Governance and assurance. CATEGORY OF PAPER Specific action required: Provides Assurance: For Information:

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1 CATEGORY OF PAPER Specific action required: Provides Assurance: For Information: Report title: Purpose of report: Key issues: (key points of the paper, how this supports the achievement of the Trust s corporate objectives, overview of risk implications, main risk details on page 2) Board of Directors Meeting 27/10/2016 Staff Engagement and Communications Update This report provides an overview and update of ongoing activity in Staff Engagement and communications. The paper provides feedback on key areas of activity such as the quality Walkround, crew observations, and communications team activity. Key issues for employees include: Red8 triage Relationship between road crews and operations centre Issue previously considered by: Recommended actions: Sponsor / approving director: Report author: Governance and assurance Link to trust corporate objectives: (please tick) Link to CQC / KLOE: (please tick) Any relevant legal / statutory issues? (Such as relevant acts, regulations, national guidelines or constitutional issues to consider) Equality analysis completed If this is not relevant please explain why: Key considerations Executive Team To note the issues raised by staff on the Quality Walkround To continue to support the Quality Walkround programme and note the schedule of events and attendees for the following dates: Chief Executive Officer Assistant Director of Communications & Engagement x Caring Responsive Effective Well Led Safe x Yes No Not Relevant Details Confirm whether any risks that have been identified have been recognized on a risk register and provide the reference number: Page 1 of 7

2 Please specify any Financial Implications Please explain whether there are any associated efficiency savings or increased productivity opportunities? Are any additional resources required e.g. staff capacity? No None identified. Is there any current or expected impact on patient outcomes/experience/quality? Improved patient outcomes expected from improved staff engagement and satisfaction. Specify whether appropriate clinical and/or stakeholder engagement has been undertaken: (stakeholders could include staff, other Trust departments, providers, CCGs, patients, carers or the general public) Are there any aspects of this paper which need to be communicated to our stakeholders (internal or external)? (Please tick if yes then please complete all boxes. Please briefly specify the key points for communication and ensure the Comms team are informed via N/A Yes No Positive Negative Proactive Reactive Internal External *The Trust corporate objectives are: 1. To continuously improve the quality and safety of our services, ensuring the CQC fundamental standards are achieved and patient outcomes are improved. 2. To achieve financial break-even position in 2017/ To improve organisational culture, aligned to Trust mission, vision and values to achieve delivery of our strategy. 4. Develop a future workforce with the correct staffing levels and skill mix across both clinical and non-clinical functions to support safe, effective and compassionate care and employee well-being. 5. To deliver the agreed Transformational and Vanguard programmes. 6. To plan, agree and implement a front line operational delivery model aligned to current and future need and planned performance improvement. Page 2 of 7

3 1. Quality Walkround Trust Board meeting Staff Engagement and Communications Update 26 th January Board directors have been conducting Walkrounds at hospitals in Newcastle, Gateshead, Cramlington, Darlington, Stockton and Middlesbrough. In addition, all directors participated in visiting ambulance stations across the service to visit crews and distribute chocolates for staff working over Christmas and New Year. 2. Feedback Emergency Care Two recurring themes are highlighted in the last quarter that have been raised by crews in the past the triage of Red incidents which they feel ought to be assessed as a lower acuity case and the relationship between road crews and operations centre staff also continues to be an issue regarding attitudes and discourse Crews also felt that NHS111 generated red responses too readily Specific cases were highlighted in regard to Red-rated incidents. One related to an NHS111 call in which the patient told the ambulance crew they had asked for a GP appointment, but the disposition had been for an R2 response; the second related to a question as to why patients were not being referred to district nursing teams where this was felt to be more appropriate ECS crews were aware that Manga Elk and alternative chairs have been piloted for lifting patients, especially in awkward / confined spaces, but were frustrated in the time that we are taking to get these operational Some raised concerns about the decommissioning of the bariatric vehicle There was positive feedback about the new Zoll defibrillators. Many crews also remain positive about the ECCM role and support that this is now giving them Two issues raised by staff is leading to some joint work with acute trusts. Firstly, some crews raised concerns about patients readmittance to hospital, sometimes as quickly as the day following their discharge from hospital; and secondly, there was enthusiasm for direct admission of patients to wards for some conditions being extended across all acute trust providers. PTS The relationship between road crews and operations centre staff continues to be an issue regarding attitudes and discourse There was a dis-satisfaction over the planned consultation meetings with managers during working hours and the subsequent letters regarding ICaT (integrated care and transport), which some reported as having created a level of anxiety Some staff felt there was a lack of hospital wheelchairs at South Tees and North Tees adding to turnaround time for patients. 3. Staff Friends and Family Test Page 3 of 7

4 3.1. The staff FFT survey is incorporated into the annual NHS Staff Survey, which was circulated in Q3. NHS England require all NHS Trusts to pause the routine FFT survey during Q3 to maximise staff survey completion rates The results of the staff FFT survey in Q3 will be published with the annual NHS staff survey in February Communications 4.1. Q saw the Press Office generate 423 articles, a 51% increase on the previous quarter reflecting the additional attention upon the NHS at this time of year. These stories created million opportunities to reach people across the country, with an article value of 661,736 in positive and balanced media coverage in the quarter. The increase in media coverage is seen particularly in November and December: 250 Volume of media stories Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec 4.2. Stories which generated the most coverage in national and regional press and broadcast included: o Hospital handover delays and winter pressures (all national, regional and broadcast); o CQC inspection ratings (all regional and broadcast); o Christmas and New Year operations (all regional and broadcast) 4.3. The top 10 stories, by volume, covered in the last quarter in the media are shown here: Page 4 of 7

5 Top Stories in Q3 Community defibrilators End of life transport service NEAS present bravery certificate Restart a Heart Day Slow NEAS response Legal high callouts Assaults on staff Black-eye Friday/Operation Ginger CQC inspection findings NEAS severe pressure - handover delays Performance response times and poor patient experience as a result of long waits for an ambulance continue to generate the most negative articles in the media. o o o All these negative stories relate to elderly patients assessed as being a Green priority and experienced a delay in their ambualnce response. The CQC rating contributed mostly to positive coverage of the service; although ambulance response times in the CQC report was viewed negatively by patient and political reaction. End of Life Transport; the first anniversary of the Durham Dales tri-responder scheme; community first responder and defibrillator schemes; and the annual NEAS Beyond the Call of Duty awards contributed to positive coverage of the Trust across the other categories: Balanced Negative Positive 4.5. The reach of media stories is dominated in the last quarter by national BBC channels, as a result of the BBC Ambulance Day on 30 th November 2016 in which 11 of 13 ambulance trusts took part in the BBC exploration of pressures in the service and the measures being taken to address these. Page 5 of 7

6 Article Reach ('000) 4.6. Although the reach of national media is significantly higher than local or regional media, the latter offer greater access to the patients and public served by NEAS. Consequently, of these 423 stories in Q3, 258 were broadcast on local and regional television and radio; 123 were published in local or regional newspapers; 23 were published in national newspapers and 19 were broadcast on national television or radio The national news agenda on NHS and ambulance services over the last month includes: The Daily Telegraph (23 Dec) reported that the number of elderly patients visiting A&E in December has risen 25% over six years, far outstripping the rise in the ageing population over the same period, according to data from NHS Digital. The Daily Mail s front-page splash (24 Dec) reported Professor Keith Willett urging people to stay away from A&E and go to a pharmacist or call 111 instead. The Daily Telegraph (3 Jan) reported that ambulance services had to go into crisis mode amid severe pressures. South East Coast Ambulance Service declared a business continuity incident as services became overwhelmed by high demand on New Year s Day. East Midlands Ambulance Service also declared a critical incident after struggling to cope with its busiest 48 hours ever. The following day, Daily Telegraph reported that busy A&E departments are forcing thousands of people to wait for hours in ambulances outside hospitals as they struggle with the winter influx of patients. Taj Hassan, president of the Royal College of Emergency Medicine, said departments across Britain were buckling under pressure with staff working at the very limits of their abilities In a front page lead, the Daily Telegraph (7 Jan) reported the British Red Cross warning the NHS is facing a humanitarian crisis as hospitals and ambulance services struggle to keep up with rising demands. Also on the same day, The Times reported that ambulance trusts have been accused of regularly manipulating 999 performance by taking advantage of NHS rules enabling them to log ambulance response times as near-zero if there was a defibrillator within 200m of a patient. The Times also reported the postcodes that cover Wooler and Haltwhistle, where community paramedics have worked since 2006, were among the fastest in responding to emergencies compared with the rest of the UK. 5. Recommendations The Board is asked: To note the issues raised by staff on the Quality Walkround Page 6 of 7

7 To continue to support the Quality Walkround programme and note the schedule of events and attendees for the following dates: 10 th March 2017 Jo Baxter Ash Winter Time Location Darlington Memorial Hospital University Hospital of North Tees James Cook Hospital 12 th April 2017 Mark Cotton Carolyn Peacock Shobha Srivastava Time Location Gateshead QE Hospital Royal Victoria Infirmary NSECH Cramlington Page 7 of 7

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