North East Ambulance Service NHS Foundation Trust

86 Pages·2013·2.34 MB·English

North East
Ambulance Ser vice
NHS Foundation Trust
Annual Report and Accounts
for the period 1 April 2012 - 31 March 2013
North East
Ambulance Service
NHS Foundation Trust
Annual Report and Accounts
for the period 1 April 2012 - 31 March 2013
Presented to Parliament pursuant to Schedule 7,
paragraph 25 (4) (a) of the National Health Service Act 2006
Table of Contents
Page 6. Foreword: welcome from our Chief Executive and Chairman
Page 8. About us
Page 11. Financial review
Page 38. A year with us
Page 42. Quality Report
Page 97. Patient Care
Page 105. National staff survey
Page 108. Directors’ report
Page 122. Council of Governors
Page 124. Remuneration Report
Page 132. Audit Committee
Page 132. Nomination and Remuneration Committee
Page 133. Foundation Trust membership eligibility and constituency boundaries
Page 136. Regulatory ratings
Page 137. Other disclosures in the public interest
Page 145. Year accounts 1st April 2012 - 31st March 2013
4 | Quality Report 2013 North East Ambulance Service NHS Foundation Trust | 5
Foreword: Welcome from our
Chief Executive and Chairman
Welcome to our second Annual Report and Financial Accounts for the North East
Ambulance Service NHS Foundation Trust (NEAS). This covers our first full year in
operation as an NHS Foundation Trust.
This Year was a further year of considerable of these commissioners that they wish to subject
turbulence for the National Health Service (NHS), our Patient Transport Service (PTS) to a review
with the passing of the Health & Social Care Act and possible competitive tendering during the
2012, and in the context of continuing economic year ahead. Again, we will endeavour to ensure
restrictions, the Trust once again delivered that we are in a strong position to continue
positive results in terms of achieving national providing this essential service to maintain the
response time targets, despite continuing strong links with our emergency care and contact
increases in activity and reduced costs as required centre businesses and preserve the resilience that
by the Government. PTS provides to the NHS as a whole when under
severe pressure.
During this period our staff continued to serve
the needs of our patients here in the North The Trust’s mission is to ensure that patients
East with their usual attention to safety and receive the ‘’right care in the right place at the
quality of service. The Care Quality Commission right time” and we have worked for some years
(CQC) completed an unannounced inspection in now to build an infrastructure which can truly
December, with much positive feedback being enable this mission to be fulfilled for users of
obtained from our patients and staff regarding NHS services here in the North East of England
the quality of the services we deliver. Our staff and elsewhere. After an intense period of hard
in the patient transport, contact centre and work by our team, working in partnership with
emergency care services are to be congratulated Northern Doctors Urgent Care, we expanded
upon their achievements and they are supported our provision of the new NHS 111 service to
strongly by staff in all areas of the Trust for whom cover the Gateshead, South Tyneside and
patient care is also their highest priority. Sunderland areas, building upon the service
that had previously been introduced in County
We have been very conscious that the Health Durham and Darlington in July 2010. With effect
& Social Care Act 2012 has brought about from April 2013 we have further expanded the Whilst the achievement of further cost improvements and developments that entailed.
changes to the way in which commissioning for service to cover the whole of the North East. improvements is a major challenge for the He is to be congratulated upon his achievements
the future will be determined by placing more When set alongside the 999 service, this puts the Trust we remain committed to tackling this and leadership and he retires to Sussex with the
decision making in the hands of the Clinical ambulance service at the heart of joining up the requirement whilst maintaining the quality of best wishes of all at NEAS. Tony is replaced by
Commissioning Groups (CCGs) that replace urgent and emergency care system, based on a our services to all our patients. The coalition Ashley Winter who brings a powerful blend of
Primary Care Trusts (PCTs) with effect from April, decision making process that is evidence-based government’s strategy has been to focus more commercial and public sector experience which
2013. We will do all we can, as a significant and consistent in assessing patients’ needs over closely upon measures of outcome from the care will be highly relevant to the development of the
provider of health services in the North East, to the telephone and referring them to the most provided by the NHS and the Trust is working Trust’s activities in the future.
help the new players establish themselves and to appropriate service available. For our region, it closely with other ambulance colleagues to
ensure that we continue to deliver the highest means that patients will be seen more often by compare and contrast our clinical outcomes in There are many other achievements and
quality of services possible within the resources the clinician who is most able to help them in the order to learn from each other and share good initiatives which we could have mentioned in
available to us. We are now on notice from some timeframe appropriate for their need. practice. The clinical outcome measures can be this introduction but we will leave those for the
readily viewed on our website at: reader to discover in the pages that follow. The
www.neas.nhs.uk/ needs of patients are what motivate our people
and determine the shape of our services. We
In December our Chairman of almost nine hope that you enjoy reading our Annual Report
years, Tony Dell, relinquished his role. Tony and will continue to share a sense of pride in the
guided the Trust through many challenges and achievements of your ambulance service.
achievements during his tenure including a
merger, the introduction of the NHS Pathways
system which underpins both our 999 and 111
services, and Foundation Trust Status with all the
6 | Quality Report 2013 North East Ambulance Service NHS Foundation Trust | 7
About us
The North East Ambulance Service NHS Foundation Trust is one of the highest Our Partners Our mission, vision and strategy
performing ambulance services in England.
Our partners include eight acute hospital Trusts, Our mission
two mental health trusts and 12 local unitary
“Right Care, Right Place, Right Time”
authorities, as well as the police and fire services
We operate across Northumberland, Tyne It provides medical support and training so that
in the North East. We also work very closely with
and Wear, Durham and Teesside. the service is prepared in the event of a major
Patients are at the heart of everything that
St John Ambulance Service and the British Red
incident.
we do to support our mission of “right care,
Cross.
We provide emergency and urgent care and
right place, right time”. We have a strong
patient transport services for an area of Patient Transport Service
track record of delivering high quality patient
How we are monitored
around 3,230 square miles and we employ
care; focussing resources to produce the most
over 2,700 people who serve our population of Our Patient Transport Service (PTS) facilitates vital
effective outcomes. We are at the leading edge of
Ambulance performance was monitored in 2012-
approximately 2.66million people. access for many patients requiring healthcare or
innovative service design which has consistently
13 by the NHS Primary Care Trust Boards and
treatment services at outpatient appointments.
led to us being one of the highest performing
overseen by NHS North East - the Strategic Health
We currently have 65 Trust locations, including 56 We plan for over one million patient transport
ambulance trusts in the country.
Authority for the region. These organisations are
emergency care ambulance stations. A number of journeys every year. We also provide an urgent
these stations also house non-emergency Patient transport service in County Durham and being replaced with new bodies in April 2013. Our vision
Transport Service employees and vehicles and Darlington for patients with an ‘urgent’ (non-
Emergency Care ambulance services were paid for “To make a difference by integrating
we share some of our sites with fire and rescue emergency) healthcare need.
by NHS Primary Care Trusts, of which there were
services, securing financial efficiencies. our care and transport in the pursuit of
12 in the North East and our lead commissioner
Contact Centre Operations
equity and excellence for our patients”
for this service was NHS North of Tyne. We met
Core Services Overview
regularly to discuss the quality and efficiency
Emergency Care and PTS are both supported by
This means we will drive through improvements
of the service. In April 2013 the Primary Care
Emergency Care Service our two contact centres which manage in excess
in service delivery and work to ensure all of our
Trusts will be replaced by Clinical Commissioning
of 800,000 calls per annum. Our first contact
patients have a positive experience, not losing
We receive, prioritise and respond to more than centre is based at our headquarters in Newburn Groups (CCGs). The Strategic Health Authority will
sight of our requirement to eliminate waste,
371,000 emergency and urgent incidents per and the second of our contact centres, Russell be disestablished during 2013, and some of its
inefficiency and unnecessary costs.
annum. Of these incidents, more than a third House, has now been operational for three years, functions taken over by Area Teams representing
are immediately life threatening and require an enhancing our call handling resilience. NHS England.
Values
eight minute response time. There are also 11
Ambulance Quality Indicators which are aimed NEAS will also provide NHS 111 services for the We were also monitored by our Council of Our values underpin everything we do:
Governors, elected from our FT membership, the
at judging the quality of care we provide and whole North East region by 2013. This service is
assessing patient outcomes. currently live in County Durham and Darlington 12 Local Involvement Networks in our area and by • Committed, professional and accountable
our local authority health overview and scrutiny
for people who need healthcare but are unsure if
• Working together
The emergency care division also provides service they need an ambulance. A trained call handler committees.
for patients who need transport to hospital will assess their needs and either refer them to • Delivering consistently
Our Fleet
up to four hours at the request of a doctor. An a local point of care, for example, their GP or
• Shaping the future
additional 1,500 patients per annum require a walk in centre, or if an emergency ambulance is
We have:
high dependency transfer. needed, it will be deployed without delay. • Showing we care
Traditionally the Ambulance Service had Non-core Services • 142 Emergency Care (A&E) ambulance
Our strategic intentions
always operated within the ‘cold zone’, areas frontline vehicles;
where contamination was not present and Training Services We have a strong track record for delivering
• 68 Rapid Response Vehicles including Urgent
the area was deemed to be a safe working high quality and good value patient care, but
Care Service (UCS) cars;
environment. Various major incidents in recent We provide a range of first aid, first responder, we are not complacent and we continue to
years, alongside the increasing threat of a accident prevention and conflict resolution • 231 Patient Transport Service (PTS) vehicles; seek improvement and good value. Even with
chemical, biological, radiological or nuclear training for external organisation. the economic challenges ahead we are more
• 39 other vehicles including, resilience, pool
occurrence resulted in ambulance staff being committed than ever to driving forward our
trained and equipped to work within a ‘warm Medical Cover and logistics vehicles; strategy. With this in mind we have put in place
zone’ environment, in order to provide • We also utilise helicopter support funded by six equally important strategic intentions, which
decontamination to casualties and emergency We provide Paramedic cover for local events are supported by our corporate objectives.
the Great North Air Ambulance Service,
services workers under medical supervision. The such as music concerts and sporting events
where necessary.
Trust’s Hazardous Area Response Team (HART) including football and rugby matches. We played
provides this service for the North East. an important part in the Olympics last year,
providing cover at Olympic events held within
Our Emergency Planning Department also forms the region.
part of emergency care operations and is a
service that we are required to provide under
the Civil Contingencies Act 2004.
8 | Quality Report 2013 North East Ambulance Service NHS Foundation Trust | 9
The ‘house’ graphic summarises our mission, vision, strategic intentions
Financial Review
and our values; with patients as a central focus.
This section of our annual report looks at how we have managed our financial
affairs and contributed to our strategic intention “to have sound financial health”,
for the period ended 31st March 2013 and how we have performed against our
mandatory targets.
The Directors are responsible for the preparation Any activity in addition to the contracted volumes
of the financial statements and for being satisfied is charged at a marginal rate.
that they give a true and fair view in accordance
with the NHS Foundation Trust Annual Reporting Patient Transport Service Contracts are based on
Manual 2012-13. a block contract for transporting patients to out-
patient appointments, day centres, Out of Hours
Directors have a reasonable expectation that treatment centres and Primary Care Centres.
the Trust has adequate resources to continue in Additional Income is also received from Durham
operational existence for the foreseeable future. PCT for the 111 Service. This year also saw the
For this reason the Trust continues to adopt the roll-out of 111 to the South of Tyne PCT areas,
going concern principle in preparing the annual resulting in additional income.
accounts and annual report.
Our income was ahead of our original plan,
Our full accounts, presented at the end of the submitted to Monitor (the independent regulator
report, have been prepared in accordance with of Foundation Trusts), as we received additional
the directions made under paragraph 24 of funds due to the following:-
schedule 7 of the National Health Service Act
2006 and Monitor, the Independent Regulator • Increased activity volumes above those
of NHS Foundation Trusts. originally contracted for.
• Funds from NHS North East (SHA) to maintain
It has been another financially challenging
performance during the winter months.
year for the Trust as we continue to develop
the services we provide for the people of the • Extra Contractual Referral income from
North East whilst at the same time dealing with patients requiring transport out of our area.
increasing demands for our services in fluctuating
• Funds from the Department of Health for the
To lead in the provision of emergency care To be a well governed and accountable service
weather conditions.
Hazardous Area Response Team (HART).
• We want to be the provider of choice for • We want to continue to ensure that the safety
Emergency Care services and lead through and quality of our services to patients remains The majority of our income comes from the contracts The Trust has complied with Section 43(2A) of
innovation, research and performance. our highest priority. we negotiated with our lead Commissioner, the NHS Act 2006 (as amended by the Health
Newcastle PCT, for the provision of our Emergency and Social Care Act 2012) which requires that
To be a key partner in urgent care reform Our Annual Forward Plan provides more detailed
Care Services and Patient Transport Services. the income from the provision of goods and
information about our business objectives for each
• We want to help deliver the changes that our
services for the purposes of the health service in
patients and our commissioners are asking for year and can be found on our website.
Emergency Care contracts are based on a locally England must be greater than its income from
using our expertise and infrastructure.
agreed tariff for an agreed volume of incidents the provision of goods and services for any other
The Trust was successfully registered with the
To transform patient transport services independent regulator of NHS providers, the Care relating to number of calls answered and triaged purposes. The impact of other income on the
• We want to continue to be the provider of Quality Commission on, 1 April 2010 for the following and then either treated on scene or transported Trust is insignificant.
choice for PTS in the North East. regulated activities without compliance conditions: to hospital.

To be a first rate employer
• Treatment of Disease, Disorder or Injury
• We want to ensure our staff are appropriately
• Transport Services, Triage and Medical Advice
supported, with fair pay and flexible working
Provided Remotely
conditions and a safe and productive working
environment. In September 2010 the Trust also registered for
the following activity, again without conditions:
To have sound financial health
• We want to maintain strong financial • Diagnostic and Screening Procedures
health that enables us to invest in new
service developments, constantly taking the
organisation forward.
10 | Quality Report 2013 North East Ambulance Service NHS Foundation Trust | 11
Cost Improvement Plan equipment and systems equated to £1.1 million
as part of the Trust on-going plan to enhance
The Trust had a Cost Improvement Plan of £4.83 telephony infrastructure. Investment in our
million for 2012/13. The scope of the plan is estate amounted to £8.5 million, with our most
broad, encompassing cost improvements across all significant transaction being the purchase of
of the Trust’s functions and service lines as well as our Headquarters/Contact Centre building. This
Other PCT’s (1%) income generation opportunities. provides long term cash savings for the Trust
compared to the original lease expenditure.
Durham PCT’s (44%)
We achieved £5.5 million savings which puts us
We also continued with our “Invest to Save”
South of Tyne PCT’s (22%) in a strong position as we start work against next
schemes with investment in energy efficient
year’s target of £4.35 million.
North of Tyne PCT’s boilers at a number of premises and installation
of photovoltaic panels in ambulance stations to
FT’s (1%) Financial Performance
improve energy efficiency.
Education and Training (1%)
The Trust continues to demonstrate a strong
The value of the Trusts tangible and intangible
Department of Health (1%) financial base and our key headline financial
assets at the end of 2012/13 was £38.0 million.
indicators are as follows:-
Other Income (3%) However, the purchase of Bernicia House led to
an impairment of £5.8 million reduces the value
• Year- end deficit of £2.98 million – the main
of fixed assets accordingly.
reason for the deficit was an exceptional one off
Other PCT’s (1%)
impairment charge of circa £5.24 million relating
Cash Flow Management and Prudential
Durham PCT’s (44%) to the purchase of the Trust’s HQ Bernicia House-
Borrowing Limit
please refer to section on Capital.
Our running costs continue to be tightly controlled a nuSmoubthe ro of Tfy Enme PeCrgTe’sn (2cy2 %d)epartments in the region
with some underspends in the areas of training, vehicle considerably stretching our expenditure on resources. • Year-end normalised surplus of £2.34 million The Trust has a Prudential Borrowing Limit, set by
North of Tyne PCT’s
insurance, uniform purchases and finance lease costs (as (after taking account of all exceptional Monitor of £30.2 million. The Trust has no loans
a result of the purchase of our Headquarters/Contact ExpFePTna’sdy ( i(1t6u%5r%)e )on Governors travel expenses amounted charges). outstanding nor were any taken out during the
Centre building). We provided additional funds to to £5,600 for the whole year. year. With healthy cash balances held throughout
prepare for the winter, increasing our 4x4 fleet capacity ESduupcpaltiieosn a anndd S Terraviniciensg ( (21%%)) • Year-end cash balance of £10.4 million. the year and an end of year balance of £10.4
during this period to increase assurance of our ability A bDrEeesaptkaabdrtloimswhemnn teo onfft oH(2ue%ra l)ethx p(1e%n)diture by type is shown • Capital Investment of £13.2 million. million there was no requirement for us to utilise
to sustain response performance during the winter below: any of our agreed working capital facility.
OTtrhaners pInocrot m(8e% ()3%) • Financial Risk Rating of 4 reported.
months. In addition, during certain times of the year,
the Trust had to deal with severe handover delays at Premises (4%) Monitor also applies a rating system from 1 to During the year, surplus cash was invested
5, where higher scores are better. The Trust’s resulting in an additional £35,000 income. All
Depreciation (7%) performance was: - cash and cash equivalent balances (other than
Expenditure Analysis 2012/13 negligible petty cash balances and investments)
Impairments (5%)
Capital are held with Government Banking Services.
Education and Training (1%)
EBITDA Margin 4
Insurance (1%)
EBITDA % Plan Achieved 5
POapye (r6a5ti%ng) Leases (1%)
Financial Efficiency 5
SOutphperli e(5s% an)d Services (2%) Liquidity Ratio 4
Establishment (2%) Overall 4
Transport (8%)
The Trust funds its capital investment from
Premises (4%)
internally generated funds and made investments
Depreciation (7%) in excess of £13.2 million during the year.
Vehicles and equipment purchases of £3.6 million
Impairments (5%)
reflected the continuing investment in front
Education and Training (1%) line vehicle replacement for Emergency Care
(A&E), Rapid Response and Patient Transport
Insurance (1%)
vehicles. Investment in Information Technology
Operating Leases (1%)
Other (5%)
The Trust has complied with the cost allocation and charging requirements set out in HM
Treasury and Office of Public Sector Information guidance.
12 | Quality Report 2013 North East Ambulance Service NHS Foundation Trust | 13
Looking Forward The Trust is of course aware of the potential for • The organisation has recognised the risks Aduit Costs
tendering of such services in the North East and is arising from the scale of the financial
The medium term environment for the Trust is working hard to protect this service line. challenge and the need to secure staff PwC was the Trust’s external auditor for the period
uncertain with the prospect of continuing pressures and management buy-in to the measures 1st October, 2012 to 31st March 2012. Their fee for
for efficiency savings, decreases in the local tariff The current Durham Urgent Care Service is likely to necessary to achieve the Foundation Trust’s auditing the accounts was £36,950 +VAT and for the
prices paid for Emergency Care Services and Patient be the subject of a tender to take effect from 1st Strategic Plan. To mitigate this risk there is an audit of the Quality Report £8,950 +VAT. During
Transport Services and uncertain activity levels as April 2014, the contract having been extended by Improvement Steering Group in place including the year the Trust did not purchase any “non-audit
NHS 111 is rolled out across the wider North East one year (2013-14). Preparations are in hand and we staff side representatives to manage the services” from the external auditor.
from 2nd April 2013. At the same time the Trust are a position to respond with an experienced bid Cost Improvement Programme with minimal
will continue to deliver improved quality. A major team at the ready. organisational disruption and with a priority Director Statement regarding Audit
challenge in the first months of 2013-14 will be to of maintaining the quality of our services.
adapt resourcing levels to actual activity levels as Overall we look to retain financial stability whilst The Directors confirm that so far as they are aware:-
the impact of 111 becomes known. developing a business model which seeks to
• As outlined earlier the Trust recognises the risk • There is no relevant audit information of
maximise business opportunities.
to its PTS services and the prospect of other which the North East Ambulance Service
From 1 April 2013 the contracts for all of our
services move to be commissioned, procured and Financial Risks competitive tendering, which if unsuccessful auditors are unaware.
will result in residual overhead costs that
monitored by CCGs, themselves supported by • They have taken all the steps they ought
The financial risks facing the organisation are undermine its financial position.
the North of England Commissioning Support to have taken as directors in order to make
included in the Trust’s risk register and are
Unit (NECs) and the exact direction of change is • The uncertainty over activity levels is a themselves aware of any relevant audit
continuously monitored throughout the year with
unknown. There will be a challenge for the Trust to significant risk to the Trust. A prudent approach information and to establish that the North
regular updates being provided to the Board.
engage at an early stage with the CCGs given their to resourcing has been taken in the early East Ambulance Service’s auditors are aware
agenda, and we will take the opportunity to utilise months of the financial year 2013-14 i.e. of that information.
The major financial risks incorporated into the
the pressing urgency to set up Urgent Care Boards potentially over-resourcing to ensure quality of
Trust’s organisational risk register were: • Made such enquiries of his/her fellow directors
to ensure that we continue to be seen as a key service. Close scrutiny will be maintained and
and of the company’s auditors for that
player to assist them in reforming the Urgent and any necessary adjustments made to ensure the
• The organisation recognises that the purpose; and taken such other steps (if any)
Emergency Care system. One of our priorities will be financial position of the Trust is protected whilst
longer the requirement for on-going cost for that purpose, as are required by his/her
to help improve the patient flow when arriving at maintaining performance and quality standards.
improvement programmes of 4% and duty as a director of the company to exercise
our local accident and emergency departments.
above and the more easily achievable cost Pension Costs reasonable care, skill and diligence.
improvements exhausted, the more difficult
Emergency Care services from the 1 April 2012 Fraud and Corruption
it is to achieve them without redesigning The provisions of the NHS Pensions Scheme cover
moved to being commissioned on a Payment by
and reforming the way services are provided. past and present employees. The scheme is an
Results (PbR) basis. The Trust is currently the most The Trust’s contracts with commissioners for
It is more important than ever to have staff unfunded defined benefits scheme that covers
economical provider of services of all the English healthcare include specific clauses and schedules
and management backing to support the NHS employers, General Practices and other bodies
Ambulance services. PbR at present is based on a regarding counter fraud arrangements.
cost improvement programme. Any failure to allowed under direction of the Secretary of State
system of local tariffs but the Trust will be actively
maintain this focus may lead to financial and in England and Wales. The scheme is accounted
promoting its case for moving towards national Local Counter Fraud Specialist Services (LCFS) are
reputational issues and a negative impact on for as if it were a defined contribution scheme:
best practice tariffs and seek recognition from CCGs provided to the Trust via contract arrangements
the Trust’s position the cost of participating in the scheme for an NHS
that in order to maintain the quality of services with Sunderland Internal Audit Services (SIAS).
body is taken to equal the contributions payable
the local tariff should be adjusted to gradually • The organisation recognises that in the current Individuals appointed as LCFS have been
to the scheme for the accounting period. The total
move the Trust towards the norm. This would economic climate, and continuing below inflation approved as suitable for this role by the Counter
employer contribution payable for 2012-13 was
result in increased income levels which the Trust headline rises in salary levels there is a potential Fraud and Security Management Service (CFSMS).
£6,881,163.
would re-invest in services such as the Trust’s CARe for significant staff side resistance to change, The lead LCFS is Paul Bevan. An annual plan,
programme to contribute to the reducing avoidable resulting industrial relation issues. To minimise updates on progress against the plan and an
The scheme is a final value scheme and on advice
hospital visits. this risk the Trust has well developed consultation annual report on compliance against the Counter
from the scheme actuary, scheme contributions
arrangements with its main Trade Unions through Fraud arrangements are presented to the Audit
may be varied from time to time to reflect changes
The Patient Transport Services business stream the Joint Consultative Committee. Committee regularly. The Trust’s Counter Fraud
in the scheme’s liabilities. A more comprehensive
produced a strategy for modernisation in 2012-13 Policy is available on the organisations website.
accounting policy note on pension liabilities is
which is in the process of being implemented. It aims
included in the full set of the accounts. Information
to maximise efficiency and put the service in the
on directors’ pension entitlements can be found
most robust financial position possible whilst actively
in the Remuneration Report on page 106 of this
engaging with commissioners to ensure it meets the
annual report. The Trust’s accounting policies for
required quality and performance standards.
pensions and other retirement benefits are set out
in Note 10 of the accounts. Further Information is
also disclosed in the Annual Governance Statement.
14 | Quality Report 2013 North East Ambulance Service NHS Foundation Trust | 15
Better Payment Practice Code at an agreed rate. Performance indicators are Activity Levels for 2012/13 versus 2011/12
set and subject to performance monitoring by
The Government’s ‘Better Payment Practice Code’ Commissioners. ECS is measured by activations This table shows the activity and volume of demand on our service in terms of calls and patient
requires public sector bodies to pay all trade (the number of times an ambulance response journeys, for the period April 1st 2012 to March 31st 2013, and a comparison against the same period
creditors within 30 days or within the agreed terms. vehicle is requested). for the previous financial year.
The Trust is an approved signatory of the prompt The Patient Transport Service (PTS) contract is
Activity April 1st 2011 Activity April 1st 2012
payment code, hosted by the Institute of Credit provided on a block basis. This is measured by Service
to March 31st 2012 to March 31st 2013
Management on behalf of the Department of the number of journeys it carries out.
Business Innovation and Skills.
The NHS 111 service is provided on a block
As a result the Trust is committed to:
basis based on the agreed annual contract
ECS-number of total journeys 305,579 315,449
value. During 2011/12 this service was available
• Pay suppliers within agreed terms.
in the County Durham and Darlington areas
• Ensure suppliers know how to invoice them. only. Following a tender process, the Trust was
successful in their bid to provide the NHS 111
• Encourage good practice.
service through the North East region. The South PTS-number of total journeys 877,155 896,531
During 2012/13 no interest was payable under the Late
of Tyne area (Sunderland, Gateshead and South
Payments of Commercial Debts (interest) Act 1998.
Tyneside) saw a successful rollout from December
2012, with the other areas – North of Tyne and
Pension Liabilities ECS-number of calls answered
Teesside – to have the NHS 111 service live from 467,139 500,005
by the Contact Centre
2nd April 2013.
There were two individuals who retired early on
ill-health grounds during the period. This gave
A summary of the performance against contract
rise to additional pension liabilities of £154,000.
for each of the three core service lines is PTS-number of calls answered
351,110 363,193
summarised on the next page. by the Contact Centre
Sickness data
The organisation is required to report sickness
data based on a calendar year. Of the 451,125 FTE NHS 111- number of calls
162,281 247,502*
days available, 26,442 FTE days were lost due to answered by the Contact Centre
sickness giving an average of 13.2% sickness rate.
* During 2011/12 there were only two PCT areas with NHS 111 services available. 2012/13 saw NHS 111
Trust development and performance
become available in a further three PCT areas from December 2012 onwards.
The business of the Trust is delivered predominantly
through three core service lines; Emergency Care
Services (ECS), Patient Transport Service (PTS) and
Contact Centres.
Performance against contract
The Emergency Care Service has been contracted
on a Payment by Results (PbR) basis. This means
that a financial value is agreed for each of four
tariffs each year and indicative activity levels set;
the four tariffs relate to Call volumes, Hear &
Treat (calls), See & Treat (incidents), and See Treat
& Convey (incidents). The value of the contract is
calculated at the beginning of the year against
the indicative activity levels and the value of each
tariff. Any variation by PCT is charged by incident
16 | Quality Report 2013 North East Ambulance Service NHS Foundation Trust | 17
National Performance Targets
Performance for 2012/13 is summarised below.
Emergency Care Service
Key Performance Indicator Actual Performance Actual Performance
We believe the UK has some of the toughest performance targets of any ambulance service in the
2011/12 2012/13
world set out by the Department of Health, and demand for our emergency service continues to rise
every year.
1. Call abandonment rate 0.84% 2.19%
Response time standards were amended in June 2012 to take account of changes to incident priorities
2. Re-contact rate following discharge of care
from Category A incidents to a split between Red 1 and Red 2 incidents. Red 1 calls are time critical
incidents that genuinely require an emergency ambulance response within 8 minutes; for these
Re-contact rate following discharge of care by
incidents the Call Connect clock start would remain the same. Red 2 calls allow for more a more 14.94% 15.81%
telephone
appropriate emergency response to be provided based on the specific needs of the patient; for these
incidents the clock start will be the earliest of i) the point at which a chief complaint of the call has
Re-contact, following discharge of care from
5.22% 4.99%
been identified ii) a vehicle has been assigned to the call iii) a 60 second cap from the Call Connect treatment at the scene
time; though these calls too will result in an 8 minute ambulance response if the call results in a final
categorisation of Red 2. Proportion of calls from patients for whom a
Procedure being developed
locally agreed frequent caller procedure is in place
The Trust successfully met and exceeds all challenging performance targets for 2012/13:
3. Outcome from cardiac arrest-return of spontaneous circulation (ROSC)
Category A (Red 1 and Red 2) 8 – Life threatening emergency calls, presenting conditions which
may be immediately life threatening and should receive an emergency response within 8 minutes ROSC at time of arrival at hospital (Overall) 21.49% 26.29%*
irrespective of location in 75% of cases.
ROSC at time of arrival at hospital (Utstein**) 50.00% 45.90%*
Category A (Red) 19 – Life threatening emergency calls, presenting conditions which require a fully
equipped ambulance vehicle to attend the incident, must have an ambulance vehicle arrive within 19 4. Service experience
minutes in 95% of cases.
5. Outcome from acute ST-elevation myocardial infarction (STEMI) (Heart attack)
Key Performance National target Actual performance Actual performance
Percentage of STEMI patients receiving NEAS do not practice thrombolysis. The Trust
Indicator 2012/13 2012/13
thrombolysis within 60 minutes of call worked to PPCI instead (see indicator below)
Category A (Red - all) 8 75% 76.41% 77.88%
The percentage of patients suffering a STEMI
who are directly transferred to a centre capable
Category A (Red 1) 8 75% 76.59% N/A*
of delivering primary percutaneous coronary 96.25% 95.68%*
intervention (PPCI) and receive angioplasty
Category A (Red 2) 8 75% 76.50% N/A*
within 150 minutes of call.
Category A (Red) 19 95% 96.98% 98.83%
The percentage of patients suffering a STEMI who
78.29% 84.69%*
receive an appropriate care bundle.
* Category A calls were split into Red 1 and Red 2 priorities from June 2012 and not recorded as such
during 2011/12.
6. Outcome from stroke for ambulance patients
The Trust is committed to the delivery of the national response targets set for ambulance services The percentage of Face Arm Speech Test (FAST)
and proactively monitors daily forecasts and actual performance. The impressive year-on-year track positive stroke patients (assessed face to face)
record of success, in the face of an increased demand on health services, continues to provide strong potentially eligible for stroke thrombolysis, who 85.90% 78.52%*
assurance for patients and Commissioners that we are able to respond to patient need and achieve arrive at a hyperacute stroke centre within 60
national response targets. minutes of call.
April 2011 saw the introduction of new Ambulance Quality Indicators (AQI) for the whole ambulance The percentage of suspected stroke patients
service, in addition to the Category A (Red) 8 and 19 minute targets; these new indicators were shadow (assessed face to face) who receive an 93.61% 97.24%*
reported during 2011/12 as no targets had been set by the Department of Health. The 2012/13 NHS appropriate care bundle.
Standard Contract included local targets for us against the Quality Indicators. These new indicators are
7. Outcome from cardiac arrest – survival to discharge
designed to look at the whole patient care pathway and to encourage discussion at a local NHS level
as to how care can be improved. Their aim is to monitor patient care and outcomes alongside response
Survival to discharge 6.48% 4.58%*
time performance.
Survival to discharge [Utstein**] 22.11% 17.65%*
18 | Quality Report 2013 North East Ambulance Service NHS Foundation Trust | 19