Table Of ContentNorth East Ambulance Service NHS
Foundation Trust
Annual Report and Accounts 2016/17
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North East Ambulance Service NHS
Foundation Trust
Annual Report and Accounts 2016/17
Presented to Parliament pursuant to Schedule
7, paragraph 25 (4) (a) of the National Health
Service Act 2006
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© 2017 North East Ambulance Service NHS Foundation Trust
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North East Ambulance Service NHS Foundation Trust
Annual Report and Accounts 2016/17
(for the period 1 April 2016 – 31 March 2017)
Contents
Performance Report ............................................................................................................................... 7
Overview of Performance ................................................................................................................... 7
Chief Executive’s Statement ........................................................................................................... 7
About Us – Our Purpose, Activities and History ........................................................................... 10
About Us – Our Strategy and Key Objectives for 2016/17 ........................................................... 10
About Us – Key Issues and Risks ................................................................................................... 12
Going Concern Disclosure ............................................................................................................. 13
Performance Analysis ....................................................................................................................... 14
Our key performance measures and how we monitor them ....................................................... 14
Our operational and financial performance in 2016/17 ............................................................... 15
Environmental & Sustainability Matters ....................................................................................... 20
Social, community and human rights issues ................................................................................. 21
Accountability Report ........................................................................................................................... 24
Directors’ Report ............................................................................................................................... 24
Board of Directors ......................................................................................................................... 24
Statement of disclosure to auditors ............................................................................................. 33
Council of Governors .................................................................................................................... 34
Foundation Trust membership ..................................................................................................... 39
Quality governance reporting ....................................................................................................... 42
Stakeholder relations .................................................................................................................... 52
Remuneration Report ....................................................................................................................... 55
Annual statement on remuneration from the Chairman ............................................................. 55
Senior Managers’ Remuneration Policy ........................................................................................ 57
Annual report on remuneration ................................................................................................... 60
Staff Report ....................................................................................................................................... 66
Recruitment and organisational structure .................................................................................... 66
Analysis of staff costs and numbers (subject to audit) ................................................................. 67
Training, development and support ............................................................................................. 68
Sickness absence ........................................................................................................................... 68
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Staff policies and actions .............................................................................................................. 69
Staff Survey 2016 .......................................................................................................................... 75
Expenditure on consultancy .......................................................................................................... 79
Off-payroll engagements .............................................................................................................. 79
Exit packages (subject to audit) .................................................................................................... 80
NHS Foundation Trust Code of Governance ..................................................................................... 82
Mandatory disclosures .................................................................................................................. 82
Comply or explain disclosures ....................................................................................................... 86
NHS Improvement’s Single Oversight Framework ............................................................................ 88
Segmentation ................................................................................................................................ 88
Finance and use of resources ........................................................................................................ 88
Statement of Accounting Officer’s Responsibilities .......................................................................... 89
Annual Governance Statement ......................................................................................................... 90
Scope of responsibility .................................................................................................................. 90
The purpose of the system of internal control ............................................................................. 90
Capacity to handle risk .................................................................................................................. 90
Review of economy, efficiency and effectiveness of the use of resources ................................ 102
Information governance ............................................................................................................. 103
Annual Quality Report................................................................................................................. 103
Review of effectiveness .............................................................................................................. 104
Conclusion ................................................................................................................................... 106
Quality Report ..................................................................................................................................... 107
Independent Auditor’s Report .................................................................. ......................................... 176
Annual Accounts 2016/17................................................................................................................... 181
Glossary of Terms............................................................................................................................... 212
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Performance Report
Overview of Performance
Chief Executive’s Statement
Our operating environment
2016/17 has been a busy and eventful year for the
Trust, and whilst there have certainly been
significant challenges, there have also been a lot of
positive developments and I’m incredibly proud of
our staff for their achievements and the dedication
they have shown to our patients.
As I predicted in my foreword to last year’s Annual
Report, we continued to operate under a climate
of system pressures across the region, increased patient acuity and financial constraints. The whole
ambulance sector, indeed the whole of the NHS, has been under significant pressure this year with
respect to demand and capacity, impacting upon the ability to meet national standards and targets
for patients.
Regrettably, we did not achieve our national emergency response targets for the year, despite
placing a significant amount of focus and attention in this area. No ambulance service achieved its
national targets this year, and we were broadly in line with the national average. We continue to
work hard to recover our national response targets, through internal efficiencies and service model
improvements, as well as close working with our commissioners and partners.
Whilst response targets have not been met, I am assured that the quality of the care received by our
patients remains high. The year began with our planned inspection by our regulator, the Care Quality
Commission (CQC). We were delighted to be awarded a rating of ‘Good’, being only the second
ambulance trust to receive such a positive rating at the time the inspection report was published.
This is testament to the care and professionalism that all of our staff dedicate to our patients and
service, often in incredibly difficult circumstances.
Staff, governors, volunteers, patients and partner organisations have worked incredibly hard since
the CQC first inspected our services in February 2014. I would like to thank them for their hard work
and the difference that they have made to bring about much of the change needed. We will
continue to work in partnership with them all to ensure we deliver against our plans.
We have continued to perform strongly in respect of our national ambulance quality indicators in
2016/17, and more than 85% of patients surveyed across all services have consistently said that they
would recommend the care and treatment delivered by our Trust staff to their friends and family.
However, we must not be complacent, there is still a lot of work to do to ensure standards are
consistently applied across all areas for the benefit of everyone who uses our services. The Trust is
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committed to ensuring ongoing learning and improvements and consequently processes are
continuously being reviewed for gaps and resulting improvements.
Whilst the financial environment remained challenging in 2016/17, the Trust finished the year ahead
of plan and was able to achieve a surplus position for the first time in two years, whilst still investing
significantly in our services and in new developments to improve patient care and quality.
Our staff
We have made significant progress on our paramedic vacancies during 2016/17, building on the solid
alliances with our local universities, which has seen vacancies fall and establishment levels achieved
in March 2017. We were delighted to work alongside Sunderland University to launch the new two
year Diploma in Higher Education in Paramedic Practice in September 2016.
We are also excited that the development of the Clinical Assessment Service provides us with an
opportunity to increase the multi-disciplinary aspect of our workforce, and look forward to
welcoming professionals with different clinical and medical backgrounds to support both our
patients and our call-handlers.
Our staff survey results for this year demonstrated an improved position, with an increase in
participation rates, an increase in our overall engagement score, and significantly better results in 41
out of 88 areas.
We have worked with staff during the year to seek and respond to their feedback, enhancing the
training and development opportunities available to them and improving working conditions, for
example by increasing the timeliness of meal breaks for our crews.
We have continued to work to ensure that the Trust is an inclusive and supportive environment for
all current and future staff. We retained our Top 100 position in the Stonewall index, and received a
number of awards, for example in relation to the promotion of mental health support for staff.
Transforming, collaborating and planning for the future
We have worked with our partners and stakeholders in the North East throughout the year to share
plans and work collaboratively on the development of health services for the local population.
We have been engaged in the development of the two Sustainability and Transformation Plans
(STPs) for the North East. The STPs provide significant opportunity to deliver system-wide changes,
which we can contribute towards through our role as the out-of-hours gateway, as well as helping
manage flow through hospitals both by reducing conveyance to Emergency Departments and
facilitating timely discharge.
In addition, we have been working closely with Yorkshire Ambulance Service NHS Trust and North
West Ambulance Service NHS Trust as part of the Northern Ambulance Alliance. The Northern
Ambulance Alliance was formally launched in April 2016 to share ideas for innovation and quality
improvement, work collaboratively together and identify efficiencies across all three trusts. A
number of project workstreams are ongoing, and I’m really excited to see what we can achieve in
2017/18.
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About Us – Our Purpose, Activities and History
The North East Ambulance Service NHS Foundation Trust operates across Northumberland, Tyne and
Wear, County Durham, Darlington and Teesside. We provide an Emergency Care Service to respond
to 999 calls, and a Patient Transport Service (PTS) which provides pre-planned non-emergency
transport for patients in the region. Since 2013 we have delivered the NHS 111 service for the region
to provide urgent medical help and advice, and we have been able to demonstrate how this service
can run alongside the 999 service to provide a seamless access point for patients. We also deliver
specialist response services through our Hazardous Area Response Team (HART). HART units are
made up of specially trained paramedics who deal with major incidents. Our front line services are
delivered from 61 stations across the North East region.
We became a Foundation Trust in November 2011 and are one of ten ambulance services in
England, covering an area of around 3,230 square miles. We serve a population of more than 2.71
million people and employ more than 2,500 staff including our valued volunteers.
Our mission is to provide safe, effective and responsive care for all, and our vision is to deliver
unmatched quality of care every time we touch lives. Even in the most challenging situations we
strive to perform to the highest professional standards in a spirit of collaboration and team work.
Caring for and treating more patients closer to home is at the heart of our plans, and our committed,
compassionate and caring staff are critical to our success.
About Us – Our Strategy and Key Objectives for 2016/17
During 2016/17 we have continued to embed our mission, vision and values which were launched in
the previous year, following a period of extensive consultation. Our mission, vision and values put
our patients at the very heart of everything that we do.
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Description:responsive and timely patient transport across the NEAS region for patients with palliative and end of life care needs, enabling them to be cared for and die in the place of their choice. The service provides dedicated End of Life vehicles to avoid conflicting priorities about allocation of vehicle
