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The Scottish Ambulance ServiceInitial Agreement – FMC Programme

IA - Future Mobile Communica tions (FMC) Prog ramme Version 1.5 March 2013 – J. Baker 1 | P a g e

The Scottish Ambulance Service Board

Initial Agreement

For the establishment of a

Future Mobile Communications Programme

Document Control InformationControl Status Approved for PublicationDate Last Printed February2013Version Number Version 1.5

Author John Baker, Interim General Manager, ICT



Owner:

GM ICTVersionNo:1.5

Doc& page:22 pages.

Review arrangements:Ambulance Service Board

Date of Release:

14th February2012

Date Intranet Posting:TBC

Implementation:

On release

Executive Approval by:

Chief Executive Officer

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Equality & Diversity Impact Assessment:

No issues relating to equality and diversity have been identified within the document.

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Via Service document control arrangements to the Executive Team, Ambulance Service Board, eHealthProgramme Board and Strategic Implementation Programme Board.

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eHealth Business Case Guidance - Initial Agreement Content Checklist

IA Content Checklist Check IA ContentReference

Title of the Programme Yes Cover Page

Executive Summary Yes Pages4-6

Strategic Case Yes Pages 7- 10

Economic Case Yes Page 10

Commercial Case Yes Page 11

Financial Case Yes Page 11

Managerial Case Yes Page 12

Proposal Yes Page 12

Initial Agreement - Sign Off Yes Page 13

Appendices Yes Pages15–21

Glossary of Terms Yes Page22



Executive Summary

Introduction

The purpose of this document is to establish a case for change within the Scottish Ambulance Service (theService) and to outline the need for investment in the Service’s Future Mobile Communications (FMC)

Programme in order to secure the future of mobile voice and data services when existing contracts expirein 2016 and 2020. The objective of this document is to secure the Initial Agreement to proceed with thisprogramme.

Organisational overview

The Scottish Ambulance Service is one of eight Special Health Boards within NHS Scotland. It is also one ofthe three Scottish emergency services. With over 4300 staff and an overall budget of over £220 million, the

Service are at the frontline of the NHS in Scotland providing an emergencyambulance service to a populationof over 5 million people serving all of the nation’s mainland and island communities. In addition, the PatientTransport Service (PTS) undertakes over 1.3 million journeys every year. The PTS service provides care for

patients who need support to reach their healthcare appointments due to their medical and mobility needs.

The Service are now at the mid-way point of a five year strategic framework “Working Together for BetterPatient Care” which was published in January 2010. “Working Together for Better Patient Care” established the

vision to deliver the best patient care for people in Scotland, when they need it, where they need it, putting ourpatients at the heart of everything the Service do.

This strategy was, and continues to be, focused on three main goals:1. To improve patient access and referral to the most appropriate care

2. To deliver the best service for patients3. To engage with all of our partners and communities to delivery improved healthcare.

Existing Business StrategiesIt is clear that this programme cannot be considered in isolation. As outlined insection one of this document,

cognisance has been taken of relevant local planning in the form of Local Delivery Plans, HEAT Targets and localstrategies. Cognisance has also been taken of national planning in the form of the five Strategic Outcomes of the

Scottish Government (a Scotland that is: Wealthierand Fairer; Smarter; Healthier; Safer and Stronger, andGreener) as well as other relevant documents like the McClelland Report and the Christie Commission. Links torelevant strategy and planning documents mentioned in this document are provided in Appendix1.

Investment objectivesThe investment objective for this programme is fairly straightforward; it is essential that the Service have

access to mobile voice and data services in order to meet the demands placed on it by the Scottish public in anefficient and effective manner and thereby protect patient safety and care. The current contracts for

providing these services expire in 2016 (mobile broadband data) and 2020 (mobile voice and short data).Therefore, the objective of this investment is to ensure that the Service have access to mobile voice and data

services that are, as a minimum, as good as those that are currently in place through to 2020 and beyond.There is alsoa requirement for Service staff to be able to communicate effectively with their Police and Firecolleagues, as well as other relevant responders, in the event of jointly responding to incidents and especially

in the case of major incidents. There is also a crucial security and safety role to be performed by effectivecommunication methods.

Existing arrangements

Mobile voice and short data services are currently provided through a fully managed service contract withAirwave Solutions Ltd (ASL). The contract expires at the end of 2020 and it costs circa £6M per annum. Mobiledata services are providedthroughan installation, support and maintenance contract with TerrafixLtd. The

contract expires in 2016 and costs circa £1.5M perannum. A detailed description of these existingarrangements can be found in Appendix2.



Business needs

This programme is perhaps not typical in that the main investment driver or objective is the expiry of existingcontracts (the Airwave contract in particular) and not the ‘business gap’ between the existing and futurearrangements. Therefore the high-level business need can be summarised as the ability to communicate with

mobile resources via wireless voice and / or data services.

Business ScopeThe scope of this programme covers all current and future mobile voice and data services utilised by the

Service. These services include mobile radio and data terminals as used in A&E and PTS ambulances, airambulances, SORT vehicle and officers’ cars. They also include hand-held radio terminals as used by theService paramedics and managers. The scope also covers the mobile voice and data services utilised by the

Ambulance Control Centres (ACCs).

Resultant Service RequirementsIn terms of mobile voice and short data, the services provided under the current Airwave contract are

considered to be ‘fit for purpose’ andare likely to remain so through 2020 and beyond, however the ongoingaffordability of Airwave may become an issue due to current austerity pressures. In terms of mobilebroadband data, current services are considered to be adequate; however, there are network coverage and

bandwidth (data-rate) limitations. Therefore the high-level service requirements can be summarised as:

Mobile voice and short data serviceso Improve, or at least maintain, current coverage and functionality

o Reduce, or at least maintain, costs compared to the current contract

Mobile broadband data serviceso Improve, or at least maintain, current functionality

o Increase coverage compared to current arrangementso Increase bandwidth compared to current arrangements

BenefitsThe main benefit that will be delivered by this programme is very straightforward; The Service will continue to

be able to offer Scotland’s residents and visitors efficient and effective A&E and Patient Transport Ambulanceservices. If the current mobile data and voice services are not replaced in 2016 and 2020 respectively, patient

safety, staff safety and the ability for emergency services to communicate will undoubtedly be compromised.

Risks

Risks to the programme will be identified, mitigated and controlled in accordance with standard programmegovernance methodology using both a “Likelihood” and “Impact” assessment. The main high level risks

identified at this earlystage are:

That the programme does not delivery within the required timescales

That the programme is not provided with the resources it requires

That the programme does not deliver a solution that meets the minimum / essential userrequirements

ConstraintsThe main constraints related to this programme that have been identified so far are:

Timescales – e.g. the current contracts expire in 2016 & 2020

Procurement legislation e.g. OJEU thresholds

Government policy- e.g. shared services agenda, McClelland Report etc

Technical – e.g. the ability of telecoms providers deliver high-speed mobile broadband

Commercial / Legal / Contractual –e.g. the legality of extending the current Airwave contact ifrequired, or desired

Resources – e.g. financial envelope



DependenciesThe two key dependencies related to this programme are the Scottish Government led Scottish FutureCommunications Programme (SFCP) and the UK Government led Emergency Services Mobile Communications

Programme (ESMCP). These dependencies will be managed appropriately throughout the programme lifecycle.The Service are currently well represented at all levels within the SFCP and at a senior level in the ESMCP. At

the time of writing (November 2012), both of these programmes are at draft SOBC stage. The SOBCdocuments are still in draft form and they are commerciallysensitive, however copies can be made available

to appropriate parties if required.

Preferred Way Forward

In order to ensure that interests and requirements of the Service are addressed inan appropriate, timely andcost-effective manner, the preferred way forward is for the Service to manage the early stages of the FMC

Programme within existing local governance structures whilst remaining engaged with both the SFCP andESMCP programmes until they reach the OBC stage (expected to be Q3/Q4 2013). An informed decision can

then be made whether to continue with either of these two programmes or to progress the FMC Programmein some other way.

RecommendationIt is recommended that the preferred way forward outlined in this Initial Agreement is endorsed and that a

mandate is given to progress to the Outline Business Case (OBC) stage whilst maintaining full engagement withthe SFCP and ESMCP programmes.



Section 1: Strategic Case

1.1 Strategic ContextThe purpose of the strategic case is to explain the strategic context for the FMC Programme, present the

strategic drivers and argue the case for change.

In this section, the strategic ‘fit’ of the programme is considered from two separate but related perspectives; the

external strategic landscape and current internal strategies and plans.

1.2 External Strategic Landscape

1.2.1 ‘Purpose’ of the Scottish Government

The overarching purpose of the Scottish Government is “to focus government and public services on creating amore successful country, with opportunities for all of Scotland to flourish, through increasing sustainable

economic growth”. This purpose is underpinned by five strategic objectives:

Wealthier and Fairer – enabling businesses and people to increase their wealthand more people toshare fairly

in that wealth.Healthier – helping people to sustain and improve their health, especially in disadvantaged communities,

ensuring better, local and faster access to health care.Safer and Stronger – helping communities to flourish, becoming stronger, safer places to live, offering improved

opportunities and a better quality of life.Smarter - expanding opportunities tosucceed from nurture through to lifelong learning ensuring higher andmore widelyshared achievements.

Greener – improving Scotland's natural and built environment and the sustainable use and enjoyment of it.

The intended outcome of this programme is to ensure the Service can continue to provide effective and efficientpatient care by having access to up-to-date telecommunication systems that are reliable, robust and resilient. If

this outcome is met, the programme will, as a minimum, contribute to making Scotland Healthier, Safer andStronger.

1.2.2 McClelland Review

The overall purpose of the McClelland Review was to review the strategic management of investment in Scottishpublic sector ICT infrastructure and to report on how best to deliver improved value for moneyand supportmulti-agency working including shared services. The FMC Programme will take into account the

recommendations made within McClelland. Indeed, the proposed way forward outlined in this document willensure continued collaboration between the Service, its Emergency Services partners and the Government.

1.2.3 Christie CommissionThe Christie Commission on the future delivery of public services stresses the importance of achieving ‘more with

less’ as demand for services are expected to increase dramatically over the medium term. One of the keyprinciples identified by Christie towards reform is that public service providers must be required to work much

more closely in partnership, to integrate service provisionand thus improve the outcomes they achieve. Again,the proposed way forward outlined in this document will ensure continued collaboration between the Serviceand its Emergency Services partners.

1.2.4 Spending Review / AusterityThe FMC Programme will take account of the current financial landscape and in particular the Spending Review

which requires difficult decisions to be taken to sustain the public finances and public services. As a result, therewill be considerable emphasis placed on cost-effectiveness and value for money throughout the programmelifecycle.



1.3 Internal Strategies and Plans

1.3.1 The Scottish Ambulance Service Five Year Strategic Framework

The Service are now at the mid-way point of a five year strategic framework “Working Together for BetterPatient Care” which was published in January 2010. “Working Together for Better Patient Care” established the

vision to deliver the best patient care for people in Scotland, when they need it, where they need it putting ourpatients at the heart of everything the Service do.

This strategy was, and continues to be, focused on three main goals:

1. To improve patient access and referral to the most appropriate care

2. To deliver the best service for patients3. To engage with all of our partners and communities to delivery improved healthcare.

Points 1 & 2 above are underpinned by the effective and efficient use of mobile voice and data services, whetherit be the Airwave terminal used to communicate with an A&E vehicle that is responding to an emergency call, or

a PTS vehicle picking up a patient to take them to hospital being tasked using a mobile data terminal.

1.3.2 HEAT Targets (Health, Efficiency, Access and Treatment)

Each NHS Board must set out in a Local Delivery Plan (LDP), an annual delivery agreement with the Scottish

Government Health Department, based on key Ministerial targets. LDPs reflect the HEAT Core Set – the key

objectives, targets and measures that reflect Minister’s priorities for the Health portfolio. The key objectives are

as follows, with the HEAT acronym derived from the initials:

Health Improvement for the People of Scotland – improving life expectancy and healthy life expectancy

Efficiency and Governance Improve ments – continuall y improve t he e ffi ciency a nd effectivenessof the NHS

Access to Health Services – recognising patient’s need for quicker and easier use of NHS services;and

Treatment Appropriate to Individuals – ensure patients receive high qualityservices that meet their needs.

Building upon the recommendations contained within the Scottish Government Healthcare Quality Strategy

for NHS Scotland, May 2010, and more recently, the Scottish Government paper on Achieving Sustainable

Quality in Scotland’s Healthcare – A ‘20-20’ Vision, the Service revisited, and revised its mission statements,

long term corporate objectives, and key result areas. This resulted in the development of the Service’s HEAT

Delivery Plan and Corporate Plan in order to fully support the Healthcare Quality Strategy ambitions for NHS

Scotland which are to be:

Person-Centered – mutually beneficial partnerships between patients, their families and those

delivering healthcare services which respect individuals needs and values and which demonstrate compassion,

continuity, clear communication and shared decision-making.

Clinically Excellent – the most appropriate treatments, interventions, support and services will be provided

at the right time to everyone who will benefit, and wasteful or harmful variation will be eradicated.

Leading Edge – Processes and New Technology will be aligned and developed wherever possible, to fully

underpin the Operational Service Delivery requirements of both the Unscheduled and Scheduled Care

Services.

Safe – there will be noavoidable injury or harm to people from healthcare they receive, and an

appropriate, clean and safe environment will be provided for the delivery of healthcare services at all



times.

A copy of the current HEAT Targets, including an outline of the specific HEAT targets that are underpinned by

mobile communications relevant to the FMC Programme, is included in Appendix3.

1.3.3 eHealth ICT Strategy 2012 - 2017

The Service firmly believes that eHealth / mHealth has a vital role to play inshifting the balance of care as timely

information on a patient’s condition will allow them to be appropriately cared for in their ownenvironment.

The Service also believes that eHealth and mHealth canassist with diagnosis and treatment performed through

Telehealthand decisionsupport from distant clinicians, especially in the remote and rural parts of Scotland. In

support of this belief, the Service has developed a 5-year eHealth Strategy and will:

Continue to develop ‘See and Treat’ technology to enable people to be treated in their own community

supported by access toan appropriate and secure communications infrastructure without the need for

an A&E attendance or admission.

Aim to improve the availability of appropriate securely held information for its clinicians and to

provide the tools to use and communicate that information effectively to improve the quality of care it

provides to patients.

Continue to develop access to ECS and KIS for frontline clinicians, and will continue to develop

interfaces which pass information to A&E departments electronically prior to the patient’s arrival, thus

improving the outcome for patients and developing a system that is streamlinedand reduces waste

and harmful impacts on patients.

Continue to work with Scottish Government and Healthcare Partners to develop its mobile voice and

data strategy for both the Unscheduled and Scheduled Care Services and to facilitate the secure exchange

of patient centeredcare information through better use of integration technology.

Continue to work with Police and Fire and Rescue Partners, to ensure that agreed levels of

interoperability standards continue to be maintained and developed.

Ensure all systems are as efficient as possible, and that waste and inefficiency is reduced, producing

cash savings. Benefits will be measured to enable value for money to be demonstrated as part of the

aim.

Progress the development of mobile broadband solutions, in order that it can contribute toenhancing

overall patient care in the local communities, through the transmission of Clinical Telemetry,

Telehealth and Telemedicine applications and e xploitation of mobile communication device

technology and on-line services.

Support people to manage their own health and wellbeing, and to become more active participants in

the care andservices they receive through better use of information systems. The Service recognises

however that eHealth is only one aspect of the support individuals require to enable them to manage

their own health and well being and will continue to provide links to other support mechanisms as

not all patients have access to e-systems.



Through the FMC Programme, the Service aims to develop a secure communications infrastructure that

will underpin the various integrated eHealth and mHealth applications delivered through the eHealth

Strategy.

1.4 Drivers for Change1.4.1 Existing Contracts Expiry Dates

The primary driver for change is the fact that existing contracts to supply the Service with wireless mobilevoice, short-data and broadband data services expire in 2016 (mobile broadband data) and 2020 (mobile voice

and short data). Although these dates may at first appear to be some way off, the reality is that although theService could realistically go to market and procure off-the-shelf mobile data services over a relativelyshorttimescale, current mobile voice andshort-data services are provided by Airwave Solutions Ltdand are shared

with all UK Emergency Services. As a result, the programme timescales for renewing, extending or replacingthe current Airwave contract is estimated to be at least 5 years.

1.4.2 Cost Savings e.g. Through Consolidated Contract Structure

The Service currently spends between £7.5m and £8m per annum on mobile voice and data services, largelythrough two contracts (Airwave@ circa £6m pa and Terrafix@ circa £1.5m pa). Given the current economicclimate, the Service are keen to explore all potential options for reducing, orat least containing, these costs.

One option will be to evaluate the potential of cost savings through a consolidated contract for voice, short dataand broadband data services. At a National (Scotland) level, the current Airwave contract costs in the region of

£32m pa, by progressing the recommended way forward the Service FMC Programme will be able to explore allviable technical, contractual and commercial options for reducing mobile communications related costs.

1.4.3 Greater data volume services

The Service presently use the Airwave system to fulfill voice and short data (text format) communicationsrequirements. Data transmission services via Airwave are limited andare recognised as inadequate for currentneeds. These services are currently provided through a contract with TerrafixLtd to supply faster mobile data

rates via the Vodafone mobile telephone network. One of the main drivers for the FMC Programme is to supportfrontline ambulance services and improve the scope and quality of patient care through the provision of truly

broadband speed data services.

Section 2: Economic Case

2.1 Outcome

This programme has one overarching outcome: to procure and deliveran affordable, reliable, robust andresilient voice and data mobile communicationsystem (or systems) that fulfils the current and future operationalrequirements of the Service.



2.2 Options for way Forward

2.2.1 Option 1: Do nothing

Outline Description: Allow the existing contracts to expire in 2016 & 2020 and cease using mobile voice and dataservices.

Evaluation: Undesirable. This would fail to meet the Service requirements and would have a detrimental impacton patient safety and care. It would also compromise the Service position as a Category 1 emergency responder.Recommendation: Reject option.

2.2.2 Option 2: Progress the Service FMC Programme independentlyOutline Description: Disengage from the SFCP & ESMCP programmes and progress the programme, using onlyService controlled resources.

Evaluation: Feasible but Undesirable. Whilst there is little doubt that this option could deliver a fit for purposemobile voice and data solution, it is likely to cost significantly more than option 3. In addition, this option would

not support the strategic objective of working with other public bodies whilst levering best value througheconomies of scale.Recommendation: Reject option.

2.2.1 Option 3: Progress the Service FMC Programme in conjunction with the SFCP and ESMCP programmes

until they reach SOBC stage.Outline Description: The Service FMC Programme would be progressed in line with two relevant Government led

programmes.Evaluation: Desirable. This option would allow the Service to meet the strategic objective of working with otherpublic bodies whilst levering best value through economies of scale. This option does not eliminate the

possibility of the Service progressing the FMC Programme in some other way. It does, however, provide theopportunity to make an informed decision whether to continue with either of these two programmes or to take

an alternative approach to progressing the FMC Programme once these programmes have reached OBC stage.Recommendation: Accept option.

2.2.1 Option 4: Progress the Service FMC Programme in conjunction with the SFCP and ESMCP programmeswhilst progressing it independently in parallel

Outline Description: This is a hybrid of options 2 & 3.Evaluation: Feasible but Undesirable. Whilst there is little doubt that this option could deliver a fit for purpose

mobile voice and data solution, it is likely to cost significantly more than option 3 for very little added benefit.Recommendation: Reject option.

Section 3: Commercial Case

3.1 Potential Suppliers and Partners

3.1.1 Partners – As outlined previously, the preferredway forward for the FMC Programme is for the Service to

remainfully engagedwith the SFCP and ESMP programmes. As such, the main partners at presentwill be: ThePolice Service, The Fire Service, ScottishGovernment and UK Government.

3.1.2 Potential Suppliers –Given the current economic climate and the specialist nature of emergencyservicesmobile communications, therewill potentially be a relativelysmall number of credible potentialsuppliers over

and above the incumbentservice providers. However, the draft SFCP SOBC has a relativelyadvance ‘best-practice’ commercial engagementmodel using a lot based approach.Theaim being toallow smaller niche

companiesto bidalongsidelargermore established organizations. The preferredway forward outlined in thisdocumentwillallow the Service to benefit from this approach.



Section 4: Financial Case

4.1 Indicative costsRevenue costs - The revenue costs associated with current mobile voice and data service provision is circa £7.5M

pa, £6M for mobile voice & short data and £1.5M for mobile data. It is, however, worth noting at this early stagethat the current cost model used for Airwave mobile voice and short data provision (which is based on users) is

unlikely to continue in future. Given the wide and varied geography covered by the Service, if a cost modelbased on required geographical coverage were to be adopted, then the Service revenue costs could increase

significantly.One-off costs–Given that technical solutions have yet to be identified andevaluated and that there has been noassessment of possible funding models it is far too early to give accurate costs. However, based on similar

previous projects and given the size of the organization, the service requirements and the level of integrationrequired it is reasonable to estimate one-off transition costs will in the region £1M - £6M.

The Service do not currently incur any direct costs relating to their involvement in the SFCP & ESMCP

programmes. The only costs incurred relate to the time staff spend participating inmeetingsandworkshops.

4 .2 Funding avail ableRevenue - It is anticipated that current revenue funding will continue to be available through 2016 and beyond ,although value for money will require to be demonstrated

Capital – The requirement for capital has not yet been identified, but if required this will be identified by theOBC stage.

4 .3 Pote nti al fundi ng source sThe twomain potential funding sources at present are existing Service budgets and alternative Scottish

Government funding sources.

Calculating more accurate cost estimatesand identifying funding sourceswill be key objectives during the nextphase leading up to OBC.

Section 5: Management Case

5.1 Initial Project Structureand Governance Arrangements for Business Case Development

The preferred way forward outlined in this Initial Agreement involves the Service participating in two wellestablished government led programmes until they reach the OBC stage (e xpected to be Q3/Q4 2013).

The Service are currently well represented at all levels within the SFCP and at a senior level in the ESMCP. Inorder toavoid duplication and waste, a pragmatic approach will be taken whereby Service staff continue to

participate in the SFCP and ESMCP without any dedicated internal programme structure. Copies of the SFCP &ESMCP governance arrangements are contain in their respective draft SOBC documents. These documents arestill in draft form and they are commercially sensitive, however copies can be made available to appropriate

parties if required.

However, in order to keep a ‘watching brief’ on the Service FMC Programme, a standing agenda item will beadded to the existing eHealth Board until the SFCP & ESMCP reach OBC stage. At this point, a decision will be

taken as to the most suitable governance structure to take FMC Programme forward.

The key Service staff members responsible for progressing the FMC Programme business case to the next

stage are:

Pamela Mclauchlan – Director of Finance & Logistics and Chair of the eHealth Board

Gary Hardacre - Head of Risk & Resilience and Senior User for Airwave



Tom Robinson – Airwave In-Life Manager

Stuart Airey – Project Accountant

John Baker- Interim General Manager ICT

Section 6: Proposal

6.1 PreferredWay ForwardIn order to ensure that the Service interests and requirements are addressed in anappropriate, timely and

cost-effective manner, the preferred way forward is for the Service to remain engaged with both the SFCP andESMCP programmes until they reach the OBC stage. An informed decision can then be made whether tocontinue with either of these two programmes or to progress the Service FMC Programme in some other way.

For clarity this means that Option 3 would be progressed and that all other options would be rejected.

6.2 RecommendationIt is recommended that the preferred way forward outlined in this Initial Agreement is endorsed and that a

mandate is given to progress to the Outline Business Case (OBC) stage whilst maintaining full engagement withthe SFCP and ESMCP programmes.

Section 7: Special Health Board Review and Sign-off

TheInitial Agreementwas presented to the Scottish Ambulance Service Board on 28th November 2012 and

was formally approved for submission to the Scottish Government.

Signed: ___________________________________________ Date:

Name: Pauline Howie

Position: Chief Executive, Scottish Ambulance Service Board



Section 8: Appendices



Appendix 1: Acknowledgements and Links toRelevant Strategy and Planning and Review Documents

It is worthy of note that the Scottish Future Communications Programme Strategic Outline Business Case

document written by Keith Nicolson and Paul Sharp on behalf of the Scottish Government was utilised as avaluable reference source when producing this document.

The McClelland Review – http://www.scotland.gov.uk/Publications/2011/06/15104329/0

The Christie Commission – http://www.scotland.gov.uk/Publications/2011/06/27154527/0

Scottish Ambulance Service Documents

Working Together for Better Patient Care 2010-2015 -

http://www.scottishambulance.com/UserFiles/file/TheService/Publications/TheService%204548%20.%20Future%20Strategies%20Doc%20final.pdf

Corporate Plan 2012-2013-http://www.scottishambulance.com/UserFiles/file/TheService/Publications/Corporate%20Plan%2

02012-2013-low-res.pdf

HEAT Delivery Plan 2012-2013 -http://www.scottishambulance.com/UserFiles/file/TheService/Publications/heatdeliveryplan12-

13.pdf



Scottish Ambulance Service Corporate Publications -http://www.scottishambulance.com/TheService/publications.aspx

Appendix 2: Description of Current Services

Description of the Current ServicesThe following provides a summary of the Service Mobile Voice and Data Services as they currently stand.

Mobile Voice and Data solutions are provided through distinct commercial contracts that are currently inplace with two suppliers:-

Mobile Voice Services

Mobile Voice Services are provided through a Fully Managed Service Contract with Airwave Solutions Ltdthat is currently in place 2020. The Fully Managed Service Contract provides for the supply and maintenance

of all mobile radio equipment that is installed within the majority of Service vehicles and rotary wingaircraft, all Fixed Mobile Radio Equipment that is installed in Hospital Facilities and Event Stadia, all ACCAirwave Operator Positions that are located at each of the ACC Dispatch Desks, and which are connected

back to two Integrated Communications and Control Systems (ICCS) by an appropriate and resilientcommunications infrastructure.

The schematic below provides an overview of the Airwave Network Infrastructure that is currently inplace:-



Through a number system developments implemented by way of a formal Change Control Process,

bespoke interfaces have been developed between the CSIS DS2000 ICCS and the MIS Emergency ServicesLtd, C3 Command and Control System, that enable System Logon, Status Messaging, and other functionalityto exist between the two systems.

The table on the following page, provides a high level summary of the technical and physical resources

that make up, and use the Airwave networkacross the Service:-



Component Narrative

ICCS, ACC ICCS Operator Positions and Operational CrewDS2000 ICCS One ICCS located in Inverness with 22 CCI Ports. One ICCS

located in Edinburgh with 23 CCI Ports.

ACC Operator Positions Inverness ACC has 6 ICCS Operator Positions that are hard wired tothe Inverness ICCS. Inverness ACC cannot access the Edinburgh ICCS.

Edinburgh ACC has 10 ICCS Operator Positions.Glasgow ACC has 13 ICCS Operator Positions.

Paisley ACC DR Site has 13 ICCS Operator Positions.Edinburgh, Glasgow and Paisley Operators can connect to both ICCS Sites.

Operational Staff Using Airwave Approximately 3,700 Service staff have been trained to use the AirwaveAmbulance ServiceResources and Mobile Radio Equipment

Fixed Mobile Radios ACC 2xFixed Mobile Radios per ACC and the ACC DR Site.Fixed Mobile Radios Hospitals 47xFixed Mobile Radios (1xper Casualty or Receiving Station area).Fixed Mobile Radios PTS ASOs 15xFixed Mobile Radios (6 xEast, 6 xWest and 3 xNorth).Fixed Mobile Radios Stadia / Other 21xFixed Mobile Radios (1xper special events / strategic area).Vehicle Gateway Radios A+E 600xSepura Gateway Radios (1xper A&E Operational Vehicle).Hand Held Radios A+E 1200xSepura Hand Held Radios (2xper A&E Operational Vehicle).Vehicle Gateway Radios PTS 600xSepura Gateway Radios (1xper PTS Operational Vehicle).Hand Held Radios PTS 600xSepura Hand Held Radio (1xper PTS Operational Vehicle).Handheld Radios Officer / Other 150xSepura Hand Held Radios (1xper Officer / Other Vehicle, suppliedas a

‘car kit type’ charger and hands free facility.ACC Hand Portable Radios 23 Hand Portables across the three ACCs covering the Primary Dispatch

Talk Groups.Air Ambulance Resources 2xHelicopters, each with 2 Comms Cradles peraircraft (front and rear

mounted) and 2xHand portables. 1 xFi xed Mobile per AirbaseMotorcycles 9xMotorcycles, each with a customised Gateway Radio Installation and

Hand Portable Radio.Intrinsically Safe Radios 16x Intrinsically Safe Radios that are used by the SORT Teams.Mobile Ambulance Control Units 3xMobile Ambulance Control Units, each with 3xGateway Radios and 12x

Hand Held Radios.BASIC GPs 37xHand Held Radios provided to BASICs GPs.

Planned or UnplannedEvents ManagementPlanned / Major Event 122xSpare Hand Portables retained by the Risk and Resilience Department

and deployedas and when required for Incident / Event Management.System Integration

Telephony Integration ICCS to Telephone System Integration at each POP Site, to enablePBX/PSTN calls to be made from the Airwave Terminals.

CAD ICCS to CAD System Integration enabling single User logon to CAD andICCS, Synchronisation of Status Messagingand Resource Group Call

Voice Recording Voice Recording Interface to ICCS enabling Ops Positions to be recorded.Airwave In Life Contract Management Resources and Facility

Airwave In Life Manager 1 Whole Time Equivalent.Airwave Radio Services Manager 1 Whole Time Equivalent.Airwave Operational andTechnical Specialist.

1 Whole Time Equivalent.

Technical Vehicle Coordinator 1 Whole Time Equivalent (currently on secondment).Vehicle Logistics Driver 2 Whole Time Equivalent.

Airwave In Life Management Office 1 dedicated office, located with the Motherwell Divisional Headquarters.



Mobile Data Services

Mobile Data Services are provided through anInstallation, Support and Maintenance Contract with TerrafixLtdthat is in place until 2016.

The Installation, Support and Maintenance Contract provides for the supply, installation and maintenanceof all mobile data equipment andapplication software that is installed in all Frontline A&E vehicles, all

Patient Transport Service vehicles. As well as the Mobile Data Communications Server Systems that are installedwithineach ACC. These servers provide a Mobile Data Interface between the C3 Command and Control

Systems, the Central PTS Patient Transport System and the Vehicle Mobile Data Terminals.

Terrafixprovide data interfaces from the ACC to Hospital Receiving Centres, in order that the ElectronicPatient Report Form (ePRF) In formation may be passed electronically to those recei ving cent res thathave the necessary SCI Store or Ensemble Inte gration Inte rfaces Developed.

Terrafixalso provide a secure method of accessing the Electronic Care Summary (ECS) from the rear mobile

data terminal in A&E Frontline Resources.

The Schematic below, provides a high level overview of the TerrafixMobile Data Solution that is currently in

place for the Unscheduled Care Service, and how it is used operationally:-


IA - Future Mobile Communications (FMC) Programme Version 1.5 Ma rch 2013 – J. Baker 2 0 | P a g e

The Schematic below, provides a high level overview of the TerrafixMobile Data Solution that iscurrently being implemented for the Scheduled Care Service:-

Alternative Mobile Communication DevicesIn addition to the Mobile Voice and Data Solutions described above, the Service also utilises the

following communications devices:-

Mobile TelephonesThere are approximately 800 mobile telephone inuse across the Service of whicharound600 are

installed in operational vehicles to support Defibrillator Telemetry and Fall-BackCommunications.

Radio Pagers

There are approximately 200 Radio Pagers in use across the Service.

Smartphone Technology

At the time of preparing this document there are approximately 200 Smartphones in use acrossthe Service.

Portable Automatic Vehicle Location (AVL) Units

In addition to the main AVL units installed in frontline ambulances, there are approximately 200portable tracking units currently in use by responding officers across the Service.



Appendix 3: Heat Targets

Note The SAS prefix below denotes a target specific to the Scottish Ambulance Service. The NHSS prefix denotes a target for all NHS Boards

HEALT H

SAS H1: Between 12-20% of eligible cardiac arrest patients wi th Return of Spontaneous Circulation (ROSC) on arriva l at hospi tal .

SAS H2: Reach 80% of card iac arrest patients wi thin 8 minutes (m ainland).

SAS H3: Reach 75% of Category A (life-threatening) emergency incidents wi thin 8 minutes (m ainland)

SAS H4: Reach 95% of Category B (serious but not life-threatening) incidents wi thin 14 19 or 21 m inutes (m ainland)

SAS H5: Reach 55% of all emergency incidents wi thin 8 minutes (Island NHS Board areas)

EFFICIE NCY

NHSS E1: NHS Boards to operate wi thin thei r agreed revenue resource limi t; operate within thei r capital resource lim it; m eet thei r cash requi rement

NHSS E2: NHS Boards to deliver a 3% efficiency saving to reinvest in frontline services

SAS E3: Reduce energy consum ption by 2.5% per annum in line wi th NHSSE3

SAS E4: Achieve sickness absence rate of less than 5% for ful l year continuing di rection of progress towards the national HEAT Standard of 4%

ACCESS

SAS A1: Reach 93% of 1-hour urgent calls wi thin target time

SAS A2: Ensure 72% of al l PT S Patients arrive at hospi ta l 30 m inutes or less before appointm ent tim e

SAS A3: Ensure 90% of all PT S Patients are picked up wi thin 30 minutes of agreed tim e after appointment

SAS A4: Ensure that no m ore than 0.5% of booked PT S journeys are cancelled by T he Service

T REAT M ENT

SAS T1: T reat 12% of em ergency incidents at scene

SAS T2: Convey 80% of hyper acute stroke patients to hospi tal within 60 minutes of receipt of cal l a t The Service.



The tables below , provide a checkpoint, against each of the Service HEAT Targets, w here the appropriate application of specif ic mobile voice anddata solutions w ill support the delivery of the specif ic target:-He

Health

ICT Enabler Supporting NarrativeH1 Y Enabled through efficient Mobile Voice & Data Communications and Telemetry.H2 Y Enabled through efficient Mobile Voice & Data Communications and Telemetry.H3 Y Enabled through efficient Mobile Voice & Data Communications and Telemetry.H4 Y Enabled through efficient Mobile Voice & Data Communications and Telemetry.H5 Y Enabled through efficient Mobile Voice & Data Communications and Telemetry.

Efficiency

ICT Enabler Supporting NarrativeE3 Y Efficient Control and Management of resources through mobile technology.E4 Y Reduce Stress through reliable and efficient mobile communications technology.

Access

ICT Enabler Supporting NarrativeA1 Y Enabled through efficient Mobile Voice & Data Communications and Telemetry.A2 Y Enabled through efficient Mobile Voice & Data Communications and Telemetry.A3 Y Enabled through efficient Mobile Voice & Data Communications and Telemetry.A4 Y Enabled through efficient Mobile Voice & Data Communications and Telemetry.

Treatment

ICT Enabler Supporting NarrativeT1 Y Enabled through deployment of efficient Mobile Broadband Technology.T2 Y Enabled through effective communications withspecialist receiving centres.



Glossary of Terms

A&E – Accident and emergency

ACC – Ambulance Control CentreASL – Airwave Solutions Limited

AVLS - Automatic Vehicle Location SystemCBT - Cab Based Terminal

CCI – Communications Control InterfaceCCS - Command and Control SystemCHI - Community Health Index

CITSD - Communications and IT Services DepartmentCLERIC - Supplier of the PTS System

ECS - Emergency Care SummaryeHealth – Generic term for electronic/ ICT enabled healthcare solutions

EHR - Electronic Health RecordEnsemble – ICT systems integration tool utilised throughout NHS ScotlandEPR Electronic Patient Record

ePRF - Electronic Patient Report FormESMCP – The UK Government run Emergency Services Mobile Communications Programme

FMC Programme – The Scottish Ambulance Service Future Mobile Communications ProgrammeGPS - Global Positioning System

GPRS - General Packet Radio ServiceHEAT - Health, Efficiency, Access and TreatmentIA – Initial Agreement

ICCS – Integrated Communications Control SystemICT - Information and Communications Technology

KIS – Key Information SummaryLDP – Local Delivery Plan

mHealth - Generic term for mobile communications enabled healthcare solutionsNHS – National Health ServiceNHS24 - The Scottish 24 hour healthcare advice line service

N3 - Ne xt Generation NHS Private Communications NetworkPTS - Patient Transport Service

SFCP – The Scottish Government run Scottish Future Communications ProgrammeSORT – Special Operations Response Team

SOBC – Strategic Outline Business CaseOBC- Outline Business CaseOJEU – Official Journal of the European Union

RRU Rapid Response UnitsSAS – The Scottish Ambulance Service

SAT Nav - Global Satellite Positioning for Navigation in VehicleSCI - Scottish Care Information

VPN - Virtual Private Network