The Chief Executive of the East Midlands Ambulance Service (EMAS) NHS Trust, Richard Henderson, will present a report to the Trust Board on 10th October 2023.
The report provides an update on the key issues currently facing the Trust and the actions being taken to address them.
Key Points:
Performance and Priorities:
The Trust’s main focus is the successful implementation of its priorities for 2023/24, as outlined in the annual plan approved in June.
A significant emphasis has been placed on achieving the national requirement of an average response time of 30 minutes for Category 2 calls.
The Trust’s performance as of 31st August 2023 indicates an average response time for Category 2 calls of 37 minutes and 3 seconds, which is above the planned trajectory.
Improvement Initiatives:
The Trust received an additional £23.5 million to achieve the 30-minute average response time for Category 2 calls.
The implementation of NHS Pathways as the primary triage tool in EMAS Emergency Control Centres (EOC) is progressing well, with a significant number of staff trained. Full implementation is expected by the end of November 2023.
Operational Challenges:
The Trust did not meet any of the national operational performance metrics in August 2023.
The unvalidated month to date position against the national response standards (as at 25 September 2023) is shown in the table below.
We are not achieving the nationally defined standards however Leicester, Leicestershire and Rutland; Northamptonshire; and Nottinghamshire divisions are achieving the Category 1 ninetieth percentile national standard.
Despite challenges, there have been improvements in response times for Category 1 and Category 2 calls compared to the previous year.
More on these targets:
Category 1: Life-threatening
Time-critical life-threatening event needing immediate intervention and/or resuscitation, e.g. cardiac or respiratory arrest; airway obstruction; ineffective breathing; unconscious with abnormal or noisy breathing; hanging.
Category 2: Emergency
Potentially serious conditions (ABCD problem) that may require rapid assessment, urgent on-scene intervention and/or urgent transport.
Category 3: Urgent
Urgent problem (not immediately life-threatening) that needs treatment to relieve suffering (e.g. pain control) and transport or assessment and management at the scene with referral where needed within a clinically appropriate timeframe.
Category 4: Non-urgent
Problems that are not urgent but need assessment (face-to-face or telephone) and possibly transport within a clinically appropriate timeframe.
The Addendum to the NHS Constitution requires all ambulance trusts to:
- Respond to Category 1 calls in 7 minutes on average and respond to 90% of Category 1 calls in 15 minutes.
- Respond to Category 2 calls in 18 minutes on average (amended to 30 minutes for 2023/24) and respond to 90% of Category 2 calls in 40 minutes.
- Respond to 90% of Category 3 calls in 120 minutes.
- Respond to 90% of Category 4 calls in 180 minutes.
Hospital Handover Delays:
There has been a reduction in hours lost to hospital handover delays. However, significant hours are still being lost, impacting the Trust’s efficiency.
The reduction in the amount of hours lost to hospital handover delays which we saw at the beginning of the year has continued. As the graph below shows, we are losing significantly fewer hours than last year, however we still lost 7,397 hours in August and the projection for the month of September is 7,459 lost hours. This is more than the full month in August and equates to 26 twelve hour shifts a day, still a significant number of hours to lose.
Quality and Safety:
There has been a reduction in the number of Serious Incidents (SI) and Patient Safety Incident Investigations (PSII) reported in July and August 2023 compared to the previous year.
The Trust continues to monitor and address incidents related to delayed responses and sub-optimal care.
COVID-19 Updates:
As of 20th September 2023, the Trust had no active COVID-19 outbreaks but is monitoring two areas with clusters of cases.
Non-Emergency Patient Transport Services (NEPTS):
Performance in Northamptonshire and Derbyshire remained static in July and August 2023. However, there have been positive results in Lincolnshire since the service’s mobilisation on 1st July 2023.
Financial Overview:
As of August 2023, the Trust reported a surplus of £0.987 million against a planned break-even position.
The Trust’s financial plan for the year assumes cash-releasing efficiency savings of £11.2 million.
