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Welsh Ambulance Services NHS Trust Integrated Medium Term Plan Summary 2018-2021

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Welsh Ambulance Services NHS Trust Integrated Medium Term Plan Summary 2018-2021 Welsh Ambulance Services NHS Trust Integrated Medium Term Plan Summary 2018-2021 Published: June 2018 www.ambulance.wales.nhs.uk www.facebook.com/welshambulanceservice @WelshAmbulance 0 1- INTRODUCTION Welcome to our Integrated Medium Term Plan (IMTP) Summary for 2018/19 - 2020/21. The IMTP is vital for us in the Welsh Ambulance Service to ensure there is a clear plan in place for the organisation. Our full IMTP is a detailed technical document that many may not have the time to read, so this summary aims to capture its key messages to ensure that we can reach a wide audience in a reader-friendly way. The IMTP is a requirement of Welsh Government for all Health Boards and Trusts in NHS Wales and it sets out our direction for the next three years, outlining our priorities, challenges and main risks. The plan commits us to delivering 44 actions, more detail can be found in the main IMTP. In their foreword, our Chair and Interim Chief Executive reflect on our place as a global leader in ambulance services, highlighting successes such as our clinical model. They outline the need to look at our strategy for the long term to make a fundamental difference to the landscape of unscheduled and scheduled care in the next 10 years. We will focus on how we shape our services to respond to our changing population, which can be achieved only with support from our partners and by ensuring our teams have the right skills. We hope you find this summary a useful insight into the Trust and the work we are doing to improve the quality of care we deliver to our patients. Alongside consolidating our achievements in the last two years, we remain a highly ambitious organisation and we have tried to demonstrate this in our plan, whilst recognising the significant challenges that still remain in the ‘here and now’ which we must address. In the immediate term, we intend to: Realise benefits of investments into the organisation and service such as CAD and Band 6 Address the continued challenges we face around our Amber cohort of patients Make more progress in using the skills of our paramedics in the community Carry out innovative work with patients who fall - another large cohort of patients we help frequently Deliver a key component of the NEPTS business case through the transfer of work from local health boards to the Welsh Ambulance Service (WAST) These key programmes, along with many other innovative and transformative actions, are detailed throughout this summary and further information can be found here in the main IMTP document. 1 2 - STRATEGIC OVERVIEW Developing a Long Term Strategy We are proud that we are in our third year of having an approved IMTP. Having this status has not only contributed to stabilising the organisation, but also given us the thinking space to consider what the long-term term strategic plan for the future of ambulance services in Wales needs to be. In 2017/18, we began developing a long term strategy for ambulance services in Wales and we have progressed this by identifying four pillars: (i) Widening our Clinical Offer, (ii) Leadership and Workforce, (iii) Working Together, and (iv) Embracing Technology. Consequently, we have adopted a collaborative approach to developing what these four pillars mean in detail by engaging with a range of stakeholders including the public, partner organisations and our staff through a range of workshops. Next Steps Work has already commenced on developing these themes into some more specific statements of ambition and some clear short, medium and long term priorities. Through 2018 we will undertake further targeted engagement on these, both internally and externally, prior to publishing our strategy. Our Strategic Aims Our document is framed around our strategic aims and is underpinned by five key priorities which are outlined in this section. We will place quality at the heart of everything we do, whether that is supporting all our leaders to be vibrant and compassionate, ensuring our services are excellent, in developing strong partnerships or in striving for continued value, excellence and efficiency • To deliver value, innovation and efficiency across the organisation. • To build even stronger partnerships with staff, patients, the wider public and our full range of stakeholders. • To ensure service delivery excellence and further improve the services we provide to patients. • Our staff are fantastic. We must ensure they are continually able to be their best. • To ensure all our leaders are vibrant and compassionate and help create a compassionate, caring culture. 2 Our Priorities Our five priorities are: 1. We will progress our quality improvement journey – implementing all strands of our quality improvement strategy. 2. We will sustain our Red performance whilst delivering further improvements and efficiencies in our clinical contact centres and our Amber performance. 3. We will continue the transformation of our NEPTS service, placing a significant focus on the successful transfer of work from health boards and implementation of the Quality and Delivery Assurance Framework. 4. We will deliver patient and system benefits through effective partnerships with health boards, our blue light partners, the third sector and the people in Wales. There will be a specific focus on estate, fleet, joint training opportunities and the continued rollout of the 111 service. 5. We will continue to develop, re-shape and engage with our workforce. We will place a specific emphasis on the implementing and embedding of the Band 6 paramedic role. 3 By bringing together our behaviours, priorities and our strategic aims, we have created a Strategy Map for the next three years, as shown below: 4 Overview of Our Performance We have made good progress in improving key elements of our performance during 2017/18, in particular Red performance, improved hear and treat rates and performance against concerns responses. However, we recognise that we still have areas where performance is fragile, where there is variation or where focused attention is required to demonstrate improvements. A detailed look at our performance is available in the IMTP main document. Key points from the analysis are: The Demand and Capacity Review In last year’s plan we identified the initial findings of a detailed Demand and Capacity Review. Over the past 12 months we have begun to make use of these opportunities as follows: Improving the alignment of our rosters Expanding the Clinical Desk Modelling the impact of 20 Community Paramedic Schemes Work is underway to realign internal resource to reduce the relief gap of circa 205 full time equivalents Identifying a way of building modelling software and expertise in house to become business as usual for the Trust The need for additional staff (circa 60 full time equivalents) by 2020/21 5 Our Performance Ambitions We have set ourselves a number of performance ambitions. These are ambitions which are discrete to the organisation and are not mandated by Welsh Government. It is important to set ourselves these ambitions so that we can measure that the work and actions which we are progressing are having a material impact on the services we provide. A detailed list of our performance ambitions can be found in our full plan. The list below represents just a few examples: Measurable Ambition Baseline 2018/19 2019/20 2020/21 2017/18 Percentage Hear and Treat 6.70% 8% Sustain 10% Number of NEPTS bookings made by 30% 15% 0 0 fax/paper Improving Infection Prevention & Control - 0% 20% 50% 95% Aseptic training to increase Percentage of suspected stroke patients who are documented as receiving appropriate stroke care 96.20% 95% 95% 95% bundle National Policy Context The Welsh Ambulance Service operates within a complex national picture and, in developing this plan, we have had to take into account a number of external polices, directives and work which we know is progressing. Some of these external factors are shown below. 6 Emergency Ambulance Services Committee: Parliamentary Review - An expert panel was Welsh Ambulance commissioning intentions - set up at the direction of the First Minister to we are commissioned by Health Boards through undertake a review of health and social care in a single committee known as EASC. Our plan is Wales. Our plan has to respond to those set against what our commissioners are asking recommendations. us to focus on. WAST A long term strategy for Health and Social Care Prosperity for All - This is Wales' current - Welsh Government is currently finalising an programme for government which was overarching strategy for NHS Wales. Clearly all published following the last Assembly elections. NHS Wales bodies, of which we are one, must look to realise this wider strategy. Emergency Ambulance Services Emergency Ambulance Service (EMS) commissioning (this means agreeing what outcomes need to be delivered with which resources) in Wales is a collaborative process underpinned by a national EMS Collaborative Commissioning Quality and Delivery Framework (CQDF). Working with the Chief Ambulance Services Commissioner (CASC) and his office on the development and delivery of the CQDF continues to be critical and core business for WAST. The framework’s overall strategic aim is to move activity towards steps 1 and 2 and away from step 5: Designed with permission using the CAREMORE® 5 steps. Copyright, 2017 WAST Non-Emergency Patient Transport Services The Non-Emergency Patient Transport Services (NEPTS) commissioning framework went live (in shadow form) on 1 November 2017. Like the EMS framework there are five steps: Step 5 - Step 1 – Step 2 – Step 3 - Step 4 – Take me to Help me to Answer my Coordinate Pick me up my choose request my journey destination At this stage, the NEPTS commissioning framework includes only WAST delivered services.
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