Delivering a quality service: update from Director of Service Delivery Kevin Brown, 6th October

Over the last year we have made significant strides forward, including being rated as ‘outstanding’ by the CQC for the care staff and volunteers have given to patients.

These strides have been delivered against a backdrop of an extremely challenging environment.  Demand on the 999 service has continued to increase and has reached record levels. Indeed demand on EEAST has doubled in the last 10 years. Not only has the number of seriously ill patients increased significantly, but those patients requiring a more complex ambulance response. Hospital handover delays have also remained a challenge as a result of the continued pressure on the wider healthcare system. Given this, we should all be very proud of the achievements we have made; thank you for your support and hard work.

I also want to thank all of you for your fantastic efforts, commitment and achievement on our quarter two Red 1 performance. We have also moved into the top part of national Red 1 performers, and notably we were top nationally last week. These are obviously our sickest patients and the ones we really do need to get to as quickly as possible. 

The Trust has been working closely with our commissioners (the people who hold and allocate the money for the NHS locally) about how we can improve our services further.  These discussions have looked at the capacity and resourcing issues we face. Whilst the Trust has recruited more than 750 student paramedics, and continues to recruit hundreds of new patient facing staff, they all need to complete their training and this takes time.  

To help, we have been talking about what we can do to increase capacity in the short term and our commissioners have agreed a mechanism to fund more capacity, via private ambulance providers.  This will take the strain off existing staff and ensure our patients get an improved service.  This will, however, only be funded if we can show how we are improving our service to patients.

As a result we have all agreed that the area which needs most improvement is the service we provide to our most seriously ill patients. And rather than looking at the blunt tool of performance, which I agree creates many problems, we will be looking at our speed of response to Red 1 patients (i.e. those in cardiac arrest or those about to go into cardiac arrest who absolutely need the fastest possible response), and trying to reduce the length some of our red patients have to wait, as this will improve patient safety.

Therefore we have put in place the following measures to better support you and our patients: 

1. All clinically trained officers will be asked to be available to respond to our sickest patients; this will not only help us provide a better service to these patients, but will also support our staff managing these patients, who are often in the most challenging circumstances
2. These officers will be spread across the patch, with staggered start and finish times, so they are able to support as many patients and staff as possible and give greater cover to our more rural communities
3. Continued investment in additional ambulance resources through private ambulance services whilst we build our staffing levels up
4. Greater support in EOCs to help manage our most critical patients
5. Ensuring staffing in EOC, in particular call handling, clinical advice line and clinical support desks is optimised
6. Continuing to share messages with the public about using alternatives to the emergency service
7. We will be developing a home responder scheme for staff and managers; more details will be released on this in a few weeks’ time. 

We have also started the ‘dispatch on disposition’ trial this week, which should help reduce the amount of resource that sometimes responds.

I truly believe that together – colleagues and volunteers - we can all help make further improvements to the service we give to our patients. We have shown what we can achieve together over the last six months, of which I am truly thankful to you. I know you will join me in getting whole heartedly behind the Trust, so we can be a shining beacon of patient care and experience.

Have a good week,

Kevin

Published 6^th October, 2016