East of England Ambulance Service Quality NHS Trust Account

87 Pages·2016·3.49 MB·English

East of England
Ambulance Service
NHS Trust

EEAST Annual

Quality Account

2020/21

*
EEAST: Annual Quality Account 2020/21
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Contents
PART ONE PART THREE – Review of 2020/21
Page Page
Introducing the East of England Ambulance Service 4 Progress on the Quality Account priorities 2020/21 24
NHS Trust (EEAST) quality account
Performance of the Trust against mandated quality 25

Statement of accountability: Interim Chief Executive 6 metrics
41
Officer, Tom Davis
Clinical audit
42
What is a quality account and what does it mean to 7
Participation in research
EEAST and the public we serve? 43

Patient safety incidents
8
Statement on quality from the Board 44

Serious Incidents
10
Our current quality position 45

What went wrong and what we did
12
Care Quality Commission 46

Duty of Candour
15
Department of Health Core Quality Indicators 47

National Patient Safety Alerts
16
NHS number and General Medical Practice Code 48

Validity You said, we did
16
50

Clinical Coding Error Rate Patient experience and feedback
16
58

Data Quality Patient and public involvement
17
59

Data Security Protection Toolkit Raising concerns and Freedom to Speak Up
62

PART TWO Results from the NHS Staff Survey

64

How we have prioritised our quality improvement 18
Commissioning for Quality and Innovation (CQUIN)
initiatives 68

Other quality successes in 2020/21
Priority 1 Patient safety 19 72

Quality Governance Committee Assurance
Priority 2 Clinical effectiveness 20 73

Statements from stakeholders
Priority 3 Patient experience 22 80
Glossary

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Welcome to the East of England Ambulance Service NHS Trust Quality Contributions to this document
Account for 2020/21. This document has been approved by the Trust
All clinical commissioning groups including Ipswich and East Suffolk
Board and is an accurate account of the level of quality of service
Clinical Commissioning Group (CCG) (the lead commissioner),
provided to patients. In developing this Quality Account, we have set
HealthWatch groups and the region’s health overview and scrutiny
out a summary of achievements for 2020/21 and goals for 2021/22 as
committees (HOSCs) have been asked to provide a commentary on
mandated within the regulatory guidance.
the provision of our quality and care to include within this document.
Improving quality is an overarching priority of the Trust and this report

lays out plans for developing future services to improve the quality and
Where can you get hold of this document?
safety of patient care and patient outcomes.
This Quality Account is available on the NHS website at
In order to help do this, the Quality Account is based on data from a
https://www.nhs.uk/Services/Trusts/Overview
range of sources. In setting the local priorities for the coming year, a
number have been continued from the previous year due to delays in or write to:
implementation and progress caused by the COVID-19 pandemic
East of England Ambulance Service NHS Trust Headquarters,
during 2020/21.
Whiting Way,
Further information about us and our achievements can be found in
Melbourn,
our Annual Report.
Cambridgeshire
Assurance for quality and safety is given to the Trust Board by the
SG8 6EN
Quality Governance Committee which is in turn informed by our
Tel: [phone]
Compliance and Risk Group. Underpinning the Compliance and Risk

Group are a number of groups which cover the multiple aspects of
our service including; patient safety, medicines management, If you require this document in another format or language, please
contact our Patient Advice Liaison Service (PALS) on 0800 028 3382
safeguarding, infection prevention and control, medical devices and
or by emailing [email protected]
patient experience.
Information on all groups and how other factors contribute to this
such as Healthwatch, internal audit and regulatory inspections can be
found on page 72.

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Our Trust provides emergency and urgent care
Part One
services throughout Bedfordshire,
Cambridgeshire, Essex, Hertfordshire, Norfolk and
Suffolk.
Introducing the
During 2020/21 we also provided non-emergency
East of England
patient transport services for patients needing
non-emergency transport to and from hospital,
Ambulance
treatment centres and other similar facilities within
Service NHS Cambridgeshire, parts of Essex, Bedfordshire and
Hertfordshire. • •
Oereh.am
Trust Quality
We cover an area of approximately 7,500 sq •
miles with a resident population of around six
Account and
million people. •
Huntingdone •
"'
Improvements
We employ more than 4,000 staff operating from rivuT,ain,ngll
Cambridge Worbhop)
(Ch"ryHin•t•onR ol'd-Pn) ~ ~wm;nht Tr;urnng Cent,e
130 sites and are supported by more than 1,500 ~t~c:re,) • ewm.rket ee sBuurryy SStt .Efddmmuunndd~• (Parkw~y)
(Ad~•. . e stowmarket
dedicated volunteers working in a variety of roles
including: Community First Responders; volunteer • HMea~r1thlo ,"1am
car drivers; BASICS doctors; chaplains and our
community engagement group.
The Trust Headquarters is in Melbourn,
Cambridgeshire and there are ambulance
Hemel
Hem•P' IUd
operations centres (AOC) at each of the three
Borehamwood
W~Tfo•rd •
locality offices in Bedford, Chelmsford and
Norwich which receive over 1 million emergency
calls from across the region each year as well as
calls for patients booking non-emergency
transport.
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The east of England is made up of both urban and rural areas with a Scheduled Care Service – Patient Transport Service
diverse population. As well as a resident population of about six million
We provide a non-emergency Scheduled Care Service, more
people, several thousand more tourists enjoy visiting our area in peak
commonly known as the Patient Transport Service (PTS) to and
seasons each year. Our area also contains several airports including
from home to outpatient appointments at hospitals or other care
London-Luton and London-Stansted as well as major transport routes
centres around the region to help people who need assistance
which increase the number of people in our region on a daily basis.
because of their medical condition or age. In 2021 we transported
64,408 individual patients and 26,724 patient escorts. Some of
these patients travelled more than once, and in total, we delivered
We have four areas of service provision:
426,799 journeys.
Response to 999 calls as an emergency and urgent care service

In 2020/21, our ambulance operations centre (AOC) received
Special and partnership operations
1,195,670 emergency contacts from the public.
The Trust operates two hazardous area response teams (HART) and
On average, over 2,123 emergency 999 calls come into the
has a resilience and emergency planning department who work
ambulance service every day and are answered and managed in our
closely with critical care charities and community volunteers to
ambulance operations centres.
respond to a variety of emergency situations.
Call handlers record information about the nature of the patient’s

illness or injury using sophisticated software to make sure they get
the right kind of medical help. This is known as triaging, and allows us Commercial services
to ensure that the most seriously ill patients can be prioritised and get
We operate a number of services which generate income for the
the fastest and most appropriate response.
Trust. These include first-aid training, medical cover for events and
Once this key information is established, the response will be festivals, medical repatriation and the provision of management
selected from a range of care providers including a single clinician in services to both the public and private sector through our National
a fast response car, a double staffed emergency ambulance Performance Advisory Group.
dispatched on blue lights, or a clinical assessment conducted over
We also provide a contact centre which takes around 800,000 calls
the phone by an appropriate clinician for patients with conditions that
a year for more than 70 different contracts including the Patient
do not require a face-to-face response.
Transport Eligibility and Booking Service for EEAST.
This response would include advice over the phone from a
paramedic/nurse/social worker or a referral to their GP, pharmacist or
walk-in centre.
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Statement of Accountability

As Accountable Officer and Interim Chief Executive of the Trust, I have responsibility for
maintaining the performance and standards achieved within our services, and to support an
environment of continuous quality improvement.

This is the 13th Quality Account produced by the East of England Ambulance Service NHS
Trust, in line with the requirements of the Health and Social Care Act 2012. The Quality
Account contains details mandated by the regulations and also identifies the measures that
the Trust, in association with our NHS and public partners, has decided will best
demonstrate the work that has been done to improve the standards and quality of clinical
care.

The results of these measures show that much work has been undertaken this year to
improve the quality of care to patients; however, there are areas in which the Trust needs to improve to ensure all patients have a positive
experience in using the ambulance service.

As Accountable Officer, it is also my responsibility to ensure both the quality and accuracy of the data within this Quality Account and to confirm that
it presents a balanced picture of the Trust’s performance. Therefore, to the best of my knowledge the information contained within this Quality
Account for the East of England Ambulance Service NHS Trust is a true and accurate record.

Dr Tom Davis
Interim Chief Executive Officer

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What is a Quality Account and what 4. Ensuring that people have a positive experience of
care
does it mean to EEAST and the
5. Treating and caring for people in a safe environment
people we serve?
and protecting them from avoidable harm

A Quality Account is a mandatory report about the quality of
services an NHS healthcare trust provides and is required to
be completed in line with the Health and Social Care Act.
Quality reports and accounts are set against the framework
of three overlapping key themes, patient safety, clinical
Effectiveness
effectiveness and patient experience, which can be used to
define quality of care.

The content is defined by NHS England and includes
outcome results against specific indicators under five
headings: Patient
Patient Safety
Experience

1. Preventing people from dying prematurely
2. Enhancing quality of life for people with long term
conditions
3. Helping people to recover from episodes of ill health
or following injury
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Statement on quality from the Board

Welcome to the East of England Ambulance Trust NHS Trust’s Quality Account for 2020/21.
At the time of writing the pandemic restrictions are easing and the demand on our services for COVID cases is reducing. Our
teams are now preparing for the predicted increase in calls related to restrictions easing and the summer season.
The last 12 months have been extremely challenging for the Trust. Alongside the pandemic the Trust has been placed into
special measures. Despite both of these factors the hard work of our staff has continued unabated. Our teams have worked at
pace to adapt practices to ensure the safety of our patients and staff. Supported by our regional and national regulators, we
have ensured colleagues have been appropriately protected whilst continuing to provide an excellent service to patients. Our
support services have adapted to new ways of working to ensure provisions and frameworks have permitted a dynamic
approach to providing a service during a level four pandemic. Our staff have worked tirelessly to keep patients and each other
safe.
None of this would have been possible without the incredible support from our communities. We have received excellent
support from our community first response teams and fire service colleagues to support the rapid increase in resources
required during the pandemic. Our local communities have demonstrated incredible support to our staff which I know has been
important in maintaining morale and maintaining a quality service.
Importantly, throughout the process we have developed a governance framework to ensure our decision making has been fair,
safe and appropriate. We have focused on lesson learning as a continuous process throughout and are working towards
embedding these as part of our improvement journey and to demonstrate a well led organisation.
I am delighted to be able to report that since Christmas, we have vaccinated 93% of staff and volunteers with the first COVID
vaccination and are already well on the way to delivering the second vaccination to ensure sustained protection. Delivery of
this programme has been generated at pace whilst ensuring resourcing is maintained.
In April last year we relaunched our ground breaking Mobile Stroke Unit in East Suffolk which helped prevent death and
serious disability. It uses a modified Ambulance to provide prompt diagnostics and the right treatment to help keep as many
people as possible out of hospital during the COVID-19 pandemic.
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The team decide on the best course of treatment, which can include giving a clot-busting thrombolysis to increase a patient’s
chance of making a good recovery, transport to a specialist centre or a referral to their GP.
In September last year we asked for volunteers to assist in knitting “Cuddle Pockets” and I am delighted to report that the Trust
launched them on all our vehicles from 1 December. Cuddle Pockets are designed for the compassionate conveyance of pre-
term stillborn infants (less than 24 weeks) and we are very proud to be working with Cuddle UK to help support our patients in
this way.
As a Trust we are working to improve our digital maturity. A good example of this is our rollout of a new Electronic Patient Care
Record solution. This is enabling us to replace technology and, thanks to the support of NHS Digital, move from a device per
vehicle to a device per clinician approach to mobile devices. This innovate approach will ensure our clinicians can access the
Summary Care Record (SCR) to understand a patient’s clinical history and make certain that they can respond to their specific
needs delivering a higher level of care.
Despite the challenges this year our staff and volunteers continue to provide outstanding care to patients, as we work in
partnership with the wider health economy. I am extremely proud to be part of this organisation, and the high quality care we
deliver 24 hours a day, 365 days per year. We will continue to make the improvements needed whilst ensuring the patient and
our community remain at the heart of our planning and progress.

Tom Davis

Interim Chief Executive Officer

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which encourages us to continue to improve and drive quality
Our current quality position
standards upwards.

Learning from incidents - both positive and negative experiences - has
Before looking back at the quality position, I wanted to just take a
been a focus over the last 12 months. The Trust has maintained a
moment to remember our colleagues in the NHS and those in the
high level of incident and near-miss incident reporting in line with good
wider communities that have been affected by COVID-19 Pandemic,
incident management and continues to demonstrate a good safety
the impact of which continues and is likely to be long lasting. What is
culture.
both humbling and truly amazing is to see how the quality of health

care and the response of our Trust and the wider health and care
We also continue to see a good level of compliments compared to
community has enabled us to continue delivering our services to
complaints and on average this has been at a ratio of 5:1.
patients during this time.
One area that requires further focus is fully adopting and embedding
Over the past 12 months the Trust has strived to continually improve
the Learning from Deaths within the Ambulance Services
on previous years, focusing on enhancing the quality of life, not only
recommendations from the National Quality Board.
for those with long term conditions, but for all the patients, families and
The Trust have met the required milestone of introducing a new policy
carers we come into contact with. We aim to improve our patients’
that will lay out the foundations for implementation. We will be able to
experiences of care and to assist in helping people recover from ill
report on our progress next year.
health or injury, in a safe and supportive environment which is free
from avoidable harm. On review of our progress against this year’s priorities, the Trust has
exceeded the national ambulance average quality indicators for heart
At the time of the last quality account, the Trust was awaiting our CQC attack, stroke and cardiac arrest survival to discharge (Utstein
inspection report. The Trust received a rating of Requires comparator).
Improvement overall and inadequate for ‘Well Led’. Whilst
All ambulance care quality bundles for chest pain, stroke and sepsis
disappointed, the Trust understand the reasons and we are working
have seen an improvement in timeliness and response to the most
hard with our staff, commissioners and regulators to ensure that the
critical patients.
CQC and NHS England/ Improvement’s improvement notices and
A decision was taken to realign to the launch of the new Clinical Trust
action plans are met.
Strategy in line with the national urgent and emergency care work and
Further information can be found within the Quality Account.
the work of the Integrated Care Systems to reduce conveyance and

ensure patients have the best care in the right place.
It was extremely pleasing to gain outstanding in the caring domain for
The clinical strategic principles are 1) providing individualised safe and
the second time running and improve upon the responsive domain
effective patient care to improve outcomes, 2) deliver innovative
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