We Are EEAST Briefing - Thursday 15th July 2021

Go to questions answered

The latest We Are EEAST Briefing and Executive Q & A comes from Marcus Bailey, our Chief Operating Officer.

Hi, a very good afternoon everybody, thanks for joining the Exec Q&A, I’m Marcus Bailey, Chief Operating Officer, hope are well. We’ll just give it another minute for colleagues to join us, and then we’ll start.

Obviously we’ve got the Q&A in here, so please send in your questions and I’ll do my best to answer all of them which we get in as well, and we’ve had a couple that have come in beforehand as well, and we’ll work our way through. So, just going to give you a couple of update bits and then give us a chance for you to ask and for me to look to answer some of those questions as well.

We’ll give it another few seconds and then we’ll look to make a start.

Ok, so as I’ve probably said, I’m using a couple of screens which I’m looking at questions and things, so if I’m moving away and looking away please don’t think I’m being rude, it’s literally just so I can double check my screens for what is coming in as well.

Ok, so I’m going to start. Thank you for joining us. The first news I’m going to start with is additional to some of the briefings I’ve done this week for apprentices and the announcement that the Trust made which is very disappointingly around the OFSTED inspection and the results.

So, OFSTED came in on the 10th June, it was an unannounced inspection, and it was an inspection that focused solely on safeguarding, and safeguarding I guess in its wider sense, because it’s safeguarding of learners learning in the workplace. That inspection resulted in a rating of insufficient which is the lowest rating, and from that the events have then unfolding in respect of the ESFA, so Education and Skills Funding Agency. #

That’s the body actually where the registration of training and apprenticeship providers happens. So, OFSTED are a bit like the CQC in that they are regulatory body, and the ESFA are our registrant body, so in essence that’s where we hold our registration and contract. The ESFA, based around the OFSTED report, made a decision to terminate our contract in line with the contracts that we do have, and there is now a withdrawal process that has commenced.

It’s obviously really difficult, and it is a real shame, I said to the apprentices and will say now, I’m really sorry that we are in this situation, and it’s a really difficult time that we’re looking to manage. Our focus is supporting, providing support to everyone involved, so apprentices themselves all the way through to the training team in terms of this period at the moment because it means, practically, we have to find a new education provider for the apprentices that we were the education providers for.

That means there are a couple of pathways, so some of the Apprentice EMT programmes are through MediPro, and the Paramedic Apprentice are through the University of Cumbria. It’s a very different arrangement in the sense of they are the education providers. Commonality among all of that is that we deliver the practice placement areas as well.

We’ve set up a helpline, we’ve set up an ability for questions and answers, frequently asked questions are being updated and there will be some more out this evening based around the third and fourth sessions that we had yesterday. We’re then planning, we’ve got a dedicated email address, we’ve also got plans for further communications next week including the offers of one to ones plus also reminding people of the Employee Assistance Programme, but also confidential conversations, the ability to contact…well actually any of us, but also Freedom to Speak Up if you want to be able to talk about something different to raise concerns as well.

So the concerns around safeguarding are very much about the issues and the challenges that we have faced which were highlighted in the CQC report. So, OFSTED highlighted that there was progress, but actually the progress had not sustained because it’s new and it happens everyday in some of the bits dealing and reacting to the issues and concerns that happened. From that point of view it was very hard for them to judge whether that was in effect, in place, was sustainable and allowed learners and people to be safe.

A lot of it is around behaviours that cover time in practice, it also covers some of the behaviours in training, so where people experience a learner-on-learner behaviour as well as staff. Every day this is something we look to move forward on, every day around addressing those cultural challenges and lets not use the term cultural challenges, some of this is about behaviour, and just wrong behaviour. This is not, in terms of a cultural bit, that is a very complex thing – culture is complex, but this is just about inappropriate behaviour in the workplace and that’s the bit that creates a real challenge that actually we’re dealing with a lot of on the day things and having the conversations which I know we’ve done in these sessions before. It’s very much looking at the responsibility we have, and I’ll give some of the examples we’ve had before – going to work and swearing at each other, going to work and making reference to people who are of a protected characteristic, that’s not banter, that’s not ok, that’s just wrong. We can’t police the environment, we can’t police every single workplace, we can’t police every single episode we have contact with each other and therefore that’s the bit that I reflect on here. So, I can look at all the process changes, I can look at all the systemic changes, I can work with leadership teams, I can do all of those things, but there are choices that we make, and people are making the wrong choices.  That’s all I can say. If anyone thinks we’re not dealing with it, if anyone thinks it’s not happening, we are dealing with it and it is happening and sadly it’s still happening. I dare say someone today will be subject to something that is not ok and that’s where the balance of all of this and the unintended consequences of people saying you are making progress but actually are we making enough progress in terms of those.

So, I use that as an opportunity to reflect in these discussions and the ability for us to think, take a breath, to regroup but also have a determination that says we have to keep going so we are all safe at the workplace. What that does not do is though is detract away from our other urgent bit for apprenticeship colleagues and learners. We need to find you a new education provider and literally as I’ve said that work is ongoing. There was a meeting yesterday, we’ve had one today, and we’re looking, hopefully, being able to identify the provider by the beginning of next week. That means that we can then enter into contractual negotiations, it means we can then start to plan that transition period for getting individual learner records and moving on.

I’ve highlighted the support out there. The key message I’ve given on the sessions that I want to reiterate here is – we will tell you if we don’t want you to do something in apprenticeship terms such as, the update as the moment is, if you have a portfolio completed ready for hand over, please hold onto it, because we can’t progress marking of that. If you’ve got a ride out, if you’re attending cardiology study days all of those examples its gathering evidence, nothing stops. The key bit here is being able to hand over as much of the work done in your individual learning record to your new education learning provider. Remember it’s the same award, its FutureQual diploma award, the difference will just become around the new provider assessing, how they run the programme to how we run the programme and just how the assessment of the leaner outcomes is undertaken, that’s the work that we look to undertake there.

The other bit that I just wanted to touch upon is, covid and the discussion I had at board this week. Covid is not gone, Covid is manifesting itself in many ways for us, one is about the period of sustained pressure we’re under. I’ve not seen this is all my years and we know we’ve had an announcement that there is some short-term funding that will be released by the government to all English ambulance trusts. We’re now working though that at a rapid pace to have the discussion with our commissioners this week as to what that might look like. I’m very keen that this needs to be put into more resourcing and people, that’s to help our patients, it’s to help you, it’s also what I can do for wellbeing. So, there’s a number of things in there that I want to look after you. I’d rather use it to help you and also relieve the pressure by bringing more people in and balancing that with supporting learners and learning within the organisation. That piece of work is good but will take some time for us to mobilise but that’s where we’re looking at and where we are focusing on.

The other bit with Covid is actually around the restrictions. We’ve seen generally a doubling of covid cases as each week has gone on and we’re expecting that to rise and peak probably in the eastern region within the next month as we’re probably two or three weeks behind some other areas so probably say around another month and then you see another impact of that for the two weeks in terms of illness and hospital admissions. That takes us into the summer, into August. We know that Covid will be out there, from our point of view, we know there is a roadmap of easing of restrictions and we can see that with regards to what the government has published. From a health perspective we have to view it from another angle, and the other angle is we’re still dealing with vulnerable people, we’re still dealing with people who we need to support and protect, we need to do that for each other and we need to do that for other colleagues in health and social care as well. From our point of view, none of the guidance, for healthcare workers or the ambulance service has changed. We’re maintaining where we are, so that covers everything from PPE level 2/3, covers masks in cabs – why, because this is about maintaining and restricting as much as possible and also working to keep us all well as we can recognising where we are. So, the cornerstone to all of this is vaccination which we’ve done really well – thank you everyone who has had their vaccine, we carry on with testing and that includes LFTs or lamp testing saliva testing that we’re trialling, it includes following the guidance using PCR testing as required, it’s about covid measurements in terms of cleaning, hand washing, social distancing, it’s also about recognising those are a precaution measure of using level 2 PPE for community spread, level 3 for AGP and those become really important.

We’ve already seen there are a number of bodies saying that they’ll make it, you must wear it, or a strong precautionary advice to use it in there along with personal choice. So again, we are saying we need to maintain that, if anything changes we’ll absolutely let you know.

The other bit for us is also just looking at how we now start winter planning now in summer because we know the pressure across urgent emergency care is really significant and we know that in hospital handover delays are increasing and we know the amount of calls we get in from the 999 system is really significant. So we have to use the money I mentioned earlier and all of those to start supporting in a different way. Also trying to get a bit of balance back, because I’m absolutely conscious that the balance in all of this is, and we go through the dilemma everyday is, about how much we can do as an organisation, how much can we do around supporting yourself and how do we do that in balance of operations. We have the same challenges in PTS, in terms of their workload, the amount of on the day discharges, the work we’ve got within different hospitals around the infrastructure of turning out patient appointments. The impact of covid still there and must travel alone patients or those requiring social distancing so all of that adds another pressure dimension for us to be able to plan and work through. Building at a greater pace some of the resourcing, some of the increasing in resourcing that we look to have.

I’m really sorry to have to start the news and I’m sorry to have to have done the briefings, I’m very happy to do the briefings in the sense of speaking to people, but the news is not the news that we want to convey. The commitment is about supporting and assisting. It’s also about the determination of we need to sort this stuff out, we’ve absolutely got to sort this stuff out and actually I’m saying we all need to help each other in this one for some of the stuff that I’m highlighting because this is fundamental and basic. We need to give ourselves a different barometer of what society may look at regards to those. Just ask to pause, think and have the conversation again.

Thank you for your questions, they allowed a good conversation, sorry I’m judging that myself, I think a good conversation in the sense of hopefully open, honest answers. Want to thank you about the bit I picking up today around us having conversation, being out and working with you more closely but maintaining social distancing and in line the bit I said about covid guidance. It is the best part of my job when I get to speak with you and see patients, the best two things of my job, making a difference is really important for all of us. I will see you out and about. I accept the invitation and the challenge to do so. Thank you for the questions today. Please look after yourselves, thank you for what you are doing and we’ll speak again very soon. Thanks everybody.

Questions answered

Q -  I wonder what the exec team would be on introducing a few trial changes, such as patient safety 15 where crews get an extra break during a 12 hour night shift and replacing the current IX with crews at the end of shift, reducing later finishes and avoiding people waiting on station for a vehicle or waiting at a hospital because the end of their shift is near. This could run for a trial period of six months, to review as a benefit on staff morale, reducing fatigue and improving patient care, whilst there is longer term work undertaken the change would be felt by staff immediately.

Q -  Following consecutive and hugely disappointing CQC reports, it was upsetting to read Ofsted’s justifications for removing the apprenticeship training contract from our organisation. Themes raised echoed similar identified by the CQC and suggest not much has changed, year on year. My query must therefore be, why do our board members and SLT believe they remain the right people to lead us when theses external agencies identify continued failure across so many parts of our service?

Q - During the Pandemic a new dispatch code number 36 Pandemic was created which prioritises as Cat 2. It has been noted that this is frequently used inappropriately for cases that do not fit in other codes and therefore increasing the priority of a call. Example of this was only last week where a crew was sent to a patient that was "incontinent" and had nothing to do with the Pandemic. This inappropriate coding is causing additional stretch to current resource and I feel should be reviewed.

Q - As mentioned on the previous Q&A briefing there was a suggestion that the executive team could participate in a 'team building' event. This would be an obstacle course of sorts, perhaps alongside the army... (not going to give too much away!). Dr Tom tentatively agreed to join, can we count on your support too? It would be really beneficial in improving communication and breaking down barriers at all levels....and fun for all! Injuries are a risk of course but on a positive note you'd be surrounded by healthcare professionals! 

Q -  Would it be good development of all people in management roles to undergo 360 degree feedback and training to deal with difficult people?

Q -  In response to the question made around call coding and  your response - a suggestion would be having clinically trained people taking the calls and that would make the triage more accurate? A cost of course but the Trust needs to stop reacting and be proactive - spend money to save money?

Q -  What would be good as I know you are all busy there for the exec team to come to stations and come on the ambulances would this be something you would consider to do ? It would be good for staff on the road. 

Q -  Can we keep the public website more up to date with regards who our leadership team are. We have had a number of leaders join, and a number leave, but the public facing website doesn't reflect a up-to-date picture. 

Q - With so many interim managers at the top it would break down barriers to get their photos on NTK/EAST24. this would help with the the possible perception that they are hiding away. It does not take long to take a picture and upload it to the system.

Q -  At the moment the trust does a whole trust survey around. Culture etc, would the trust consider local trust survey for area’s , then you may see trends and what locally can be looked at and worked upon to make working life better, which would be good for staff. 

Q - Other NHS trusts have given there staff  one extra day off as annual leave, to be taken in the next two years. As a thank you for all there hard work through the pandemic , would the trust consider this for all staff?  

Q -  Do we liaise with other Trusts to find out what works and what doesn't for them? Are there any Trusts with a good CQC rating that we could learn from?


Published 19th July 2021

This is a printable version of https://ntk.eastamb.nhs.uk/news/we-are-eeast-briefing-thursday-15th-july-2021-2.htm?pr=