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Report to: |
East Sussex Health Overview and Scrutiny Committee (HOSC)
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Date of meeting:
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30 July 2024 |
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By: |
Deputy Chief Executive
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Title: |
South East Coast Ambulance NHS Foundation Trust (SECAmb) Care Quality Commission (CQC) Inspection Report
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Purpose: |
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RECOMMENDATIONS
The Committee is recommended to:
1) Note the report, and consider and comment on the contents of the report; and
2) Consider whether to request a further report on any of the areas covered in the report.
1. Background
1.1. South East Coast Ambulance NHS Foundation Trust (SECAmb) provides emergency and urgent care services in response to calls from the public and other healthcare professionals across Brighton and Hove, East Sussex, West Sussex, Kent and Medway, Surrey, and parts of North East Hampshire. The Trust operates two emergency operations centres (EOC) that receive and triage 999 calls. The EOC provides ambulance dispatch as appropriate and provides assessment and treatment advice to callers who do not need an ambulance response, a service known as “hear and treat”. SECAmb is also the provider of the NHS 111 service for residents in Kent and Sussex who require urgent care and advice over the phone.
1.2. The CQC conducted a focused inspection of the Emergency and Urgent Care services provided by SECAmb in March 2022 to assess how patient risks were being managed across health and social care services during increased and extreme capacity pressures. The CQC also inspected the EOC and 111 service, and inspected the well-led domain for the trust due to concerns about leadership quality and culture in the organisation.
1.3. The CQC published its inspection report on 22nd June 2022 and rated the Trust as inadequate in its well-led domain. Due to the inadequate rating in the well-led domain, the CQC recommended to NHS England that the Trust be placed into the Recovery Support Programme (RSP). NHS provider trusts placed into an RSP by NHS England must produce an Improvement Plan that includes a target timeline for exit from the RSP. NHS England must be satisfied that the agreed exit criteria have been met in a sustainable way and any required transitional support is in place before agreeing that a trust may leave the RSP.
1.4. The Committee received an update at its 29 June 2023 meeting to consider a report providing an overview of SECAmb’s progress in its Improvement Journey to address the findings of the CQC report and the work being undertaken to improve services and exit the RSP. At that meeting the Committee were informed that SECAmb was continuing its Improvement Journey, developing a new Strategy for the Trust and were still working as part of the RSP. Consequently, the Committee requested an update report be brought to it at an appropriate time to provide an update on progress being made towards exiting the RSP.
2. Supporting information
2.1. SECAmb has produced a report for the HOSC attached as Appendix 1. The report covers the work the Trust has been doing to improve operational performance to meet NHS England (NHSE) Recovery Support Programme goals and developing a new Trust strategy. The report includes information on:
· Performance of the 999 service. There have been improvements in the ambulance response times for all call Categories (1, 2, 3 and 4) and has a mean response time for Category 2 under 30 minutes which is better than many other services and improvements in Category 1 response times.
· Emergency Call Answering times. Call answering times have improved from 47 seconds in September 2023 to 10 seconds in January 2024 against a target answering time of 5 Seconds.
· 111 Service Performance. There have been challenges in call answering and abandonment rates, but there has been positive performance in ambulance disposition, validation, and direct referrals which consistently exceeded NHS England’s national averages. The Trust has the lowest number of Emergency Department referrals and highest ambulance validation percentage.
· Hospitals Handovers. Overall, hours lost due to handovers have significantly decreased compared to 2022 through work with Acute Trust partners across Sussex, and improvement work is continuing in this area.
· Urgent and Emergency Care. New models or work have been piloted through Clinical Coordination Hubs. Pilots show early evidence of reduced conveyance to emergency departments, improved patient outcomes, and enhanced collaboration among health providers.
· Community Provider Access to Category 3 & 4 Incidents. Daily ‘touchpoint’ calls were established in 2023 which allowed community providers to view the Trust’s clinical stack of category 3 and 4 incidents and discuss potential direct referrals to Urgent Community Response teams or Virtual Wards. A portal access initiative has recently been launched which allows community trusts to directly access the clinical stack of category 3 and 4 incidents through a secure web browser, enabling the Urgent Community Response team to view and self-refer incidents throughout their operational hours.
· Improvement Journey (NHSE Recovery Support Programme). This programme continues to guide the Trust in delivering exceptional patient care through strategic initiatives and concerted efforts which include: Enhanced Quality and Quality Improvement programmes; Responsive Care; Supportive Culture and the Culture Transformation programme; and Sustainable partnerships.
· Strategy Development Programme. The Trust is developing a long-term strategy aimed at delivering high-quality, equitable, and efficient care within a sustainable financial framework. This strategy also prioritises enhancing the experience of our people, supporting our partners, and committing to environmental stewardship.
2.2 The purpose of the report is to provide HOSC with further information on the Improvement Journey that SECAmb has undertaken in response to the findings of the CQC inspection report and to gain assurance that improvements have been made to the services provided by the Trust. As part of the last report to the HOSC in June 2023 the Committee were particularly keen to hear about improvements in recruiting and retaining staff and the actions being taken to improve the organisational culture and staff morale, which were seen as key to providing effective services to residents in East Sussex.
3 Conclusion and reasons for recommendations
3.1 HOSC is recommended to consider and comment on the report and decide whether future updates are needed on any of the areas covered in the report.
PHILIP BAKER
Deputy Chief Executive
Contact Officer:
Patrick Major, Scrutiny and Policy Support Officer
Tel. No. 01273 335133
Email: patrick.major@eastsussex.gov.uk