting up the ‘NHS pathways’ and ‘capacity We firmly believe that working in partnerships to management’ systems a few years ago, we have improve the whole system of health and social care continued to lead the way on a new and consistent is vital if we want to have patient care and transport approach to assessing patients’ needs over the services that meet the demands of today’s society. phone and referring them to the correct service. This approach has been well-researched and offers There are many other achievements and initiatives value for money. I am pleased to report that in which I could mention here, but I will leave those October 2009, in partnership with County Durham’s for you to discover in the pages that follow. The NHS services, we successfully set up a phoneline needs of patients are what motivate our people and that people could ring if they weren’t sure who to determine the shape of our services. I hope that you call about their health problem. As well as this, we enjoy reading our annual report and will continue are about to develop a new urgent-care three- to share a sense of pride in what we have achieved digit number (‘111’), which people can use as an for you. alternative to ‘999’. For example, if a patient is not sure whether their symptoms are serious enough to phone 999, they can get advice from one of the operators. If this is successful, ‘111’ will be used across the UK. 3 Ambulance operations We cover an area of some 3230 square miles and provide emergency care to around 2.65 million people. Our operations directorate covers: • accident and emergency; • patient transport services; • emergency planning and resilience; • the hazardous area response team (HART); and operational support (this includes our vehicles, equipment, ambulance resource assistants and resource scheduling 3 Accident and emergency 9 The accident and emergency (A&E) service provides emergency and urgent care to patients. Members of the public contact the service by phoning ‘999’ and asking for an ambulance. Doctors can also use the service by referring their patients to A&E. We also provide a service to the hospitals in our region where we transport patients to facilities so they can receive specialised care. This may sometimes ns o mean we have to take them to hospitals outside of the area our trust covers. ati er p o e c n a ul b m A 3 How accident and emergency have performed in the last year 0 1 Once again this year, we have beaten the In the past year, we have done the following to Government’s target of responding to 75% of improve the quality of the care we provide. all ‘category A’ calls (where somebody’s life is threatened) within eight minutes. In 2009-2010, we • Increased the number of community paramedics responded to 75.45% of calls within eight minutes. in rural areas. ns In 2009-2010, our A&E crews dealt with 103,757 • Developed and improved our links with the falls o ati emergency incidents, which was an increase of teams (who focus on groups of people, such as per 14.25% on 2008-2009. This meant crews dealt with elderly people, who are at risk from being o e about 8646 incidents every month. injured after falling) throughout the North c n a East. We are pleased that, through working with ul b Unfortunately, we fell just below the Government’s a number of organisations, we have successfully m A target for responding to ‘category B’ calls (where reduced the number of falls in people over 60. 3 somebody was seriously ill or injured but their We have received significant national life was not threatened) within 19 minutes. We recognition for this work and we have spoken at responded to 93.97% of calls within 19 minutes. conferences to encourage other trusts to follow We responded to 148,562 of these calls in 2009- our example. 2010, which is the same as about 12,380 every month. The very bad weather made it very difficult • Worked closely with voluntary agencies (such as for our crews to respond in time. St John Ambulance and Red Cross) over Christmas and the new year to make sure we Our control-room staff, front-line operational can treat everybody who needs medical care. ambulance crews, voluntary staff (such as St John Ambulance and Red Cross), First Responders • Worked closely with acute trusts, such as (medically trained volunteers), mountain rescue and hospitals, to improve health-care services, for other support staff have worked incredibly hard to example, by setting up a rural ambulance service meet these standards and have shown great skill, and ‘Seizing the future’ (a programme that aims dedication and knowledge in doing so. to develop the way we work for the next five years). During last year’s particularly bad weather, all of these agencies worked well together to provide a great service to people living in the north east of England. We try our best to treat patients where they have called an ambulance from, without taking them to hospital (we call this ‘see and treat’). In the last few years, we have treated 30,000 more people at home rather than at hospital. This benefits patients who have a minor injury or an illness that isn’t life-threatening. They can be treated at home and don’t have to travel to and wait at an A&E unit, where more serious cases are given priority. This also benefits the hospitals in our region and us in how we manage the care we give our patients.