West Midlands Ambulance Service NHS Trust

Health Scrutiny

Accountability SessionThursday 26 January 2012

Anthony C Marsh

SBStJ FASI MBA MScWest Midlands Ambulance Service NHS Trust

• Established in July 2006 merging with Staffordshire in October 2007

• Over 532,000 emergency patient journeys annually

• 5.36 million population

• Over 5,000 square miles, 80% rural

• Approaching 3000 999 calls per day

• £200 million budget

• Existing fleet of over 850 vehicles

• 4,000 Staff

• 4 Air Ambulance Helicopters

Firmographics

Trust Vision

VisionDelivering the right patient care, in the right place, at the right time,

through a skilled and committed workforce, in partnership

with local health economies

Strategic Objectives

Achieve Quality

and Excellence

Accurately

assess patient

need and

direct resources

appropriately

Establish market

position

as an

Emergency

Healthcare

Provider

Work in

Partnership

Service Delivery Objectives

Deliver Service

ImprovementIncrease Efficiency

Develop our

Workforce

Transform our

Technology

Infrastructure

Values

•World Class Service

•Patient Centred

•Dignity and Respect for All

•Skilled Workforce

•Teamwork

•Effective Communication

Transformational Business Strategy

• Retain the best elements of an

operational Ambulance Service

• Emergency Planning

• Major incident Response

• Rapid Response to incidents

• Flexible and Adaptable ways of

working

• Implement the benefits of an Integrated

Healthcare Provider

• Community Paramedics

• High volume of Healthcare Professionals

• Higher volumes of referral to alternative

pathways

• Clinical Supervision and Mentoring

• Delivery of a High Performing Ambulance Service

• Top Quartile in Response Times

• Top Quartile in Clinical Outcomes

• Cost effective delivery of service

• Highly regarded by patients, public and

Stakeholders

Developing a Service embedded in the Community

Transforming from a Traditional Ambulance Service to

an Integrated Healthcare Provider

Regional Performance 2010/11

Cat A8 Cat A 19min Cat B19 5 Second Answer

West Midlands 76.8% 98.0% 95.0% 98.1%

South Western 76.9% 96.1% 95.6% 81.6%

South Central 77.5% 95.3% 91.4% 84.3%

South East Coast 76.0% 97.7% 94.3% 89.7%

London 75.1% 99.0% 87.2% 90.1%

Great Western 74.3% 95.1% 91.7% 94.9%

East of England 74.6% 95.6% 93.1% 86.3%

North East 75.8% 98.5% 93.5% 98.1%

Yorkshire 73.7% 97.4% 93.7% 94.9%

North West 73.6% 95.6% 87.0% 97.6%

East Midlands 72.4% 93.5% 88.3% 88.1%

• WMAS, The only Ambulance Service to achieve all operational

performance indicators

NEW Operational Performance Indicators

TARGET Q1 Q2 Q3 Q4TD YTD

CAT A8 75.0% 77.5% 77.3% 75.8% 79.1% 76.8%

CAT A19 95.0% 98.1% 98.0% 98.0% 98.2% 98.1%

GREEN 2 95.0% 98.5% 98.0% 97.4% 98.6% 97.9%

GREEN 4 95.0% 98.7% 97.2% 99.7% 99.6% 98.4%

5 Second

Answer95.0% 98.6% 93.1% 94.9 % 96.6% 95.7%

APRIL – JANUARY 2011

Clinical Performance Indicators

2011 / 2012

National

MeanPosition

STEMI Pats to Hosp (150 mins) 87.5% 6th

STEMI Care Bundle 71.7% 1st

Stroke Pats to Hosp (60 mins) 65.7% 4th

Stroke Care Bundle 92.7% 6th

ROSC 23.8% 4th

Cardiac Arrest – Patient Discharged 6.6% 3rd

Care Quality Commission

Quality and Risk Profile

Jan-11 Feb-11 Mar-11 May-11 Jun-11 Jul-11 Sep-11 Oct-11 Nov-11

HIGH RED

LOW RED

HIGH AMBER 1

LOW AMBER

HIGH NEUTRAL 1 3 1 3 3 3 3 2 1

LOW NEUTRAL 4 3 5 4 4 4 5 5 5

HIGH GREEN 1 1 1 1 1 1

LOW GREEN 1 1 2 1 1 1 2 2 3

National Awards

• Health Business Awards Finalist 2011

• HSJ Healthcare Organisation of the Year 2011 Finalist

• Emergency Services Award Ambulance Innovation 2011

Bariatric Ambulance

• Emergency Services Award Ambulance Technology 2011

Performance Cell

• ASI NHS Ambulance Service of the Year 2011

• ASI Technician of the Year

• ASI Control Staff Award

• ASI Innovations Award

• ASI Special Incident Award

• ASI President’s Award

• Substantial improvements in staff survey results

November 2011

Jan / Feb 122012 / Q2

Authorised as FT

Foundation Trust – Where are

we?

Membership Governors

Jan 2012 Plan + 2 years Members

Council

Public 7,937 7,500 10,000 15

Staff 4,000+ 4,000+ 4,000+ 5

Appointed na 9

Total 13,937 11,500 14,000 29

Will Elect

• Greater accountability through increased involvement of public and

staff

• More effective provider of healthcare services

By planning and looking forward for the development of our services

What will be Different

Governors

Foundation Trust & Patient Engagement

The Members Council consists of 29 Governors

Staff have 5 Elected Governors

Emergency and

Urgent Operational

staff (2)

Emergency

Operations Centre

Staff (1)

Non Emergency

Operational Staff (1)

Support Staff (1)

Public have 15 Elected Governors

West Mercia (3) Birmingham (3) Black Country (3) Staffordshire (3) Coventry and

Warwickshire (3)

There are also 9 Appointed Governors (1 each of the following)

South Staffs &

Shropshire

Healthcare NHS

Foundation Trust

Commissioning

Primary Care Trust

Malvern Hills District

Council

Birmingham City

Council

Coventry University

Community First

Responders

University Hospital

Birmingham NHS

Foundation Trust

St John Ambulance West Midlands Fire

& Rescue Service

Building for the Future

• Improving leadership, both clinically and managerially, so that

organisation structure, culture and style match new models of

care

• Improving the consistency and quality of care provision

• Improving efficiency and effectiveness

• Supporting performance improvement

• Developing the workforce

o Advanced Paramedic

o Electronic Care System

NHS Pathways & Directory of Services

Engagement with WM Stakeholders

Commissioners and Providers, over 500 presentations

4500 LIVE Entries on the CMS DOS

Full range of alternate care

services available to Call Assessors and Paramedics

NHS Pathways – Directory of Services

Make Ready

Handover Delays

Cohorting Hours Cases

2010/11 2726 3468

2011 to date 2608 3467

Total 5347 6959

Delays >30 minutes

Time Period

(mins)

2008/9

(%)

2009/10

(%)

2010/11

(%)

2011 to date

(%)

30-45 15.8 20.6 22.1 26.1

45-60 2.8 3.8 4.3 4.8

60+ 1.2 1.7 2.1 1.9

PCT Cluster / Clinical Commissioning Groups

Stafford Hospital Temporary Overnight Closure of

A&E

• Work in partnership to develop a safe alternative model

• Introduced an integrated transfer protocol

• No complaints or risks identified during the period

• Trust’s performance maintained

• Since 1 December conveyance has been arranged for an

average of15 patients per night – a total of 883 patients

Thank You

Any Questions?