Working Together October 2016

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South Central Ambulance Service NHS Foundation Trust

We're good!

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And that's official

October Twenty Sixteen

October 2016

We're good! 8

Chipping Norton First Aid Unit 14

SCAS Passes A Military Inspection 20

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CFR News 32

How Are We Doing? 44

' e W o o g October 2016

e r ' e ! d o //5

And that’s official!

October 2016

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October 2016

“England’s Chief Inspector of Hospitals has rated South Central Ambulance Service NHS Foundation Trust as Good following an inspection by the Care Quality Commission.”

Press release, 20 September 2016, Care Quality Commission

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Our excellent CQC report is testament to the hard work, dedication and commitment shown by all staff working across all our services.

The dedication and commitment of our staff was recognised by the CQC inspectors who commented on how caring and compassionate staff were and how they treated patients with dignity and respect.. In particular the NonEmergency Patient Transport Service (NEPTS) was identified as delivering ‘outstanding’ care to its patients, as staff developed supportive and trusted relationships with regular users.

The Trust welcomed the inspection which was thorough, robust and comprehensive in its approach. The CQC inspection team of 51 covered all of our services; visited 20 resource centres, both air ambulance sites, both clinical co-ordination centres and 10 acute hospitals.

They observed thirteen emergency ambulances crews, seven patient transport crews and spoke to around 350 members of staff across the Trust.

Overall rating for the Trust

è Good

Are services at the Trust safe?

è Good

Are services at the Trust effective?

è Requires improvement

Are services at the Trust caring?

è Good

Are services at the Trust responsive? è Good Are services at the Trust well-led?

The findings identified that staff were positive about working for the Trust and recognised the value of their service. They also concluded that patients and their relatives were involved in their care and treatment decisions. Patients were treated with dignity and respect, while being assessed and treated appropriately using best practice, and utilising current national guidance.

è Good

In addition the CQC noted that we have an open culture which encourages the reporting, thoughts and feedback from staff in order to provide learning and improvements for staff and for patients.

Over four million people rely on the services we provide which means SCAS more than ever is committed to continue, at pace, to deliver the improvements already identified by the CQC and continue to work in partnership with other stakeholders in achieving this.

October 2016

Whilst we have demonstrated excellence in many of our services, there are also areas we know we need to carry on improving.

The CQC recognised that we are operating in an environment of unprecedented demand.

Despite this, we are committed to finding a way to manage that demand to enable us to meet response times to ensure we respond to patients safely and appropriately. The CQC found that our staff were proud to work for the organisation; however they identified pressures on the service which were affecting staff morale and work-life balance. This was further compounded by the national shortage of paramedics, and the CQC noted the Trust was actively recruiting and developing all grades of staff to improve this.

The CQC also has acknowledged that we have focused on improving the health and wellbeing of our staff and we need to continue to improve on that. This will be achieved through continuing to review rotas to improve staff work-life balance and ensuring that we support staff through development.

The inspectors identified a number of areas of outstanding practice for which we should be incredibly proud. These included the Trust strategy of bringing new services for patients to ensure that we deliver the right care, at the right time and in the right place and working with external partners to ensure we manage the ever increasing demands placed on services. They also commented that SCAS gives good peer and management support and provides innovative training which includes the use of a specialist simulation vehicle. Finally it was clear to them that we work closely with communities, partner organisations and universities to develop our services and career development.

Will Hancock, Chief Executive, said: “I am delighted to report that our service has been rated as ‘Good’ overall. This is fabulous news for our organisation as we are the first and only ambulance trust in England to get a ‘Good’ rating. I would like to thank all our staff for their hard work and dedication, and for helping to show the CQC inspection team what an excellent service we provide to our patients.”

Non-Emergency Patient Transport Service recognised as outstanding for caring As well as the Trust’s overall ‘Good’ rating from the CQC, it was particularly satisfying to see inspectors recognise all the hard work and dedication of everyone working in SCAS’ Non-Emergency Patient Transport Service (NEPTS) by highlighting the outstanding care that NEPTS staff provide to patients.

“Care was outstanding in patient transport services where patients reported well developed, supportive, caring and trusted relationships particularly from regular users, such as renal or mental health patients. Patients appreciated this personal approach and the respect shown by staff for their social and emotional needs.”

- Care Quality Commission Report

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October 2016

The Non-Emergency Patient Transport Service is provided by over 400 team members comprising managers, ambulance care assistants and contact centre staff. This year the team will arrange and undertake over 700,000 patient journeys (an average of nearly 2,000 patients transported every day). The service is also very proud of its dedicated pool of volunteer car drivers who undertake approximately 15% of all walking patient activity with the volunteers building fantastic relationships with their regular patients.

Paul Stevens, Director of Commercial Services, who leads the NEPTS across the Trust, was particularly pleased that such high levels of care were maintained at a time of rapid expansion for the service.

October 2014

New NEPTS contract launched in Southampton, Hampshire, Isle of Wight and Portsmouth

April 2015

New NEPTS contract launched in Milton Keynes

March 2016

New NEPTS contract launched for North Hampshire Hospital, Basingstoke

April 2016

New NEPTS contract launched in Thames Valley (Berkshire, Buckinghamshire and Oxfordshire)

April 2016

New NEPTS and Logistics contract launched for Oxford Health NHS Foundation Trust (including secure transport)

August 2016

New NEPTS contract launched for Royal Hampshire County Hospital, Winchester, and Andover War Memorial Hospital

Go Live April 2017

SCAS appointed as preferred bidder for new NEPTS contract in Surrey, North East Hampshire and Hounslow

Paul said: “In the last two years we have won several highly competitive contracts, which is down to the fantastic professionalism of our teams and the reputation we have for patient care, passion for the service and dedication to providing an extremely high quality service. To have this formally recognised by our peers from the CQC with these brilliant ratings is superb, and to achieve outstanding for care shows what an amazing team we have within NEPTS, from taking patient bookings to delivering patients to their door safely; the whole team is incredible. I would like to say thank you to every single member of the NEPTS team for your ongoing hard work. We would not have won the new contracts, nor got such high ratings from the CQC, without the professionalism and dedication the teams provide every single day.�

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People like...

Louise Ketcher, Ambulance Care Assistant in Hampshire, complimented by staff at the Basingstoke and North Hampshire Hospital for being “very helpful, polite and professional; there was an issue with the SCAS booking system on the day but the crew were supportive and showed a lot of patience with staff and the patient.”

Lenore Mulford, NEPTS Contact Centre Team Leader, who received a compliment from a Buckinghamshire patient stating, “Lenore was lovely, very helpful and kind over the phone.”

Barry Brooks, Ambulance Care Assistant in Hampshire, complimented by staff at the Totton Dialysis Unit, “I want to make contact with you and say how absolutely marvellous Barry was. We had an issue with a patient’s access to her home and Barry acted in a professional and caring manner throughout until we safely got the patient back into her property.”

Dennis Hickey and Brian Teidman, Ambulance Care Assistants in Berkshire, who received this compliment from a patient they were taking; “I would like to thank the crew that looked after me. They had just returned me home when I had a seizure; they looked after me very professionally and calmly and their calmness in the situation made me calm down and helped the seizure subside.”

Alison Hudson, Ambulance Care Assistant in Hampshire, who was part of the team that helped transport a terminally ill patient from hospital. After the transfer, the hospital wrote to SCAS, stating “A heartfelt thank you to all involved in the transfer. We had a very small window of opportunity to transfer our patient and the ward team felt that waiting another day would be too late. Without your efforts the patient would have probably died in a hospital bed instead of getting to the place of his choice. The patient’s wife felt very much supported and cared for during the journey and all involved went above and beyond what is normally requested. This has made such a difference to the bereaved family.”

October 2016

Chipping Norton First Aid Unit

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October 2016

The SCAS run First Aid Unit (FAU) in Chipping Norton was established in 2011 and earlier this year, was commissioned by Oxfordshire Clinical Commissioning Group (OCCG) to continue for a further 12 months.

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Since opening, the unit has always been led by emergency care practitioners – now called specialist paramedics – and today, the FAU is led by the longest serving frontline member of staff in Oxfordshire, Gary Toohey, who qualified in 1980.

“Since we opened, we’ve seen steady growth in the number of patients who come to see us”, says Gary.

“Though even today we still see people who tell us they had no idea we were here.”

The FAU is open seven days a week on a drop-in basis; from 17.00 to 21.00 Monday-Friday and from 10.00 to 21.00 at weekends and on bank holidays. With its entrance at the back of the Chipping Norton War Memorial Hospital, Gary and his team operate out of clinic rooms used at all other times by hospital staff that would otherwise be sitting empty.

“It’s a good use of empty space. Our equipment and supplies are kept in storage when the rooms are used for clinics and we simply bring them out when we are open”, says Gary.

The arrangement with the hospital also means significantly reduced running costs for SCAS and commissioners as the vast majority of overhead expenses can be eliminated.

In total, 8,521 patients had been seen at the FAU, of which: èè 80% are treated and discharged by Gary and the team èè 15% are referred on to another hospital or treatment centre (such as a Minor Injuries Unit if, for example, they need an x-ray) èè 5% require an ambulance to be called and to be taken to a local A&E Not only does this provide local people with a fast, efficient and effective service, there are also additional benefits to the local healthcare system, as Specialist Nurse / Paramedic Manager, Dan Holliday, explains: “Undoubtedly, most of the patients we see at the FAU would have probably either called 999 or made their way to a local A&E”, he says.

October 2016

“We are seeing now an average of 200 patients a month which, given we can treat and discharge 80% of those at the FAU, this means we’re reducing demand on our clinical co-ordination centres and local A&Es by nearly 2,000 patients a year.”

A paramedic’s skillset is perfect for unscheduled, urgent care and the additional skills of specialist paramedics mean that they can treat an even greater variety of illnesses and injuries and hence avoid unnecessary trips to A&E for patients.

By working regularly at the FAU, it also means that Gary and the other specialist paramedics are given greater opportunities to practice their urgent care skills, whilst also being available to respond rapidly to any Red 1 or Red 2 calls in the local area.

The Chipping Norton FAU is believed to be the only such unit of its type in the country (i.e. one that is run by an ambulance service), but as Dan concludes, it is something that could be replicated elsewhere.

As well as seeing a large number of patients suffering cuts, sprains and bumps, Gary and the team also regularly carry out post-operative daily dressing changes for local people who have been recently discharged from hospital as well as occasionally more time-critical patients who come in with suspected symptoms of heart attack or stroke.

“One of the strangest incidents that stands out for me”, recalls Gary, “was a lady who came in very glamorously dressed complaining of neck pain and arm paralysis. It turned out she had been at a wedding and the wedding cake had fallen on her – ultimately causing a neck fracture.”

“It is an interesting and innovative model to the challenges faced by healthcare providers in delivering clinicbased practice in rural areas”, he concludes. “Here we have a singular charge per patient to the local CCG, we utilise space in an appropriate, clinical building that would otherwise by sitting empty in out-of-hours periods and we have established good relationships with local GPs and community nurses.

There’s nothing stopping that being replicated in other rural areas facing similar challenges.”

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October 2016

SCAS Passes A Military Inspection

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October 2016

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On Wednesday 7 September, South Central Ambulance Service NHS Foundation Trust (SCAS) mustered the military for a special event where existing military service personnel could find out more about the career opportunities on offer at SCAS and meet some of the Trust’s exservices staff who had swapped one uniform for the green of the ambulance service.

This was the first event SCAS held in conjunction with the Career Transition Partnership (CTP) – the Ministry of Defence’s official provider of Armed Forces resettlement – and was attended by around 20 people from across the armed services. On hand on the day were members of staff from SCAS’ frontline emergency 999 service, the Trust’s non-emergency patient transport service, along with members of the education and recruitment teams.

“I initially joined SCAS as a trainee technician, became a technician after 12 months and a fully qualified paramedic two years after that. I didn’t have any medical training, apart from the usual basic first aid training all armed forces personnel receive, but that hasn’t held me back.

I’ve developed my career in SCAS since joining and today I am a Paramedic Team Leader, managing a team of approximately 20 staff, and have a Degree.”

One of those hosting the event, which was held at SCAS’ North Harbour Resource Centre in Portsmouth, was Paramedic Team Leader, Ross Smith.

Ross talked about his own experiences to forces personnel attending the event, and was able to share some of the worries and fears of those leaving, or considering leaving, military service having gone through the same process himself. Feedback from those who attended confirmed what a valuable event it was for everyone concerned.

Ross, entered the armed services aged 16, and served both in the Army and Royal Air Force, saw action in the First Iraq War and finished his service with a three year posting to the Queen’s Flight.

October 2016

Andrew, from the Royal Engineers, said: “Today has really galvanised what I want to do. Through everything I have heard today, I know where I want to be; on the frontline, and I can’t wait to get started.”

“I came in today”, adds Lewis from 4th Battalion The Rifles, “as I wanted to speak to real paramedics and how they feel about working for the ambulance service, as well as an opportunity to see some kit and equipment. It’s given me more information to make an informed decision about my future.”

SCAS has a number of ex-military staff working across the organisation, including the current Chief Operating Officer, Philip Astle, who enjoyed a 30-year military career, seeing action in the Falklands conflict, Northern Ireland, the Balkans, both Gulf Wars and Afghanistan.

"It’s a very gentle transition"

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“My experience and knowledge of teamwork and how to get the right people, to the right place with the right kit, led me in this direction to the ambulance service”, Philip adds. “The step from the military into the NHS, particularly the ambulance service, is a really natural one. You go from one organisation that works in teams, that is uniformed and proud to serve and where people are willing to put their wellbeing and efforts into helping others, into another that operates exactly the same way. It’s a very gentle transition and I’d recommend anyone to make that step as I, and lots of other exservices personnel here at SCAS, have done.”

There has never been a better time to join SCAS as the Trust has recently been rated as ‘Good’ by the Care Quality Commission (CQC); the first ambulance trust in the country to receive such a rating.

There are a range of vacancies and career opportunities in our clinical co-ordination centres, on our emergency and non-emergency ambulance services, as well as in our logistics and support services. SCAS can therefore ensure that ex-military recruits not only use their skills and experience to help patients across the four counties we serve, but will be given all the support, training and development to take the next stage of their career as far as their aspirations want.

Find out more at www.scasjobs.co.uk

October 2016

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October 2016

NHS 111 and 999 The team works

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As Chief Executive Officer of Milton Keynes University Hospital NHS Foundation Trust, Joe Harrison is well aware of the everincreasing demands on urgent and emergency care providers.

So when he recently had to call NHS 111, he was delighted that despite such demands, the standard of care provided by SCAS’ NHS 111 and subsequent 999 staff was nothing short of exemplary.

“On the Bank Holiday Monday at the end of August I called NHS 111 in the morning as I was concerned about my mother’s health. The call handler I spoke to was very good, very calm and talked me through the information that was needed. The call was interrupted a number of times as I had to go and look after Mum, but it never felt rushed and the call handler remained very patient focussed. At the end of the call, she gave me a clear instruction that an ambulance needed to be dispatched and this arrived in less than 10 minutes.

“When Wojciech and Ashleigh arrived, they were fantastic.

They spoke to my mother, they spoke to me; they were able to assess my mother and were very capable in handling her anxiety – and mine! They didn’t do things in a rush, they took their time to do things properly and were not pre-determined in their decision making. They really did put us at ease – they were fantastic!

“As a healthcare professional, I know just how much pressure urgent and emergency care services are under and the time and focus that everyone gave to us that morning was absolutely outstanding. I and my Mum couldn’t have wished for anything more; everyone was just superb.”

Joe’s Mum was taken by Ashleigh and Wojciech to Stoke Mandeville Hospital where she was admitted for 48 hours before returning to Joe’s family home. He says she is making good progress but it will be some time before she is back to living independently.

Well done to everyone involved: èè NHS 111 Call Handler – Satpal Solanti èè NHS 111 Clinician – Pip Read èè Emergency Dispatcher – Esther Acock èè Ambulance Crew – Ashleigh Davies & Wojciech Etz

October 2016

CFR

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news

October 2016

Berkshire On Friday 30 September, Sonning Common Community First Responders took delivery of a new responder vehicle at the Vauxhall Garage in Sonning Common. The vehicle, which is the first responder vehicle in the South Central region to feature the new livery, will enable Sonning Common CFRs to carry more vital medical equipment to more of the incidents they attend.

A number of donations helped raised the funds to purchase the car, including £7,000 from the Lennox Hanney Charitable Trust, £1,000 from Sonning Common Parish Council and a generous contribution from Paul Mullin, Sales Director at Sonning Common Vauxhall.

David Hamer, Community Liaison and Training Officer for Berkshire, said: “I’m so pleased that after several years of fundraising Chris and her team have managed to secure enough funding to purchase this vehicle, and am very grateful to everyone who has donated money. The new responder car will allow the team to attend emergency calls in all weathers which is vital considering the geography of the area they operate in.”

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Congratulations to Swallowfield Community Responders who were recently shortlisted as finalists in a national competition.

The Swallowfield CFRs were a finalist in the Community Responder Scheme of the Year at the UK Heart Safe Awards 2016. The UK Heart Safe Awards is the UK’s leading national awards competition to celebrate organisations and employers who invest in creating heart safe environments and the acts of individuals who have saved lives while at work or leisure.

There were over 500 nominations to the awards, with Swallowfield being recognised as a finalist for all the work the group have done with AEDs and Heartstart in their area.

October 2016

Bucks

Hampshire

John Lewis, High Wycombe, have very generously donated £2,000 to purchase a new CFR emergency kit for the local CFR group. Each CFR kit contains an automated external defibrillator (AED), cylinder of oxygen and different types of masks, as well as several dressings, bandages, tape and gloves. In short, everything a CFR needs to provide basic life support until the ambulance crew arrives.

A new lifesaving resource for residents of Leigh Park, Havant, was unveiled on Wednesday 12 October. A brand new public access defibrillator was installed in a former phone box at the Greywell shopping centre and can now be accessed by anyone contacting SCAS on 999.

Marc Lister, Community Liaison and Training Officer for SCAS, said: “We have CFRs who are students, company directors, shop staff or local businessmen. Whatever their walk of life they form a volunteer neighbourhood team who are trained to respond to emergencies locally. In addition, some CFRs give their time and skills to the campaign to keep growing the current team to help provide round the clock coverage. The good news is that, currently, there are over 60 new volunteers in our area going through the training scheme. However new recruits also mean there is a need for more volunteer emergency kits, and these require funding. We are delighted to receive a generous donation to buy valuable new equipment from Dawn Stokoe on behalf of John Lewis High Wycombe Community Matters initiative.”

The installation was made possible with funding and support from Hampshire Constabulary, Havant Borough Council, South Downs College Public Services Group X 2016, BT, Community Heartbeat Trust, J Edwards Funeral Directors, and PJM Electricals who have installed the equipment for free. SCAS’ local CFR group will train shop staff in nearby retail premises on how to use the defibrillator.

The majority of the money needed for the equipment has been provided by the parents of seventeen-year-old South Downs College student Sarah Morgan, who sadly died in March last year after collapsing on a bus on her way home from Waterlooville.

Sarah’s Mum, Anna, said: “Our daughter suffered a cardiac arrest after shopping with friends. Despite the best efforts of everyone who helped when she collapsed, Sarah could not be revived. A week later we faced the terrible decision of switching off her life support machine.

If a defibrillator had been available when she collapsed, it could have saved Sarah’s life.”

The latest defibrillator is the sixth that the family have helped install in the local area, all funded thanks to the efforts of Sarah’s family, friends and ensure that Sarah’s legacy has continued to grow.

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October 2016

Oxfordshire Local CFRs and SCAS staff attended the Emergency Services Day in Thame on 25 September. Over 300 people attended the event, finding out in a fun way more about their local ambulance, fire, police and highways services.

David England, Community Liaison and Training Officer, said: “It was great to see so many people interested in becoming lifesaving community first responders, and we got lots of people trying out CPR (chest compressions) so hopefully they will be more confident in doing that in a real emergency if they ever come across one.�

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October 2016

Annual General Meeting & Annual Members Meeting The Trust’s Board of Directors and Council of Governors hosted its Annual General Meeting (AGM) and Annual Members Meeting (AMM) on Wednesday 28 September at the Easthampstead Park Conference Centre, Wokingham.

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.

At the AGM Chairman Trevor Jones acknowledged the highly positive recent CQC inspection report, and paid tribute to the Trust’s workforce, whose efforts and commitment had been responsible for SCAS achieving a “Good” rating. He also reflected on the challenges that the Trust faced last year, noting that these had continued into 2016/17, but that he was proud of what had been achieved in terms of the best possible patient outcomes.

Chief Executive Will Hancock echoed in his presentation the Chair’s sentiment and highlighted some of the initiatives in place to try and further improve staff recruitment and retention.

Charles Porter, our Finance Director, delivered a presentation covering the Trust’s financial performance in the period 1 April 2015 to 31 March 2016. This was followed by a presentation from Deirdre Thompson, Director of Patient Care and John Black, Medical Director on key clinical developments for SCAS over the last twelve months including the CQC inspection and outcomes, the Trust’s accelerated clinical transformation programme (e.g. live-link, non-injury falls, end of life care, mental health care, high intensity users), patient safety and effectiveness.

At the AMM Bob Duggan, Lead Governor, presented an overview of the work of the Council of Governors in 2015/16 and the priorities for 2016/17. James Underhay, Deputy CEO, presented a membership report, including an overview of engagement activities and future plans.

Deirdre Thompson focused on the Care Quality Commission Inspection in her final presentation and covered the process followed by the CQC, the Trust’s overall ratings (including comparison with other ambulance trusts), the three ‘must improve’ requirements identified by the CQC, and SCAS’ plans for addressing these.

If you would like a copy of the presentations, please contact Monica Moro at monica.moro@scas.nhs.uk

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October 2016

@clairekent09 24 Oct

@pst27 24 Oct

@SCAS999 Would like to thank the crew that looked after me so well early hours Friday 21/10 Thank you so much. #angels

Ambulance crew who picked me up on Saturday were brilliant. Thank you @SCAS999

tweet tweet

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@Lisa27Hall 22 Oct @SCAS999 Thank you for persevering and finding us in the middle of nowhere at stupid o'clock this morning in the fog. I'm eternally grateful @Jastrophe Oct 15

@JerseyBean76 Oct 3

@SCAS999 thank you Sophie and James for getting my 82yr old Dad to A&E with #sepsis. Excellent care, compassion last night around 10pm Midgham

@SCAS999 Thankyou Helen, Jason & Paul for the brilliant & kind support yesterday whilst I was ill (fd psng).

My Bf & Bff are grateful too x

Here is a small selection of Tweets that we have recently received from our partners, stakeholders and the public.

Click here to read more and to follow us!

October 2016

What our patients say about us 99 To put it simply, I could not have wished for anything more, or received such excellent care

99 Truly, truly, lovely.

The paramedic was particularly amazing, I would send the biggest bunch of flowers if I could. The student was also good. Thank you for the understanding

99 It was very reassuring to know I was being looked after by such a caring team

99 I wanted to let you know that they were both utterly brilliant, hugely professional and caring

99 Thank you for the truly wonderful service you provide day in, day out to the community

If you have been treated by SCAS, or used the NHS 111 service in this area and would like to send us your comments or compliments please email patientexperience@scas.nhs.uk

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99 They made me feel comfortable and relaxed in what was a worrying situation

99 They attended incredibly promptly and were unbelievably patient and kind

99 You were all amazing, so calm and reassuring

99 Your professionalism was outstanding at a time I needed it to be

99 They immediately had me at ease with their humour and clear and concise medical actions

October 2016

How are we doing?

September 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.

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

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

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

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

CFR stands for Community First Responder.

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.

NEPTS stands for Non-Emergency Patient Transport Service.

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Total 999 activity

Non conveyance

Non conveyance %

45,255

19,435

46.82%

Red 1 (8 mins)

Red 2 (8 mins)

Red 19

69.80%

73.40%

94.50%

NHS 111 calls answered

No. of NEPTS journeys

No. of CFR responses

95,169

46,511

1,118

October 2016

October

Twenty Sixteen Please send articles, or ideas to communications@scas.nhs.uk along with any photos or images.

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Copy deadline for the next issue of Working Together is 15 November 2016.

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