Introduction by Rod Barnes

17 Foreword from Wyn Dignan Introduction by Rod Barnes Chair of North West Ambulance Service Chief Executive Yorkshire Ambulance Service Chair of Northern Ambulance Alliance Chief Executive Northern Ambulance Alliance Programme Board

As the first Chair for the Northern Ambulance I’m delighted to be contributing to the first annual Alliance, it is a pleasure for me to be able to take the report of the Northern Ambulance Alliance. I believe time to applaud the efforts of North East Ambulance it is a real testament of our commitment to ongoing Service, North West Ambulance Service and improvement and best practice that we, as three Yorkshire Ambulance Service, as they complete independent organisations, have been able to join their first year, working in partnership, for the benefit together to share our skills and expertise for the of patients across the North of England. greater good of us all.

In recognising the current pressures that are evident in the health From the outset, our ambition has been to do better and to be better sector, it has shown a real innovative and determined spirit within and having the Alliance has presented us with a real possibility to our three Trusts that they have formed the Alliance, giving them the apply that thinking to the delivery of a patient-centred, efficient and opportunity to work together to address these challenges in the forward-looking service. most productive way. Our colleagues have undertaken to work together in each functional By taking the initiative with this tri-party approach, they are able to area to share best practice and to identify opportunities for making share best practice and make the most of the combined expertise of improvements in our ways of working. This is particularly relevant in all of their colleagues. It will give them a credible forum to discuss procurement terms as it may enable us to make tangible savings in and develop new ideas and to apply tried and tested solutions that the purchase of vehicles and equipment through economies of have already been trialled in one or more of the partner Trusts. scale and in IT, through the exchange of innovation and expertise. I understand that the Alliance has enabled us to build relationships in the three organisations, not just at the most senior level where Across NWAS, NEAS and YAS, we already have a shared history you would expect to see collaboration but at every level, amongst of mutual aid and support but as the challenges of a changing those staff who have a shared understanding and experience of health landscape add more pressures on our Services, adopting a working in the ambulance service. more unified collaborative approach, under the Alliance banner, will afford us an additional degree of rigour and resilience in our The value of this partner approach should not be underestimated structure which will stand us in good stead for the future. and I know we are going to reap the benefits of working in this way. We are at the start of this process but have already made great Finally, I’d like to add how pleased I am that the Alliance has given strides in identifying and making progress in the various us a platform to showcase the prevailing sense of teamwork that workstreams where we have initially focused our attention, an runs through our three great organisations. This is a tremendous overview of which is provided later in this report. Together with my opportunity for us in the North to show our colleagues around the colleagues, Derek Cartwright at NWAS and Yvonne Ormston at country the way forward and to demonstrate what can be achieved NEAS, we look forward to seeing the results of this positive when we put our heads together! partnership, which ultimately will provide long-term benefits for patients.

Across the North...

we have we serve 13,500 15.2 million members people of staff

weext cover we drive we have 2.3+ 14,630 232 square million ambulance miles PTS stations journeys

we handle we take 2.9 m illion 2.5+ million 999 calls NHS111 calls

Our Structure

Individual Trusts’ Board and Executive Committees (NEAS, NWAS & YAS)

NAA Programme Board Rod Barnes, YAS (Chair) Yvonne Ormston, NEAS Janet Paul, NWAS Derek Cartwright (NWAS) Programme/Project Management

Workstream 2, Workstream 1 – Digital Workstream 3, Estates, Workstream 4, Workforce Workstream 5, Value for Operations/Quality Yvonne Ormston, NEAS (CEO Fleet & Procurement Derek Cartwright, NWAS (CEO Money Rod Barnes, YAS (CEO Lead) Lead) Rod Barnes, YAS (CEO Lead) Lead) Derek Cartwright, NWAS (CEO Steve Page, YAS (Workstream Mark Bradley, YAS (Workstream Lynne Hodgson, NEAS Mick Forrest, NWAS (Workstream Lead) Lead) Lead) (Workstream Lead) Lead) Steve Page, YAS (Workstream Dave Macklin, YAS Paul Nicholson, NEAS Tracy Ellery, NWAS Caroline Thurlbeck, NEAS Lead) Joanne Baxter, NEAS Paul Lucock, NWAS Emma Bolton, YAS Roberta Barker, YAS Ged Blezard, NWAS

Project Workstreams (Each workstream will have a number of core initiatives/projects within them which will include other members of the three organisations to support delivery)

Our Aims

The aims of the Northern Ambulance Alliance have been agreed:

 To improve the quality and service delivery for patients  To maximise standardisation opportunities at scale and reduce duplication across the three organisations  Reduce the overall costs of the collective budgets of the three services Set against the backdrop of four key drivers:

 NHS Five Year Forward View & Dalton which urges organisations to look beyond traditional organisational boundaries as a means of responding to the challenges currently facing the NHS.  Lord Carter’s review which suggested that the NHS can save £5 billion by reducing variation in its ways of working and improving the fundamental approach to care.  Local alignment where, in addition to historical relationships, the three ambulance services recognises that collaboration is an essential component to the delivery of clinically and financially sustainability services.  NHSI Sector Review which was published in summer 2016.

Key Progress to Date

 Established partnership governance arrangements and joint leadership meetings.

 NWAS and YAS joint development of a local electronic patient care record for implementation in 2017/2018.

 The creation of a shared role to support Public Health initiatives across the Alliance.

 Commencement of a number of joint procurements to reduce the costs of equipment and consumables across all three organisations.

 Comparison of costs across support service areas for all three Trusts to inform opportunities for sharing best practice.

Key Priorities

The first phase of priorities for 2016/2017 were agreed to be: Digital Workstream

Activity Benefits Status Initial Completion Date Patient Care Resilience Financial Possible common tba CAD (computer-aided    despatch system) cross YAS and NWAS Possible common tba telephony across    NAA Share learning from tba Airwave Programme    Shared Vulnerable tba Patients Database    across NAA Feasibility of NEAS End 2018/19 simulation tool being  used across NAA Provide a digitised 31/01/2018 Electronic Care    Record form (EPCR) across NAA EOC back-up tba sites/shared    resilience Possible Wide Area tba Networks to be    identified

Workforce Workstream

Activity Benefits Status Initial Completion Date Patient Care Resilience Financial Identify common 31.03.2018 themes within the   staff survey and share plans for improvements Share best practice 31.03.2018 and expertise around    the Apprenticeship levy Determine benefits of 31.03.2018 cross-over and shared    knowledge on Occupational Health contract (wellbeing) Share learnings and 31.03.2018 best practice to   encourage flu vaccine take-up across NAA Explore feasibility of 31.03.2018 shared payroll   contract Review band 5 and 6 31.03.2018 paramedic career  frameworks to ensure consistency

Operations/Quality Workstream

Activity Benefits Status Initial Completion Date Patient Care Resilience Financial Share learning and 31.03.2018 resourcing from the   Ambulance Response Programme Explore benefits of a 31.03.2018 Paramedic Pathfinder   App and/or website for each partner Urgent Care Strategy 31.03.2018 Development using  Clinical Service Developments Create a Quality 30.09.2017 Compliance Alliance –   practical application of best practice Development of the 31.12.2017 nursing role within the  service by identifying common competencies and education needs Enable electronic call 30.06.2017 passing through  interoperability module in three EOCs Implement Frequent 30.06.2017 Caller project in  NWAS – sharing expertise from YAS

Estates, Fleet and Procurement Workstream

Activity Benefits Status Initial Completion Date Patient Care Resilience Financial Identify opportunities On-going for shared  sustainability ideas Develop a 31.03.2018 specification for a    single fleet management system across NAA Agree a joint tba procurement    approach for vehicles Agree standard lists 01.01.2018 and approach for    medical equipment and kit on vehicles Define and agree 01.07.2018 potential value and  approach to use of electric vehicles across NAA Consider benefits of 30.09.2017 sharing contracts  options for medical gases across NAA

Estates, Fleet and Procurement Workstream - continued

Activity Benefits Status Initial Completion date Patient Care Resilience Financial Identify benefits and 31.03.2018 explore options to   contract with one supplier to provide tyres for all three NAA organisations YAS to design a make 31.03.2018 ready vehicle  preparation specification which could be rolled-out across the NAA estate Define a 31.03.2018 comprehensive   approach to the supply and use of bunkered fuel – shelf life, locations, etc.

Value for Money Workstream

Activity Benefits Status Initial Completion Date Patient Care Resilience Financial Explore and define the 28.02.2017 possibility of a joint  CIO role for NWAS and YAS Undertake a Value for 28.02.2017 Money data gathering exercise Establish a 28.02.2018 commercial company  within NEAS Establish potential for 30.04.2018 joint working across  Legal Services in NAA

Northern Ambulance Alliance Board (NAAB) Terms of Reference

1. Introduction

In order to progress a Northern Ambulance Alliance, and enable maximum benefit from it for patients, the Board of Directors [the Board] of each of the three participating NHS Ambulance Services has agreed to establish a Northern Ambulance Alliance Board (NAAB). The three participating trusts include North East Ambulance Service NHS Foundation Trust, North West Ambulance Service NHS Trust and Yorkshire Ambulance Service NHS Trust.

The NAAB is a formal arrangement to enable increased collaboration, particularly on strategic issues. Further information on the rationale for this is set out in the related Case for Change.

2. Name

Northern Ambulance Alliance Board (NAAB).

3. Establishment

Each Board has agreed to establish and constitute the NAAB with these terms of reference.

4. Aims and Objectives

The NAAB aims to enable greater collaboration between the three ambulance services:

- To improve patient outcomes and the quality of patient care (e.g. through sharing best practice, reconfiguration of services, implementing new ways of working and implementing learning); - To create a sustainable service (e.g. by improving resilience and responding in a better fashion to constraints such as the scarcity of specialist staff); - To achieve greater financial stability (e.g. through reduced duplication and better use of existing resources across the sector).

5. Duties and Responsibilities

The NAAB will focus on agreed strategic issues that occur across the footprint of all three ambulance services and promote the best interests of patients. In doing so the NAAB will:

a. Create a clear view of the potential futures within which the three services will operate collectively as an alliance; b. Agree on the important strategic decisions to be made and the criteria and constraints in making them, including agreeing which, if any, decisions will be binding on all members of the NAAB; c. Provide a clear mandate to the Strategic Executive as to which projects are approved and within what timelines. d. Develop, explore and evaluate collective strategic ideas and levers for change.

6. Accountabilities and reporting lines/governance structure

The NAAB will work within the existing structure of organisations and existing legal frameworks.

The principle of subsidiarity will be applied to the work programme of the NAAB; issues will be addressed at the most appropriate level of decision making. Each participating trust’s substantive Board will ensure appropriate governance is in place, through their own Standing Orders/Standing Financial Instructions to allow delegated authority to the NAAB as circumstances permit.

Appendix A shows linkages with Trust Boards, Strategic Executive and work streams.

7. Decision-Making

7.1 Specific matters or types of matters, that require unanimous consent of all Members of the NAAB include: i. Contracts or shared services involving all three organisations; ii. Issues which increased the costs of any organisation would infer a veto on that organisation over other participating organisations; iii. Any joint tenders require unanimous agreement before tendering; iv. Any change to organisational form of the Northern Ambulance Alliance.

7.2 If any organisation were to leave the NAA the Termination process included at Item 19. of the TOR would be followed.

7.3 Decision-making, other than that at 7.1 (i-iv inclusive), will follow a locked gateway process as set out in appendices B and C.

All issues given to the NAAB to discuss by the substantive Boards will require an initiation stage. Such issues will require support from a simple majority of the NAAB to proceed to the case for change stage and be added to the NAAB work plan. There will be one vote for each member Trust. For those issues that require commissioner support, consideration will be given at the initiation and case for change stage, to agree at which stage in the process commissioner support should be sought or required.

Issues to be decided by the NAAB will be categorised as either Category 1 or 2. Categories 1 and 2 are defined as follows:

• Category 1 - issues where future decisions will be binding on all Trusts within the eligible constituency. The NAAB will agree a list of issues which require unanimous approval of all participating Trusts.

• Category 2 - issues on which any future decisions will not be binding on all Trusts.

The eligible constituency is those Trusts for which the matter is material and would be required to implement the outcome of the NAAB collective decision making process. Issues will be categorized as Category 1 based on the application of agreed criteria (to be agreed by the NAAB) and likely to focus on proposals that necessarily can only gain maximum benefit by standardization across all three services.

Categorisation will be assessed through, and proposed as part of, the case for change.

Category 1 Issues

The application of the locked gateway decision making process will be applied to category 1 issues as set out in detail at appendix B.

Each participating Trust’s Board of Directors will review and approve all NAAB schemes through their respective approvals process(es), in line with the Scheme of Delegation in their Standing Orders/Standing Financial Instructions and in compliance with their Quality Impact Assessment criterion and process(es).

The eligible constituency will be defined through the case for change. The eligible constituency will be re-defined at each stage as impacts on the affected Trusts become clear.

Only Trusts belonging to the eligible constituency will be able to vote at the decision gateways.

Voting at each gateway will be noted by the Chair and recorded in the minutes of the meeting. Thresholds for a decision to be carried will be applied as set out in appendix B.

Category 2 Issues

The application of the locked gateway decision making process will be applied to category 2 issues as set out in detail at appendix C.

Organisations will decide to participate and therefore become a member of the eligible constituency following the case for change. The eligible constituency will be re-defined at each stage as the affected Trusts become clear.

Once an organisation has committed to participate following the case for change, they cannot withdraw at a later stage.

Only Trusts belonging to the eligible constituency will be able to vote at the decision gateways.

Voting at each gateway will be noted by the Chair and recorded in the minutes of the meeting. Thresholds for a decision to be carried will be applied as set out in appendix C.

Items/papers submitted to the NAAB will make explicit whether they relate to Category 1 or 2 issues.

8. Membership

Membership of the NAAB shall comprise the Chair and Chief Executive of each of the participating Trusts.

Each member must designate a deputy. The deputy must be a Non-Executive Director or Executive Director, as appropriate, of the member Trust Board with voting rights.

There will be no non-voting members of the NAAB.

9. Chair

The NAAB will be chaired by each of the three service Trust Board Chairs on rotation on a two year cycle.

The Vice Chair will be each of the three service Trust Chief Executives on rotation on a two year cycle out of sequence to the Chair [so that the Chair and CEO of the same organisation will never be the Chair and Vice Chair at the same time for the NAAB]. The Vice Chair will also Chair the Strategic Executive.

10. Meetings

The NAAB shall meet quarterly or at such times as the Chair may direct on giving reasonable written notice to members. Meetings will be scheduled to ensure that they do not conflict with Trust Board meetings and are synchronized so that NAAB members can properly engage their organisations ahead of NAAB meetings.

The meetings should take place at a venue acceptable to all three trusts and be supported for administration, minute taking and governance by the Corporate Secretary of the incumbent Chief Executive’s host service who may, as agreed by NAAB, be supported by additional resource as appropriate.

On occasion it may be necessary to arrange extraordinary meetings at short notice. In these circumstances the Chair will give as much notice as possible to members of a time and place for such meeting.

Meetings of the NAAB shall not be open to the public or others, although individuals may be asked to attend for specific briefing on individual cases.

The Chair shall make a statement for all three service Trust Board annual reports about its activities, including the frequency of and attendance by members at NAAB meetings.

11. Costs and support functions

Costs incurred by and provision of support functions to the NAAB will be borne by the host Chair Trust and reimbursed at year end by all Trusts equally unless there are material grounds (agreed in advance by all members) to allocate specific costs on a different basis. Examples of costs likely to be incurred include the cost of any legal fees for advice to the NAAB and the costs of providing logistical support to the meetings.

12. Quorum

The quorum for a meeting of the NAAB shall be:

12.1 For a meeting at which specific matters or types of matters that require unanimous consent of all Members of the NAAB will be made, including: i. Contracts or shared services involving all three organisations; ii. Issues which increased the costs of any organisation would infer a veto on that organisation over other participating organisations; iii. Any joint tenders require unanimous agreement before tendering; iv. Any change to organisational form of the Northern Ambulance Alliance

12.2 For a meeting at which a Category 1 decision will be made, all of the voting members of the NAAB (or their designated deputies) must be in attendance or able to participate virtually by using video, telephone, web link or other live and uninterrupted conferencing facilities. There will be one vote available per Trust and decisions must be unanimously carried, i.e. 3 of 3 votes.

12.3 For a meeting at which a Category 2 decision will be made, at least one voting member from each Trust (or their designated deputy) are required to be in attendance or able to participate virtually by using video, telephone, web link or other live and uninterrupted conferencing facilities. There will be one vote available per Trust and decisions will be made on a majority vote, i.e. 2 of 3 votes.

13. Attendees

The NAAB can request additional attendees at meetings to provide specialist advice or information and can call for the attendance of others, such as clinicians.

The Chair can permit other persons to attend NAAB meetings, including individuals or representatives of organisations who request to attend through their host NAAB members.

Any additional attendees shall not count towards the quorum or have the right to vote at meetings.

14. Conflict of interest

Members of the NAAB must declare to the Chair any real, potential or perceived conflicts of interest in matters that are considered by the NAAB. Interests should be declared before the relevant meeting or as soon as the potential conflict becomes apparent during the meeting. These interests should be recorded by the Chair. The Chair may require a member to withdraw from a particular decision, meeting or part of meeting as necessary.

The Chairperson of NAAB will maintain and publish a Register of Interests of NAAB Voting Members (including Deputies) that will be received by NAAB at least on an annual basis.

15. Dispute Resolution

Tier One – good faith negotiation

In the event of a dispute, there shall be a tiered escalation dispute resolution process, which can be triggered by one party or a group of affected parties. Any party/parties may give to the Chair of the NAAB written notice of the dispute, setting out the identity of the parties who wish to dispute the decision and full particulars of the dispute. The NAAB shall meet within five working (5) days or able to participate virtually by using video, telephone, web link or other live and uninterrupted conferencing facilities and shall attempt in good faith to resolve the dispute, safeguarding the best interests of patients at all times. If this fails to resolve the dispute then a process of binding arbitration will be initiated.

Tier Two – binding arbitration An Independent Arbitrator will be sourced to lead and facilitate this process, and will be responsible for making the arbitration decision. The party/parties bringing the dispute will provide a statement of their case, including details of the circumstances giving rise to the dispute, the reasons why it is entitled to the solution sought, and the evidence upon which it relies. The Independent Arbitrator will identify individual(s) with the relevant experience and specialist expertise to help to resolve the dispute. These individuals should be acceptable to all parties, but the Independent Arbitrator will have ultimate authority to decide who the witnesses will be. The Independent Arbitrator will make their determination based on clinical or best practice evidence, where this is available, with an expectation that all parties wish to safeguard the best interests of patients in determining any outcome. The other party/parties will respond to the statement of case, giving details of what is agreed and what is disputed in the statement of case and the reasons why. The Independent Arbitrator shall have complete discretion as to how to conduct the arbitration, and will establish the procedure and timetable. The Independent Arbitrator will produce a written decision with reasons in a period of time agreed with the Independent chair. The decision of the Independent Arbitrator is final and binding.

16. Collective Responsibility

The NAAB will exercise collective responsibility. Once decisions are made members will have a responsibility to ensure achievement of the NAAB’s objectives and delivery of the work programme through the Strategic Executive. The Strategic Executive will be responsible for effectively communicating the action and allocating resources of NAAB member organisations to ensure delivery of the agreed actions. Externally members will be expected to represent the NAAB’s views and act as ambassadors.

17. Communications

Following each NAAB meeting a summary of actions and decisions is to be produced by the Corporate Secretary and be presented to each of the three Trust Boards at their next meeting.

An annual report will be formally presented and noted at the Boards of all member Trusts.

The Chair and Vice-Chair will be the public spokespersons for the NAAB.

18. Review of the performance and existence of the NAAB

The NAAB shall review its own performance from time to time and implement and/or recommend any necessary changes. These changes will be reported to members’ Boards.

The existence of the NAAB will be reviewed annually alongside a review of its Terms of Reference, as change is happening quickly and the decision-making arrangements may need to change accordingly. Such review will include review of NAAB’s purpose, strategy, plans and performance.

19. Termination of Membership

1. Termination: a Party may terminate this Agreement for its own convenience upon sixty (60) days written notice to the other Parties. Upon receipt of such written notice, the Chairman and Chief Executive of the Party submitting the notice will meet with the Chairman and Lead Chief Executive of the Northern Ambulance Alliance Board (NAAB) to discuss the reasons for the notice and to agree actions to mitigate any risks arising from that decision including any outstanding commitments of the terminating Party.

1.1 In the event that the Party wishing to terminate this Agreement should be the Chairman or Lead Chief Executive of the NAAB, all the remaining Members of the NAAB will meet with them to discuss the reasons for the notice and to agree actions to mitigate any risks arising from that decision including any outstanding commitments of the terminating Party.

1.2 Post-Termination. In the event of termination of this Agreement, completion of the Party’s outstanding obligations to customers under subcontracts, binding proposals, or other agreements shall be governed by the terms of the applicable subcontracts, proposals or agreements; provided, however, that any breaching Party shall be obligated to provide the non-breaching Party(ies), at the non-breaching Party(ies)’s option, commercially reasonable assistance and support necessary to (i) satisfy all outstanding services to be performed by the breaching Party(ies) under such subcontracts, accepted proposals, or agreements; or (ii) enable the non-breaching Party(ies) to provide any such outstanding services in-house or with the assistance of third parties. Upon termination of this Agreement, each Party shall immediately cease use of the other Party’s intellectual property. Upon termination of this Agreement, or at any time upon the other Party’s request, each Party shall return to the other Party, or destroy, all materials and Confidential Information provided by the other Party. Neither Party shall make any public announcement regarding termination of this Agreement without the other Party(ies)’s prior written approval.

1.3 The terms of such termination will be recorded in writing and entered into the Minutes of the next meeting of the NAAB.

20. Review of the Terms of Reference

The Terms of Reference will be reviewed annually in conjunction with the wider review of the NAAB’s purpose, strategy, plans and performance. The first review will take place once the NAAB arrangements have been tested in practice.

The NAAB has no other powers than those in the Terms of Reference.

Document name Northern Ambulance Alliance Board (NAAB) Terms of Reference

Version 2.3 Responsible Committee NAAB Responsible Director NAAB Lead Chairman Document Owner (title) NAAB Lead Chief Executive Document Lead (title) Corporate Secretary to Lead CEO

Approved By NAAB Trust Boards: NEAS, NWAS, YAS

Date Approved March 2017

Review Date May 2017

Equality Impact Assessed (EIA) Yes (Screening) Protective Marking Not Protectively Marked

Material Changes 1. Updated to Reflect Stage 1 & 2 Legal Advice 2. Termination of Membership added 3. Included in TOR annual review: review of NAAB’s purpose, strategy, plans and performance

Appendix A – The NAAB Governance in context

Northern Ambulance Alliance Board - this group will be where final decisions are approved.

Strategic Executive – this group will be more focused on operational implementation issues:

• Consist of the three Trust CEOs.

• Chaired by the CEO who is also the Vice-Chair of the NAAB.

• Will meet monthly and provide written report on progress of Projects to each NAAB meeting.

• The meetings should take place a venue acceptable to all three trusts and be supported for administration, minute taking and governance by the Corporate Secretary of the incumbent Chief Executive’s host service who may, as agreed by NAAB, be supported by additional resource as appropriate.

• Core focus is to ensure project streams deliver on agreed project timelines and objectives through continual monitoring of progress and benefit realisation.

• To conduct implementation review upon completion/closure of each project for lessons learnt and any areas for change referred back to the NAAB.

Individual Project Streams – This will include representatives from all three services. They will be established on a task and finish basis. Likely to meet as determined by the timescale of the project.

Northern Ambulance Alliance Board - Declaration of Interests for the Financial Year 2016-2017

NAAB Chairman Effective 1 April 2016 Kathryn Lavery Non-Executive Director Kath Trustee of YAS Charity Fellow Institute of Chairman Director Navigo, Lavery Associates Directors North East Chairman Hull Kingston 1 July 2016 Lincolnshire Rovers Community Trust

Chair Active Humber

Chairman Humber Business Week Ashley Winter None ** Herbert Dove None None Chairman of Community None Residential Chairman Trustees hold the Foundation Tyne & Landlords North East shares in J.T. Wear and Association Ambulance Service Dove, Regional Northumberland (Member) NHS Foundation Builders Trust Merchants Trustee Charlotte (Employee Straker Project NAAB Member Benefit Trust) Effective Vice Chairman, Herbert 1 April 2016 Director of Lion Dove Trustees ** Court (Corbridge) Ltd

Name/Dates Paid Directorships of Shareholdings Elected Trusteeships or Public Membership of Employment Commercial Office participation in the Appointments professional Companies management of (paid or unpaid) bodies/trade charities and other association or voluntary bodies similar bodies Rod Barnes None None None None Trustee of YAS Charity None Chartered Chief Executive Institute of Yorkshire Management Ambulance Service Accountants NHS Trust Healthcare NAAB Lead Chief Financial Executive Effective Managers 1 April 2016 Association (HFMA)

Derek Cartwright None None None None Board Member of None Member of Chief Executive Horwich Youth Support. Institute of Health North West A group to raise funds Care Ambulance Service for the Youth of Horwich Management NHS Trust Health Care NAAB Member Professions Effective Council (HCPC) 1 April 2016 Paramedic.

Yvonne Ormston None Director of None None None None None Chief Executive Association of North East Ambulance Chief Ambulance Service Executives NHS Foundation (AACE) Trust

NAAB Member Effective 1 April 2016

ARCHIVED INTERESTS:

Della Cannings Sole Trader None None Director/Trustee of Lay Member The Member Institute Chairman North Yorkshire Youth Lord Chancellor’s of Directors Yorkshire Specialist Ltd (company limited by Advisory Ambulance Service Advisor guarantee and Committee for Member Royal NHS Trust Care Quality registered charity) North and West Society for the Commission Yorkshire Encouragement NAAB Member (CQC) Trustee of NHS of Arts, 1 April to Providers Manufactures and 9 May 2016 Ministry of Commerce Defence Trustee of YAS Charity

Patricia Drake Specialist None None None Trustee of YAS Charity Vice Chair Locala Royal College of Deputy Chairman & Advisor Nursing Non-Executive Care Quality Justice of the Director Commission Peace Yorkshire (CQC) Ambulance Service NHS Trust (Interim Chairman from 10 May ‘16)

NAAB Member Effective 10 May 2016 to 30 June 2016

Glossary of Terms

Term/Abbreviation Definition/Explanation Accident and Emergency 999 A responsive service for patients in an emergency situation with a broad spectrum of illnesses and injuries, some of which may be (A&E) Service life-threatening and require immediate attention. Advanced Medical Priority An international system that prioritises 999 calls using information about the patient as supplied by the caller. Dispatch System (AMPDS) Ambulance Quality Indicators AQIs were introduced in April 2011 for all ambulance services in England and look at the quality of care provided as well as the (AQIs) speed of response to patients. The AQIs are ambulance specific and are concerned with patient safety and outcomes. Ambulance Response The Ambulance Response Programme (ARP) was established by NHS England in 2015 to review the way ambulance services Programme (ARP) operate, increase operational efficiency and to ensure a greater clinical focus. The trial is helping to inform potential future changes in national performance standards.

Annual Assurance Statement The means by which the Accountable Officer declares his or her approach to, and responsibility for, risk management, internal control and corporate governance. It is also the vehicle for highlighting weaknesses which exist in the internal control system within the organisation. It forms part of the Annual Report and Accounts. Board Assurance Framework Provides organisations with a simple but comprehensive method for the effective and focused management of the principal risks to (BAF) meeting their strategic objectives. British Association for A network of doctors who provide support to ambulance crews at serious road traffic collisions and other trauma incidents across Immediate Care (BASICS) the region. Care Quality Commission An independent regulator responsible for monitoring and performance measuring all health and social care services in England. (CQC) Chairman The Chairman provides leadership to the Trust Board and chairs all Board meetings. The Chairman ensures key and appropriate issues are discussed by the executive and non-executive directors. Chief Executive The highest-ranking officer in each Trust, who is the Accountable Officer responsible to the Department of Health for the activities of the organisation. Clinical Commissioning Group Groups of clinicians who commission healthcare services for their communities. They replaced primary care trusts (PCTs). (CCG) Clinical Hub A team of clinical advisors based within the Emergency Operations Centre providing support for patients with non-life-threatening conditions. Clinical Pathways The standardisation of care practices to reduce variability and improve outcomes for patients. Clinical Performance CPIs were developed by ambulance clinicians and are used nationally to measure the quality of important areas of clinical care. Indicators (CPIs) They are designed to support the clinical care we provide to patients by auditing what we do. Clinical Quality Strategy A framework for the management of quality within each ambulance service.

Clinical Supervisor Works on the frontline as part of the operational management team and facilitates the development of clinical staff and helps them to practise safely and effectively by carrying out regular assessment and revalidations. Commissioners Ensure that services they fund can meet the needs of patients. Computer Aided Dispatch A method of dispatching ambulance resources. (CAD) Commissioning for Quality The Commissioning for Quality and Innovation (CQUIN) payment framework enables commissioners to reward excellence by and Innovation (CQUIN) linking a proportion of providers’ income to the achievement of local quality improvement goals. Dataset A collection of data, usually presented in tabular form.

Department of Health (DH) The government department which provides strategic leadership for public health, the NHS and social care in England. Emergency Care Assistant Emergency Care Assistants work with clinicians responding to emergency calls. They work alongside a more qualified member of (ECA) the ambulance team, giving support and help to enable them to provide patients with potentially life-saving care at the scene and transporting patients to hospital. Emergency Care Practitioner Emergency Care Practitioners are paramedics who have received additional training in physical assessment, minor illnesses, minor (ECP) injuries, working with the elderly, paediatric assessment, mental health and pharmacology. Emergency Department (ED) A hospital department responsible for assessing and treating patients with serious injuries or illnesses. Emergency Medical Works on an emergency ambulance to provide the care, treatment and safe transport of patients. Technician (EMT) Emergency Operations Centre The department which handles all our emergency and routine calls and deploys the most appropriate response. (EOC) Electronic Patient Report An comprehensive electronic record of the care provided to patients. Form (ePRF) Equality and Diversity Equality legislation protects people from being discriminated against on the grounds of their sex, race, disability, etc. Diversity is about respecting individual differences such as race, culture, political views, religious views, gender, age, etc. Foundation Trust (FT) NHS organisations which operate more independently under a different governance and financial framework. General Practitioner (GP) A doctor who is based in the community and manages all aspects of family health. Governance The systems and processes, by which health bodies lead, direct and control their functions, in order to achieve organisational objectives, and by which they relate to their partners and wider community. Health Overview and Scrutiny Local authority-run committees which scrutinise matters relating to local health services and contribute to the development of policy Committees (HOSCs) to improve health and reduce health inequalities. Healthwatch Healthwatch England is the new independent consumer champion for health and social care in England. Local Healthwatch organisations have also been set up. Local Healthwatch organisations are a network of individuals and community groups, such as faith groups and residents’ associations, working together to improve health and social care services. Healthwatch organisations started to replace LINks (Local Involvement Networks) from October 2012. Human Resources (HR) A function with responsibility for implementing strategies and policies relating to the management of individuals. Information Asset Owner (IAO) An IAO is an individual within an organisation that has been given formal responsibility for the security of an information asset (or assets) in their particular work area. Information, Communication The directorate responsible for the development and maintenance of all ICT systems and processes. and Technology (ICT) Information Governance (IG) Allows organisations and individuals to ensure that personal information is dealt with legally, securely, efficiently and effectively, in order to deliver the best possible care. Information Management and This department consists of the IT Service Desk, Voice Communications Team, IT Projects Team and Infrastructure, Systems and Technology (IM&T) Development Team which deliver all the Trust’s IT systems and IT projects. Key Performance Indicator A measure of performance. (KPI) Knowledge and Skills A competence framework to support personal development and career progression within the NHS. Framework (KSF) Monitor The independent regulator of NHS foundation trusts. National Health Service (NHS) Provides healthcare for all UK citizens based on their need for healthcare rather than their ability to pay for it. It is funded by taxes.

National Learning Provides NHS staff with access to a wide range of national and local NHS eLearning courses as well as access to an Management System (NLMS) individual’s full training history. National Reporting and The NRLS is managed by NHS Improvement. The system enables patient safety incident reports to be submitted to a Learning System (NRLS) national database. This data is then analysed to identify hazards, risks and opportunities to improve the safety of patient care. North East Ambulance Service The NHS provider of emergency and non-emergency ambulance services in the North East. NHS Foundation Trust (NEAS) NHS 111 NHS 111 is an urgent care sservice for people to call when they need medical help fast but it’s not a 999 emergency. Calls are free from landlines and mobile phones. NHS England NHS England is responsible for Clinical Commissioning Groups (CCGs), working collaboratively with partners and encouraging patient and public participation in the NHS. NHS Improvement Provides leadership and support to the non-Foundation Trust sector of NHS providers. Non-Executive Directors Drawn from the local community served by the Trust, they oversee the delivery of ambulance services and help ensure the (NEDs) best use of financial resources to maximise benefits for patients. They also contribute to plans to improve and develop services which meet the area’s particular needs. North West Ambulance The NHS provider of emergency and non-emergency ambulance services in the North West. Service NHS Trust (NWAS) Paramedic Senior ambulance service healthcare professionals at an accident or medical emergency. Working alone or with colleagues, they assess a patient’s condition and provide essential treatment. Paramedic Practitioner Paramedic practitioners come from a paramedic background and have additional training in injury assessment and diagnostic abilities. Patient Report Form (PRF) A comprehensive record of the care provided to patients. Patient Transport Service A non-emergency medical transport service, for example, to and from out-patient appointments. (PTS) Quality Governance A process to ensure that ambulance services are able to monitor and progress quality indicators from both internal and Framework external sources. Quality Strategy Framework for the management of quality within each ambulance service. Rapid Response Vehicle A car operated by the ambulance service to respond to medical emergencies either in addition to, or in place of, an (RRV) ambulance capable of transporting patients. Red 1 and 2 Calls Previously referred to as Category A calls. An immediate life-threatening situation requiring emergency assistance eg cardiac arrest, choking, uncontrolled haemorrhage etc. The objective is to provide immediate aid to apply life-saving skills supported by paramedic intervention. Resilience The ability of a system or organisation to recover from a catastrophic failure. Serious Incidents (SIs) Serious Incidents include any event which causes death or serious injury, involves a hazard to the public, causes serious disruption to services, involves fraud or has the potential to cause significant reputation damage. Stakeholders All those who may use the service, be affected by or who should be involved in its operation. Year to Date (YTD) The period from the start of a financial year to the current time. Yorkshire Air Ambulance An independent charity which provides an airborne response to emergencies in Yorkshire and has YAS paramedics (YAA) seconded to it. Yorkshire Ambulance Service The NHS provider of emergency and non-emergency ambulance services in Yorkshire and the Humber. (YAS)