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Annual Report and Accounts 1 April 2017 - 31 March 2018

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Annual Report and Accounts 1 April 2017 - 31 March 2018 South East Coast Ambulance Service NHS Foundation Trust Annual Report and Accounts 1 April 2017 - 31 March 2018 Aspiring to be better today and even better tomorrow for our people and our patients South East Coast Ambulance Service NHS Foundation Trust Annual Report and Accounts 1 April 2017 - 31 March 2018 Presented to Parliament pursuant to Schedule 7, paragraph 25 (4) (a) of the National Health Service Act 2006 © 2018 South East Ambulance Service NHS Foundation Trust For more information South East Coast Ambulance Service NHS Foundation Trust Nexus House,4 Gatwick Road @SECAmbulance Crawley RH10 9BG www.SECAmb.nhs.uk Tel: 0300 123 0999 Email: enquiries@secamb.nhs.uk facebook.com/SECAmbulance If you require this document in an alternative format, please contact enquiries@secamb.nhs.uk or 0300 123 0999 Annual Report and Financial Accounts 2017/18 | 5 6 | Annual Report and Financial Accounts 2017/18 Contents 1. CHAIR’S INTRODUCTION 8 2. PERFORMANCE REPORT 11 Chief Executive’s Statement 12 Performance Overview 16 Performance Analysis 18 3. ACCOUNTABILITY REPORT 47 Directors’ Report 48 Remuneration Report 98 Staff Report 106 Disclosures set out in the NHS Foundation Trust Code of Governance 124 Statement of Accounting Officer’s Responsibilities 134 Annual Governance Statement 136 4. APPENDIX A – QUALITY ACCOUNT & QUALITY REPORT 2017/18 147 5. APPENDIX B – ACCOUNTS 2017/18 259 Foreword to the accounts 261 Four primary financial statements 270 Notes to the accounts 274 Annual Report and Financial Accounts 2017/18 | 7 Chair’s Introduction I’d like to begin by thanking the previous unmet social needs, who may require a different Chair, Richard Foster, for his contribution type of response than a standard, emergency to moving the Trust forward during ambulance and we have been looking at how we his 12 months with the Trust. can “do things differently”, as we all recognise that this is an area where we must improve. Whilst the Council of Governors have started a selection and recruitment process for a new Jointly with our commissioners, we are undertaking substantive Chairman, I am very pleased to an independently-led ‘Demand & Capacity be able to support the Trust as Interim Chair Review’, to determine the level of resources during this time. Having been a Non-Executive and funding we require to respond to patients Director with SECAmb since 2012, Chaired the in an appropriate and timely way and to meet Trust’s Finance & Investment Committee and the new ARP standards. This work will conclude been Deputy Chair for the last three years, I shortly but, even ahead of this, we are prioritising feel able to give my perspective on both the the resources we do have, to recruit additional challenges and opportunities facing us. staff and purchase extra emergency vehicles. 2017/18 has undoubtedly been a challenging year We have embarked on work to change the for the Trust and for the NHS as a whole. We were culture in our organisation. This is demanding inspected by the CQC in May 2017 and while the work, given the largely dispersed nature of NHS 111 service received an overall good rating our workforce but we expect to start to see and all of our staff were rated as ‘good’ for caring, the impact of this, together with changes we they did identify a number of areas of concern, are making to our management structure and resulting in an overall ‘Inadequate’ rating. You operating model, over the next few months. can read more details about their findings in the The Trust has continued it’s Board Recruitment Annual Report. Consequently the Trust remained programme and I am very pleased that we in Special Measures and we have undertaken a have ended the year with a full Executive tremendous amount of work to address these Team in place. I would also like to welcome findings together with other improvements we three new Non-Executive Director colleagues ourselves identified. Again you can read more who have joined during the year. details in the Annual Report. We have seen great progress in many areas and are keen to Despite the undoubted challenges facing the demonstrate this to the CQC when they undertake Trust, I continue to be impressed with the their next inspection but we also recognise that professionalism and dedication of our staff there is still much to do to achieve our vision. and would like to thank them, on behalf of the Trust Board, for their overwhelming In November of last year, the Trust moved commitment to providing excellent patient care. to reporting 999 performance against new national Ambulance Response Programme (ARP) standards, as you will read in the Report. Since their introduction, we have performed well against Category 1 and 2 targets, the most seriously ill and injured patients, but less well in our Graham Colbert, Interim Chair response to Category 3 and 4 patients. These are often elderly patients, with complex clinical and 8 | Annual Report and Financial Accounts 2017/18 1 Annual Report and Financial Accounts 2017/18 | 9 10 | Annual Report and Financial Accounts 2017/18 2 Performance Report Annual Report and Financial Accounts 2017/18 | 11 Chief Executive’s Statement The purpose of the Overview is to give the This led to an ‘Inadequate’ rating overall and user a short summary that provides them the Trust remaining in ‘Special Measures’. with sufficient information to understand Since receiving the most recent report, we have the organisation, its purpose, the key risks continued implementing our plans and over the to the achievement of its objectives and year have worked extremely hard to address the how it has performed during the year. areas highlighted by the CQC as well as other 2017/18 was my first full year with the Trust, areas identified through improved governance, since joining SECAmb on 1 April 2017. systems and processes. By working together, we have seen notable improvements in many areas Looking back, it’s been an extremely busy year including medicines management, safeguarding – we have undoubtedly faced some significant and complaints during the year. We still have challenges but I am also very proud of the a great deal to do but I feel confident that we progress we have made in a number of areas. now have the right processes and structures During the year, we saw a number of changes in place to continue to make progress. at Board level, as we continued to strengthen We are expecting a further inspection by the the leadership of the Trust. I am very pleased CQC at some point during the next few months, that we ended the year with a full Executive which will provide a good test of the progress Team in place, as well as a number of new Non- we have made in improving the quality and Executive Director colleagues on the Board. I governance of the services we provide. am confident that we now have the right mix of skills, experience and fresh ideas at a senior Despite extremely hard work by everyone, leadership level, to lead the Trust forwards. especially our front-line staff, the Trust was not able to meet its 999 operational and One of my first tasks was to approve and launch our performance targets during the year. Health & Wellbeing Strategy, designed to create a healthy workplace where everyone feels their health On 22 November 2017, we successfully moved to & wellbeing is supported. Around the same time, the new national Ambulance Response Performance in July 2017, I launched our new Trust Five-year (ARP) standards, which introduced four new Strategic Plan. Our focus in years one and two is categories of call. Since the move to ARP, I am on addressing the previous issues within the Trust pleased to report that the Trust has performed well and putting in place a right-sized operating model overall in responding to Category 1 and 2 patients that develops our staff, improves our response and (the most seriously ill and injured patients) but less outcomes for patients and supports the priorities well in our response to our Category 3 & 4 patients. of the NHS across the South East region as a Improving our response to these patients, who whole. We are well on our way to achieving this. are often uninjured, elderly, with complex clinical In September 2017 the Trust received the outcome and unmet social needs, requires a different of the inspection undertaken by the Care Quality type of response than a standard, emergency Commission (CQC) in May 2017. Although we ambulance. We have already been working hard had started to make progress in some areas, to look at how we can ‘do things differently’ following the previous inspection in May 2016, to provide a better response to Category 3 and it had not advanced sufficiently for the CQC to 4 patients and to work with system leaders to see our progress since the previous inspection. reduce unavailability of ambulances at hospital. 12 | Annual Report and Financial Accounts 2017/18 We are also looking at ways to improve our the west of our area, as a well as a single base, for 999 call answering and this will continue to be the first time, for the majority of our support staff. a key area of focus for us during 2018/19. At the same time, we invested in a new Computer Aided Dispatch system for our control room staff, Overall, our NHS 111 service performed well during which has significantly improved how we are able to the year against its key performance indicators, manage our resources when responding to 999 calls.
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