foundation times - issue 12 autumn 2014

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1 Welcome to the Autumn edition of Foundation Times Foundation Times A newsletter for every member of our trust Issue 12 Autumn 2014 twitter.com/SCAS999

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Welcome to the Autumn 2014 issue of Foundation Times, the newsletter for our members.

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Page 1: Foundation Times - Issue 12 Autumn 2014

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Welcome to the Autumn edition of Foundation Times

Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

twitter.com/SCAS999

Page 2: Foundation Times - Issue 12 Autumn 2014

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

The Trust showcased its mobile simulation vehicle, the Simbulance, for the first time ever, at last month’s CarFest, Laverstoke Park Farm.

During CarFest, SCAS staff were on hand to show members of the public inside the Simbulance. This is an innovative and award winning virtual classroom facility which normally enables ambulance staff to experience realistic medical situations inside an ambulance cabin thanks to educational elements including ambulance equipment, manikins and audio-visual recording capabilities on board.

Helen Pocock, Education Manager (Research and Development) for SCAS, said:

“We were looking forward to showing people of all ages a variety of medical scenarios being simulated in a mobile setting. In the past, simulation has been restricted to labs or classrooms, but the Simbulance allows us to show types of medical situations that typically happen in an ambulance. We were also keen to show the wider public how we are using this technology to develop not only technical abilities, but also some of the other skills essential to our role.

“We invited children to bring along their teddies to be assessed in the Simbulance so that they could engage with us in an interactive way and familiarise themselves with basic equipment and the overall ambulance environment. This helps to reduce the fear factor should a child ever require our services in the future. There was also a chance for children to enter our ‘Name the Manikin’ competition in aid of Children in Need”.

SCAS SHOWCASES SIMBULANCE FOR FIRST TIME AT CARFEST

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Scan this with your iphone for more information

To keep up to date about the Simbulance, follow @SCASLearning on Twitter

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

ANNUAL GENERAL MEETING

ANNUAL MEMBERS MEETING

&4

Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

The Trust’s Board of Directors and Council of Governors hosted its annual public event on Wednesday 24 September at the Gateway Conference Centre, Aylesbury, Buckinghamshire.

The day opened with the public board meeting, followed by the Annual General Meeting (AGM) and Annual Members Meeting (AMM).

Trust Directors presented the annual report and accounts for 2013/14 and also a review of how the Trust has performed over the last financial year.

This was a great opportunity to hear about our achievements in the past year and our plans for the year ahead that seek to continue to improve the services and the quality of care we provide.

As well as the AGM the Trust also invited guests, members of the public and members of our foundation trust to visit the Health and Partners Fair, which featured an array of stands showcasing SCAS services, featuring Patient Transport Service, Commercial Training, Recruitment, Community First Responders and League of Friends.

There were also stands from Aylesbury Vale CCG (Clinical Commissioning Group) and Chiltern CCG, Buckinghamshire Family Information Service (BFIS), Carers Bucks, Healthwatch Bucks, SEAP (Support, Empower, Advocate, Promote) and Thames Valley and Chiltern Air Ambulance.

Our theme this year focussed on Stroke, and the day concluded with a presentation on the subject from Rob Kemp, one of our Area Managers.

AGM & AMM WITH HEALTH AND PARTNERS FAIR

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

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999TED

999 TED

7

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

SCAS NOW PROVIDES PATIENT TRANSPORT SERVICE IN MORE PARTS OF HAMPSHIRE8

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

On 1st October 2014, SCAS took over responsibility for running the non-emergency Patient Transport Service (PTS) across Hampshire from two existing providers. We got the contract by winning a tender issued by seven Hampshire Clinical Commissioning Groups (CCGs).

It is a complicated process transferring a service like this from two providers to one new one, and a project team had been working since May 2014 to ensure a smooth handover.

63 new specialist vehicles were commissioned from Yorkshire vehicle manufacturer O&H Facilities, all of which are designed and made to exacting standards to provide Trust patients with the comfort, facilities and security they need.

Four sites were renovated to provide additional PTS bases at Gosport, Havant, Portsmouth and Totton, providing a clean, safe and comfortable base for teams to work from.

Technology will play a key role in SCAS delivering a high-quality service. Both SCAS Contact Centres are working together to provide a seamless experience to the service users, with calls being answered by the next available call handler at either centre, supported by a new single patient data system. All PTS staff will have Personal Data Assistants (PDA’s) to provide live performance data, enabling teams to be proactive in response times.

James Underhay, Director of Strategy and Business Development said:

“This is a really important contract for SCAS, and we are determined to deliver the best possible service to patients in Hampshire.

“I would like to welcome all the staff who have joined us from other providers, and to thank everyone who has worked so hard to ensure a smooth transition of services.”

New PTS vehicles being prepared

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SCAS is keen to recruit additional voluntary car drivers across the area to support patients who require car transport. Volunteers use their own vehicle, for which mileage is paid, and existing volunteer drivers enjoy this worthwhile and rewarding experience, helping others in their local community.

If you are interested, please contact us on the details below, or pass them on to a friend, family member or colleague who might be [email protected]

New PTS vehicles being prepared

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GOVERNORGOVERNOR

GOVERNOR ELECTIONS- NOMINATIONS

The race is on Governor elections are now open. These elections give you the opportunity to help shape the future of your ambulance service.

This is now your chance to get involved by:

» Standing as a Governor in one of our public or staff constituencies

» Voting for a candidate who you feel would best represent your views

What do governors do?

There are a number of specific duties that the governors must do, but in summary governors must:

» Hold the non-executive directors to account for the performance of the Board

» Represent the views of staff members » Tell members what the Trust is doing

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Staff governors No. of governors to elect

999 Operations - North 1

999 Operations – South 1

Contact centres including NHS111 and EOC 1

PTS and logistics field staff 1

Corporate / support /other 1

Public governors

Berkshire 2

Buckinghamshire 1

Hampshire 3

Oxfordshire 1

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Governors must make sure the Board of Directors and the non-executive directors are doing their job properly by:

» Looking at reports on the Trust’s finances and seeing how they are performing against service user targets and standards

Deadline for receipt of all nominations is 30 October 2014.

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STEP 1 Electoral Reform Services (ERS) / Trust issue the Notice of Election. Nomination forms to be made available to Trust members. If you want to put yourself forward for election you will need to request a nomination form from the election company, fill it in and then return it to them by 30 October You will need to provide a 250 word statement on your background and why you want to become a governor, including a recent photograph. This is all explained on the form.

Wednesday 15 October

STEP 2 Closing date for submission of nominations to the Electoral Reform Services (ERS)

Thursday 30 October

STEP 3 ERS & Trust publish summary of nominated candidates upon validation. Friday 31 October

STEP 4 Final date for candidate withdrawal. Tuesday 4 November

STEP 5 List of candidates who are standing for election published on the Trust’s website Tuesday 18 November

STEP 6 Voting packs emailed by ERS to staff members. Even if you don’t stand for election yourself, you can still have your say and vote for a candidate.

Wednesday 19 November

STEP 7 Closing date for election. Tuesday 9 December

STEP 8 ERS provide results/report to Trust. Both successful and unsuccessful candidates will be notified and we will publish these on our website.

Wednesday 10 December

Key dates for elections

The election process is managed on the Trust’s behalf by ERS (Electoral Reform Services), an electoral services supplier and independent organisation experienced in elections of this nature. The election process will run for approximately eight weeks.

How do I stand as a Governor?If you would like to stand in the election you will need to request a nomination form from the election company, fill it in and then return it to:

Electoral Reform Services LimitedThe Election Centre33 Clarendon RoadLondon. N8 0NW

Tel 0208 889 [email protected]

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

Misuse of the ambulance service costs lives.Last month the Trust sent a press release out asking the public to call 999 for emergencies and life-threatening situations only, after it received a call at the weekend from a male who wanted a lift home from Reading town centre.

At 1:23am on a Sunday morning SCAS received a call saying that someone was unconscious. An ambulance crew arrived on scene in 6 minutes however when they arrived the caller was fully conscious and was requesting a lift home.

Thankfully calls such as this are few and far between and in most instances we are able to establish those inappropriate calls before we arrive. This enables us to ensure that resources are used for serious and life threatening emergencies only.

Some of the unusual / inappropriate reasons people have called 999 include:

» Broken fingernails » Change light bulbs » Provide lifts home » Fix broken TV remote controls » Attending to sick pets » Complaints about noisy neighbours » Burning caused by food that is too hot » No credit on mobile phones to call GP.

READING MAN CALLS 999 FOR A LIFT IN AN AMBULANCE

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Will Hancock, CEO, SCAS, says:

“I would like to encourage everyone to take a look at our hard hitting campaign film ‘999 South Central’ which shows just how lives are put at risk when 999 is called inappropriately. Everyone at SCAS is committed to continually improving the service we provide to the community and we would urge members of the public to help us and only use 999 when it is absolutely necessary.”

Overall the public are very supportive of the ambulance service. However, there are a number of people who do abuse it.

Demand on the ambulance services has doubled in the last 10 years and we really need people to use the service appropriately to ensure that the most acutely unwell patients receive treatment as soon as possible.

If you are suffering an injury or illness which is non life threatening there are other avenues of care available to you. You could:

» Visit your local pharmacy » Contact your GP or out of hours GP » Call NHS111 » Attend Walk in Centres and Minor Injuries Units

» Access NHS Choices online to check your symptoms and find your nearest service.

Watch ‘999 South Central’ www.999southcentral.co.uk

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

MEETTHETEAM

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IN THIS ISSUE WE CHAT WITH MARK AINSWORTH-SMITH, CONSULTANT PRE-HOSPITAL CARE PRACTITIONER (CPHCP).

Can you tell us a bit about your role?

è I am a qualified Emergency Care Practitioner (ECP) and the Trust lead for Major Trauma. I originated from a hospital A&E background (17 years in A&E) but have worked actively in a frontline capacity for over 12 years. I work regular shifts ‘on the road’ and I am often called to support crews in their management of critically unwell patients.

Are you a member of any associations?

è I am a member of the AACE (Association of Ambulance Chief Executives) urgent care workstream, with a focus on improving the care for patients with non-emergency conditions.

What is the best part of your role?

è I attend hundreds of emergency cases every year and would readily admit that this is my favourite domain of practice.

What projects are you involved with?

è I actively teach in the Universities across the SCAS area and I am helping to develop curriculums for ECPs and an MSc in trauma. I am also involved with the education of frontline crews and EOC (Emergency Operations Centre) staff. One of my key projects has been the education of SCAS staff in dealing with major trauma. The benefits of this have been seeing a 30% reduction in trauma deaths since the “go live” of the trauma networks in 2012. I regularly deliver training sessions to staff on team training days, and work closely with our CFR (Community First Responders) schemes. Furthermore I am closely linked with the GP training schemes which run across SCAS.

Your role is very interesting. Do you represent SCAS in any external projects?

è I am actively involved to ensure that ambulance services are represented at a national level. I work regularly with AACE and national bodies to ensure that SCAS are kept at the forefront of any changes in practice. I lead the review process for private providers, to ensure that the care they deliver is closely aligned to that delivered by our own staff. Moreover I am regularly involved in audit and research projects. Much of this focuses on trauma, but current projects include a study on UTI and a patient satisfaction study.

What are you most passionate about?

è Accident Prevention. I am working closely with councils to ensure that Accident Prevention is high on the agenda in reducing morbidity and mortality of trauma patients. I am the SCAS ambulance service lead for both the Wessex and Thames Valley Trauma Networks.

In the south central region there are two major trauma centres, Oxford and Southampton. There are also trauma units and local emergency departments.

Patients are triaged according to their injury severity score and location. If the ambulance cannot reach a major trauma centre within 45 minutes, it will divert to the nearest trauma unit or emergency department.

The two regional air ambulances are a valuable resource to getting the most severely injured patients directly to a major trauma centre.

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

“The Care Quality Commission pilot inspection of SCAS, under the new A Fresh Start for the Regulation of Ambulance Services approach, took place during the week commencing 8 September 2014. “I delivered my opening presentation to the full team of CQC inspectors on 9 September and this was followed by a comprehensive range of interviews and focus group meetings with Directors andstaff. I am greatly appreciative to the five governors who met with the CQC as part of this process and discussed a range of issues.

“The inspection team have also been visiting resources centres and other SCAS locations, and participating in crew ride-outs. “Initial verbal feedback has been highly positive, particularly in terms of our staff and the commitment and care they show towards patients. We are committed to continuous improvement and look forward to the opportunities this will give us to further raise the quality of our services as well as confirming what we do well already. “The CQC have advised that they will not be issuing an inspection rating for this pilot.”

Last month’s visit from the Care Quality Commission (CQC) – an update from Will Hancock, Chief Executive on 1 October 2014.

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19@s ca s 999

TWEET US

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

A team from Buckinghamshire Patient Transport Service (PTS) attended the 147th Bucks County Show on Thursday 28 August.

The crew took one of the Bariatric Ambulances and had the opportunity to speak to the public about the services SCAS provide and also to recruit new volunteer car drivers.

999 Ted, the SCAS mascot was also in attendance giving out goodies to the children who had a great time!

The day was really successful with a lot of interest and support shown to the team, who all worked really hard.

SCAS’S NON-EMERGENCY SERVICE TEAM LEAVES ITS PRINT AT THE BUCKS COUNTY SHOW

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

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The prevalence of obesity in the UK has trebled since the 1980s and is now estimated to affect around one in every four adults and around one in every five children aged 10 to 11 in the UK.

People are classified as obese when their body mass index (BMI) goes over 30.

BARIATRIC AMBULANCES – FACTS AND FIGURES

Normal ambulances can only carry patients who weigh up to 28 stone and the bariatric ambulances are catered to support patients weighing up to 55 stone.

Find out if you or your child are a healthy weight and understand how BMI is calculatedby clicking here.

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

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A fourth defibrillator has been installed in Chinnor thanks to the fundraising efforts of Chinnor BUZZ, an independent group of local businesses.

More than £2,000 was raised at a quiz night organised by the group; sufficient to pay for the purchase and installation of the new defibrillator, as well as a pager for use by the local First Responders.

CHINNOR GETS ITS FOURTH DEFIB THANKS TO LOCAL FUNDRAISING

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Fiona Mantle, a Community First Responder and Parish Councillor, said:

“I’d like to thank Chinnor BUZZ for their fundraising efforts. Chinnor is now very well equipped in terms of defibrillators, which provide a very useful addition to the existing Community First Responders Team.

The defibrillator has recently been installed outside the Wheatsheaf pub in Chinnor.Chinnor now has four defibrillators located strategically around the village.

These modern defibrillators are very easy to use and provide spoken instructions to guide you through the process of using them. A training day for residents was also held to help make them feel at ease using the equipment.

“I’m sure the defibrillators will help save lives over the coming years.”

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

HEALTH

CORNER

BETTER ASTHMA CONTROL NEEDED TO STAVE OFF AUTUMN WHEEZING

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Autumn is not a great time of year for the million or so British children with asthma. It’s when they are most likely to lose control of their symptoms and end up in hospital. But it needn’t be so.

There is a dramatic rise in the number of children rushed to hospital for their asthma in the autumn term.

Facts and figuresAround 7,000 children with asthma are hospitalised during September and October every year in England alone – that’s half as many again as the average across the rest of the year.

Why in autumn?

It is unclear why September and October are particularly bad months, but there are likely to be a number of factors involved.

These may include exposure to asthma-triggering coughs and colds carried by class-mates, and a ‘laissez-faire’ attitude to taking medication properly over the summer holidays, rendering them more vulnerable to attacks.

While it is virtually impossible to protect children from the coughs and colds, much can be done about their use of the asthma medication.

Make sure your child isn’t one of them by acting now!

We know that up to 75% of hospital visits could be prevented by giving children the right support to handle their condition. Asthma UK’s free, award winning My Asthma pack is proven to reduce admissions by 60% and helps you develop a fun routine with your child to manage their asthma and reduce the risk of attacks.

Order your FREE pack now by clicking here.

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

Flu is an infectious and common viral illness spread by coughs and sneezes.

It’s not the same as the common cold. Flu is caused by a different group of viruses. Symptoms tend to be more severe and last longer.

You can catch flu – short for influenza– all year round, but it is especially common in winter, which is why it is also known as “seasonal flu”.

For most people, flu is an unpleasant illness, but it’s not serious. If you are otherwise healthy, you will usually recover from flu within a week.

However, certain people are more likely to develop potentially serious complications of flu, such as bronchitis and pneumonia. These people should have a flu jab each year.

Who should have the flu jab?

The injected flu vaccine is offered free of charge on the NHS to people who are at risk, to ensure that they are protected against catching flu and developing serious complications.

BEAT THE FLUBE PREPARED FOR WINTER

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You are eligible to receive a free flu jab if you:

Ù are 65 years of age or over Ù are pregnant Ù have certain medical conditions Ù are living in a long-stay residential care home or other long-stay care facility

Ù receive a carer’s allowance, or you are the main carer for an elderly or disabled person whose welfare may be at risk if you fall ill

Ù are a healthcare worker with direct patient contact or a social care worker.

For more information, please click here

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

GREEN CORNER The Trust is committed to reducing our carbon impact on the environment in which we operate and we believe this is the right thing to do for patients, our environment, the communities we serve, our finances and the planet. Planning to reduce carbon makes environmental and financial sense.

SCAS forecast carbon emission figures for the year 2013/14 show that even though there was a slight increase in carbon tonnes from utilities in this year, we hope to still show a reduction in these figures when carbon initiatives are implemented in the coming year. It is also believed the overall trend will show a downward trend in year 2015.

More information can be found in our Sustainable Development Management Plan 2013/14 to 2015/16, available on our website by clicking here.

Compare Green Car running costs... Green Car Guide has launched a new car running costs comparison calculator which allows you to compare the running costs of up to three cars, and to compare different technologies, such as petrol v diesel v hybrid or electric. Uniquely, the tool includes more realistic real-life fuel economy figures for cars such as plug-in hybrids and E-REVs than the misleading official NEDC figures for this type of technology - find out how much green cars cost to run at www.greencarguide.co.uk.

If you would like to contribute and share your ideas, please contact the Membership Office at [email protected]

08/09

14/15Forecast

FLEET

UTILITIES

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

15,044tonnes

14,055tonnes

5,034

3,040

11,119

10,010

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12/13

13/14

09/10

10/11

11/12

29

CARBON FOOTPRINT TONNESCO2

14,699tonnes

13,154tonnes

13,054tonnes

13,724tonnes

14,159tonnes

2,635

2,532

4,257

3,040

3,05210,442

11,119

10,102

11,192

10,419

10,010

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

TOTAL 999 ACTIVITY

RED 1 [19 mins]RED 1 [8 mins]

42,087

NON CONVEYANCE

16,541NON CONVEYANCE %

43.41%

76.62% 97.60%

RED 2 [19 mins]

95.81%75.69%90,064

111 CALLS ANSWERED

CFR RESPONSES

31,243PTS JOURNEYS

2,697

RED 2 [8 mins]

What does it mean?

Total 999 activity equates to the number of calls which received a SCAS response or were dealt with by our clinical support desks Non conveyance is the number of incidents we responded to where the patient was not taken to hospital.

Non conveyance % is the percentage of incidents we responded to where the patient was not taken to hospital.

Red 1 - Red 1 calls are the most time critical and cover cardiac arrest patients who are not breathing and do not have a pulse, and other severe conditions.

Red 2 - For Red 2 calls, which are serious but less immediately time critical and cover conditions such as stroke and fits.

HOW WE’RE DOINGAUGUST 2014 FIGURES

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TOTAL 999 ACTIVITY

RED 1 [19 mins]RED 1 [8 mins]

42,087

NON CONVEYANCE

16,541NON CONVEYANCE %

43.41%

76.62% 97.60%

RED 2 [19 mins]

95.81%75.69%90,064

111 CALLS ANSWERED

CFR RESPONSES

31,243PTS JOURNEYS

2,697

RED 2 [8 mins]

All figures are provisional.

111 calls answered is the number of calls answered through the non-emergency healthcare service.

CFR stands for Community First Responder.

PTS stands for Patient Transport Service.

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Foundation T imesA newsletter for every member of our trust

Issue 12 Autumn 2014

You can make a difference!

For more information, email [email protected]

or phone 01869 365126.

Thank you

for

your suppo

rt

members!

13,166public membersto date

8,000

13,000

NUMBER OFFOUNDATION

TRUST MEMBERS

5,000

12,000

FOUNDATION TRUST MEMBERSHIP

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Date Event Location Time

October

Friday 17Patient Survey Roadshow-SLOUGH

Queensmere Observatory, Slough, Berkshire

All day

Saturday 18 Fareham’s 999 Day Fareham, Hampshire All day

Wednesday 29 PlaydayThe Leys Recreational Ground, Oxford

All day

Friday 31Talk before you walk (with SCAS Patient Survey)

Eden Shopping Centre, High Wycombe, Bucks

All day

Friday 31Patient Survey Roadshow - Banbury

Castle Quay, Banbury, Oxfordshire

All day

November

Tuesday 4 Healthwatch 2014thecentre:mk, Middleton Hall, Bucks

All day

Thursday 13 Hampshire patient forumSCAS Otterbourne office, Hampshire

5pm

Friday 14 Patient Survey Roadshow - Aylesbury

Friars Square, Aylesbury, Bucks

All day

We actively seek to involve our members, patients and the public (and those who represent them) in our decision making, ensuring that we engage with our local communities and members. Come and talk to us at one of our events this autumn. For details of all our upcoming meetings visit: www.scas.nhs.uk/foundation-trust/engagingwithourcommunities/events.ashx

WE ARE COMING TO MEET YOU

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Get to know your governors

Ian Hammond

Kemi Adenubi

John Donne

Cllr Allan Glass

Tricia Kelly

Eddie Cottrell

Sue Thomas

Melanie Hampton

Jeni Bremner

David Palmer

David Chilvers

Jonathan Cotterell

Christina Fowler

Sabrina Chetcuti

Cllr David Burbage

Vacant

Paul Carnell

Vacant

Cllr Keith House

Vacant

Berkshire constituency

Hampshire constituency

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ove

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Contact the Membership OfficePlease get in touch with the membership office if you:

» want more information about what we do » have a story you want to share with other members » want us to come along to an event in your local area » want to change your contact details » want to get more involved and update your involvement choices » want membership forms or other literature to distribute » want to raise an issue with a governor

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Email: [email protected] or Tel: 01869 365126

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Bob Duggan Dave Johnson

David Ridley

Buckinghamshire constituency

Patrick Conafray

Michael Shread

Tim Windsor-Shaw

Oxfordshire constituency

Have your say and support your governors. Make a difference by helping them shape the future of your local ambulance service.

Email them at [email protected]

The Council of Governors meets five times a year and represents the interests of members and stakeholder organisations. Meetings are open to the public. For more information please visit our website at www.scas.nhs.uk/ft

The next COG meeting will be on 8 January 2015 at Shaw House, Newbury (6.30pm - 9.00pm).

Want to find out who your governors are? Go to www.scas.nhs.uk/ft

COUNCIL OFGOVERNORS

FIND 999 TEDAs from this issue we will hide 999 Ted, our mascot, in one of our articles……did you spot him?

999TED

999 TED

Page 36: Foundation Times - Issue 12 Autumn 2014

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Produced bySouth Central Ambulance Service NHS Foundation Trust Units 7 and 8 Talisman Business Centre Talisman Road Bicester Oxfordshire OX26 6HR

Tel 01869 365000 | Fax 01869 322814 | [email protected] | www.scas.nhs.uk

Design > Ben Hennessy