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Quality Account 2020/21

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Quality Account 2020/21 Quality Account 2020/21 1 Contents Introduction 3 Declaration of accuracy 5 Part One: About us 6 Our values 6 Our vision 6 Area we cover 8 Our service 8 Part Two: Looking back - review of quality improvements in 2020/21 12 Our 2020/21 priorities and progress made 12 Commissioning for Quality and Innovation (CQUIN) 15 Care Quality Commission 23 New services and innovation 24 What we have done to improve patient safety 25 Learning from incidents, experiences and feedback 25 Duty of Candour 25 Serious Incidents (SI) 26 Learning from deaths 27 Prevention of future deaths 29 Harm reviews 29 Freedom to Speak Up 30 What we have done to improve patient experience and engagement 31 EMAS Patient Voice Forum 30 Compliments 32 Formal Complaints (FC) 32 Ombudsman requests 34 Patient stories 35 Extracts from messages of thanks during 2020/21 34 Corporate communications and engagement 39 Staff communications and engagement 40 Social media and media engagement 41 Equality, diversity and inclusion 42 Part Three: Looking forward - what we want to do better in 2021/22 44 Our quality improvement strategy 44 Quality priorities for 2021/22 45 Appendix 1: Quality Improvement Strategy Year 1 progress; Year 2 priorities 48 Appendix 2: Workforce 63 Appendix 3: Data Security and Protection Toolkit (formerly IG Toolkit) 84 Appendix 4: What we have done to improve clinical effectiveness – R&D 85 Appendix 5: CQC registration 111 Appendix 6: Third Party Statements 112 Appendix 7: EMAS Trust Board 124 Director’s responsibilities in respect of the Quality Account 125 Glossary 126 Contact details 129 2 Introduction This year really has been one unlike any other, with the COVID-19 pandemic dominating all of our lives and every facet of EMAS’ work. I cannot begin this report without expressing my huge gratitude to each and every one of our staff members for their hard work throughout this most difficult of years. While this year has been incredibly tough, I have seen the determination, dedication and sacrifices people have made day in day out. But in many ways I have seen the staff of the East Midlands Ambulance Service rise to the challenge and shine. From the frontline staff who have come into work every day, despite fearing for their own safety and that of their families, to the Fleet team who’ve gone above and beyond to keep our vehicles on the road and the Logistics team who have kept them supplied with personal protective equipment (PPE), and to all the staff that have had to adapt to working from home and all the challenges that brings with it. I am so proud of the collective efforts that have been made and the level of care we have continued to provide for our patients throughout. Wherever our staff work, whether it is patient facing, in the control room or in supporting roles, they have often stepped into territory and new job roles almost overnight and it really has been a true team effort. Many of our staff have been personally affected by COVID-19; whether they’ve contracted the illness themselves, looked after or even lost family members. Our thoughts remain with the family and friends of our colleague and volunteer teams who lost their life to the disease. Their tragic loss has impacted everyone at EMAS and brought home the very real impacts of the disease. What the pandemic has done is it has allowed EMAS to do what it is best at – responding to patients. From the outset we have been able to get to patients faster than we have ever been able to get to them before but patterns have changed with staff finding themselves spending more time with patients or more time handing them over to the care of hospital colleagues. And all of this whilst having to wear additional layers of PPE for lengthy periods. Despite what has happened, we have improved. Across all of our divisions, we have worked collaboratively with Acute Trusts to facilitate temporary and permanent pathway redesign to support the response to COVID-19. At all points, EMAS has supported these changes in a way that ensured we maintained our service level to our patients, both in terms of response and quality of service given. From a service user perspective they will have seen us speed up our response times and improve our care. We have taken a leading role in national resilience, which has been recognised by other ambulance services, as well being mentioned in the House of Commons by the Health Secretary. Where other areas have declared emergencies, colleagues from the East Midlands have stepped up. For example the roll out of the digital gateway has meant that 3 some patients were calling from London, it was picked up by our control centre staff here and relayed back to the patients locality: the individuals would not even know that has happened, with no loss of care. Aside from our operational duties, we became classed as a ‘hospital hub’ and vaccinated our own staff across a wide geographical region. This followed on from us being the top performing ambulance service in the country for flu vaccinations and one of the best in the region if you take into account the huge spread and number of our people across our service. We’ve also seen an excellent take-up of the COVID-19 vaccine among our staff, exceeding NHS targets, something that should help to stand us in good stead for the coming year. Communication and engagement has also improved, as we have had to adapt quickly, we have used new platforms and live sessions where we can interact with staff. Our Staff Survey results have also improved. We have seen significant improvements in the survey questions that are used to calculate the Freedom to Speak Up Index, a measure of the Trust’s open, learning and improving culture. We have also introduced new initiatives to share learning from when things go well, not just when they go wrong, with fortnightly Learning from Events sessions hosted by our Quality and Clincial directorate teams. The initiative has been introduced as part of our new Quality Improvement Strategy 2020-2025 priority objectives. And despite the pandemic we also rolled out the new specialist practitioner role, introduced to provide more advanced clinical care to patients that would have traditionally needed conveyance to hospital for certain procedures. The role has been introduced as part of our Big 3 vision and strategic objectives. We also moved to having a GP or senior medic on site in our control room seven days a week which has been very effective. Despite the many difficulties the pandemic has brought with it, there have also been many positives during the year and lots of reasons to be hopeful for the future. We’ve been part of some wonderful partnership working with blue-light colleagues across the region and, indeed, the country. Our participation in the emergency services mutual aid scheme saw our call-takers help out ambulance services from across the UK during the busy winter period. While closer to home we worked with the fire service to train firefighters to work alongside our Urgent Care colleagues. This spirit of collaboration is also part of our plan to co-locate with blue light services in many of our divisions such as the new blue-light tri-hub at Hucknall, Nottinghamshire, where we are based alongside police and fire service colleagues. 4 I’d like to take this opportunity to thank all of our partners across the health service and blue-light services for all that they have done to support and work with us during this difficult year. Looking to the future, we’ve made fantastic progress this year with reducing the number of patients that are taken to hospital when they could be looked after safely at home, something that I hope continues to be part of our ‘business as usual’ once the pandemic has receded. In the coming year, the recovery and restoration phase will be really important to us – many many, people have gone above and beyond. We need to have a period of consolidation, we need to recognise and value each other, learning from what has happened. We need to embed those positive changes while reflecting on areas of challenge. Afad Richard Henderson Chief Executive Declaration of accuracy I confirm that to the best of my knowledge the information presented in our Quality Account is accurate. Richard Henderson Chief Executive Richard Henderson Richard Henderson Chief Executive 5 Part One: About us East Midlands Ambulance Service (EMAS) provides emergency and urgent healthcare and patient transport services. Our values EMAS has five values, designed by staff and stakeholders, which underpin everything we do, including the way we deliver our services and how we work with others. By living these values and supporting others to do the same, we will help to make sure that EMAS is an organisation we can all be proud of. • Respect: Respect for our patients and each other. • Integrity: Acting with integrity by doing the right thing for the right reasons. • Contribution: Respecting and valuing everyone's contribution and encouraging innovation. • Teamwork: Working together, supporting each other, and collaborating with other organisations. • Competence: Continually developing and improving our competence. Our vision We engaged with colleagues and stakeholders to seek their views on our vision and strategic priorities. The final versions were originally approved by our Trust Board in October 2018, these were refreshed during 2019 and again in 2020 as shown below. Our vision is to be ‘Responding to patient needs in the right way, developing our organisation to become outstanding for patients and staff, and collaborating to improve wider healthcare.’ 1) Respond - we will respond to patient needs in the right way • We will safely treat patients at home where possible, while helping to improve our patient pathways options with feedback from our clinicians.
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