2017/18 Welsh Ambulance Services NHS Trust Integrated Medium Term Plan 1 Contents 1 MESSAGE FROM THE CHAIR AND CHIEF EXECUTIVE ............................................................. 5 2 INTRODUCTION AND HOW TO READ THIS PLAN ....................................................................... 7 3 STRATEGIC OVERVIEW ................................................................................................................... 10 3.1 Developing a Long-Term Strategy .................................................................................................. 10 3.2 Performance ................................................................................................................................... 18 3.2.1 Overview of our Performance ................................................................................................ 18 3.2.2 Our Performance Ambitions 2016/17: A Review ................................................................... 19 3.2.3 Our Performance Ambitions for 2017/18 .............................................................................. 19 3.3 Our Service Initiatives ..................................................................................................................... 23 3.4 National Policy Context .................................................................................................................. 23 3.5 NHS Wales Strategic Change Agenda ............................................................................................. 23 3.6 Ensuring Integration with Our Health Board Partners’ Three Year Plans ...................................... 25 3.7 Emergency Ambulance Services Committee (EASC) and the Commissioning Quality and Delivery Framework.................................................................................................................................................. 31 3.8 Service Change in Collaboration with Blue Light Partners ............................................................. 32 4 OUR ACHIEVEMENTS IN 2016/17 .................................................................................................. 34 4.1 Key Headlines of our Successes ...................................................................................................... 34 4.2 Our Strategic Change Portfolio ....................................................................................................... 34 4.3 Our 154 Point Plan .......................................................................................................................... 34 5 OPPORTUNITIES AND CHALLENGES IN 2017 - 2020 ............................................................... 35 5.1 Specific Challenges ......................................................................................................................... 35 5.2 Demand and Capacity Review ........................................................................................................ 36 5.2.1 Amber Performance. .............................................................................................................. 36 5.2.2 Workforce Challenges ............................................................................................................ 36 5.2.3 Clinical Risk Assurance Review ............................................................................................... 37 5.3 Specific Opportunities .................................................................................................................... 38 5.3.1 The New Clinical Response Model ......................................................................................... 38 5.3.2 Realising Benefits from the Demand and Capacity Review .................................................... 38 5.3.3 Primary Care ........................................................................................................................... 39 5.4 Other Opportunities ....................................................................................................................... 39 2 6 QUALITY, SAFETY AND PRUDENT HEALTHCARE ................................................................... 40 6.1 Strategic Context ............................................................................................................................ 40 6.2 Structures – Strengthening Quality Assurance and Improvement across the Trust ...................... 42 6.3 Processes – to Strengthen Quality across the Trust ....................................................................... 43 6.4 Outcomes - (Assurance, Improvement and Learning).................................................................... 45 6.5 The Organisation and Prudent Healthcare ..................................................................................... 47 7 OUR SIGNIFICANT SERVICE CHANGES ..................................................................................... 49 7.1 OUR EMS SERVICE DEVELOPMENTS ............................................................................................... 49 7.1.1 STEP 1: Help Me Choose ......................................................................................................... 49 7.1.2 STEP 2: Answer My Call .......................................................................................................... 52 7.1.3 STEP 3: Come to See Me ......................................................................................................... 57 7.1.4 STEP 4: Give Me Treatment .................................................................................................... 61 7.1.5 STEP 5: Take me to….. ............................................................................................................. 63 7.2 OUR NON-EMERGENCY PATIENT TRANSPORT SERVICE DEVELOPMENTS ..................................... 65 7.2.1 The NEPTS Business Case ....................................................................................................... 65 7.2.2 The NEPTS Four Step Model ................................................................................................... 67 7.3 SPECIFIC PATIENT GROUP SERVICE DEVELOPMENTS ..................................................................... 70 7.3.1 Amber calls- responding to the challenge .............................................................................. 70 7.3.2 Welsh Government Together for Health National Delivery Plans.......................................... 72 8 OUR ENABLERS ................................................................................................................................. 73 8.1 Our People ...................................................................................................................................... 73 8.2 Our Finances ................................................................................................................................... 96 8.3 Our Estate ..................................................................................................................................... 113 8.4 Our Discretionary Capital ............................................................................................................. 116 8.5 Our Fleet ....................................................................................................................................... 117 8.6 Research & Development ............................................................................................................. 118 8.7 Improvement & Innovation .......................................................................................................... 121 8.8 Health Informatics and Business Intelligence .............................................................................. 123 8.9 Information Communication & Technology (ICT)......................................................................... 125 8.10 Partnerships and Engagement ..................................................................................................... 130 8.10.1 The Well Being of Future Generations (Wales) Act 2015 (WBFGA) ..................................... 133 8.10.2 Patient Experience and Community Involvement (PECI) Team ........................................... 133 3 8.11 Corporate Governance and Risk Management ............................................................................ 134 8.11.1 Corporate Governance ......................................................................................................... 134 8.11.2 Meeting our Statutory Obligations: ...................................................................................... 135 8.11.3 Business Continuity .............................................................................................................. 136 8.11.4 Plan Delivery ......................................................................................................................... 136 8.11.5 Welsh Language .................................................................................................................... 138 Annexes (Separate Document) Annex 1: Overview of 17/18 Strategic Actions Annex 2: Strategic Statement of Intent Annex 3: Alignment of 16/17 & 17/18 Strategic Aims Annex 4: Overview and Progress Against 16/17 Performance Ambitions (Q3) Annex 5: Overview of Service Change Initiatives Annex 6: 2016/17 Strategic Change Portfolio Annex 7: Progress Against our 2016/17 154 Actions Annex 8 Demand and Capacity Review Annex