An update from CEO Robert Morton: triage, deployment and pressure (21st January)

Robert Morton ambulance OPT

On Saturday (16th) I had the pleasure of meeting lots of volunteer colleagues at a specialist engagement event. I look forward to working more closely with our CFR and RAF co-responder schemes, the Trust user group, our ambulance car driver teams and the chaplaincy services in the future, all of whom give up their free time to help us improve what we do and ultimately help better people’s lives.  Thank you to those volunteers, Board members and support service colleagues who gave up their weekend to come and show their support for the event – it’s appreciated. 

I hope most of you will have seen the ‘EOC takeover’ work the communications team has been doing this week to acknowledge the hard work of everyone in EOC. We want to show the reality behind the control room – that our call-handlers help to save lives (there have been some great tweets about real stories where our call-handlers have helped to deliver babies and give truly life-saving instructions over the phone), and some of the unfortunate issues they face every day like abusive or, sometimes, ridiculous calls. But it’s self-evident that the EOC team rise above those challenges every day, and we should be professionally proud to have them as our colleagues.  

We know that EOC play a really important role in delivering our patient-facing services to patients. That’s why we need to ensure we focus on reducing the potential for serious incidents in triage and ensuring we have robust leadership and support arrangements in place to ensure we deliver services in a continuous quality ensured environment. EOC will also become a significant focus of activity as we work to develop our Clinical Hub and improve our Hear and Treat performance in a safe way. We also need to recognise that EOC has high attrition rates with colleagues working there not always feeling valued and respected by the Trust and seeing a clear career pathway.   

In this context, I am pleased to note that following some robust and constructive representation by Unison Branch Chair, Steve Imrie, and Unison EOC representative Jessica Micallef working in a fruitful partnership way with Gary Morgan and his team, the executive team have just approved a set of principles which, once all of the various issues are worked through, will result in an improved and enhanced organisational structure for EOC staffing. Given the early stages of this work, it is not possible to provide timeframes, however, the initial priority is to address the call handler structures before considering dispatcher related structures and onwards.  Further news will hopefully emerge in the next few weeks.

As well as getting on with the ‘everyday’ work there’s a lot going on in the background to make sure that Norwich and Chelmsford EOCs are ready to transfer over to the new CAD. Through our clinical quality roadshows and staff engagement events, everyone, both in EOC and on station, is telling us how important it is for us to improve our triage. We need to keep building on what we’re doing to improve our triage (like having more staff on the clinical support desk, more clinical coordinators and the GP line) and be really innovative about how we manage our demand so we get people the right care, first time, and reduce our physical response numbers. I’m hopeful that the work we’re doing on this will really bear some fruit in the not-too-distant future. 

We’re also talking to our commissioners about this work; one example is how we’d like to expand the GP project (which is increasing its reach every day) to have doctors in Bedford and Chelmsford EOCs as well, as a prelude to developing a ‘clinical hub’. There’s a broad spectrum of people involved in this and the business development team are working hard to see how this might work.  

That said, we unfortunately continue to be in dispute with our commissioners about us not achieving performance targets. This has been escalated to both the Trust Development Authority (TDA) and NHS England, all of which continue to demand immediate improvements. There is, however, recognition that this can only be sustained long-term by addressing the capacity gap we have and having a different deployment model. That different model is going to need to include increasing the spectrum of care options we provide for patients and increasing the clinical levels that we then deploy to them, working seamlessly with 111 and GP out-of-hours, and as previously mentioned, significantly increasing the volume of calls we manage at the point of demand, i.e. hear and treat. 

We have shared our thoughts around this revised operating model with our Unison colleagues, and workshops are now underway to examine how a new model might actually work in practice. You’ll be able to read more about it soon, and then we’ll be looking to share it with our commissioners. A tremendous amount of work is underway by a lot of people to bring this work to a point where we can secure the confidence, and trust, of our commissioners to buy into different ways way of delivering services, create career pathways for our colleagues, and secure the necessary investment  we need over the coming years.  

With all this in mind, many colleagues across the Trust are under a really significant amount of pressure at the moment. With performance challenges, the April CQC visit, the development of our new operating model, new CAD implementation, discussions around our emergency services contract, exploring business opportunities for PTS and 111 contracts, and pressure to strengthen our contingency measures to name just a few (and that’s not including the ‘business as usual’), I know that pressure is only going to increase over the next few months. We’re asking people to do 10 things at once so once again I ask you all to be patient and supportive of each other.  

I myself am finding it increasingly challenging to find time to visit stations and offices as much as I want to; last week I was needed at meetings with our commissioners, NHS England, the TDA, the University of Bedfordshire, Health Education England and our trade union partners. Needless to say the pace is relentless, but in two weeks’ time I’m hoping to get back to it and am setting time aside to get out and about and meet with colleagues. 

We will all stop and take a deep breath at the end of April – but there is light at the end of the tunnel.

With best wishes,


Published 21st January, 2016

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