MEMBER AND PATIENT SURVEY-REPORT

2018 MEMBER AND PATIENT SURVEY-REPORT South Central Ambulance Service NHS Foundation Trust 7/8 Talisman Business Centre Talisman Road Bicester OX26 6HR

Contents Introduction... 2 Membership - Summary of responses... 3 Recommendations... 10 Revisiting the recommendations from 2017 Survey Report... 10 What happened next?... 11 Recommendations for the future... 11 Patient survey Summary of responses... 12 999...13 Some of the comments from survey responders... 23 NEPTS (Non-Emergency Patient Transport Service)...24 NHS 111...27 Website... 35 Responders demographics... 36 Recommendations... 41 Next step... 41 1

Introduction MEMBERSHIP EXPERIENCE The sixth annual membership survey was undertaken in May of this year over a five week period. It was sent via Foundation Times, the Trust s membership newsletter to all Foundation Trust public members who have supplied the Trust with an email address. For the fourth year running we invited GP surgeries across our four counties to pass on our request to complete the survey to their Patient Participation Groups (PPGs) so they could tell us about their experience of care they receive from us. For the second year it was emailed to other stakeholders such as Healthwatch groups and councils and also promoted via social media. In total we received 348 responses. In 2017 and 2016 we received 543 and 375 respectively. Specific objectives and findings of the research: 1. Understand what membership activities our members have been involved with and what they find most beneficial about being a member 2. How members wish to get involved with their ambulance service 3. How members and service users rate the trust s emergency (999) and nonemergency services (111 and Patient Transport Service) and how these can be improved. 2

Membership - Summary of responses 105 Foundation Trust members responded to the survey. This is a significant decrease from 2017 when 201 took part. Members feedback is shown below. 1. In the last 12 months how have you been involved as a Trust Member? (please indicate one or more of the following) The table below shows that 69% read Foundation Times, the members newsletter (up 3% and 4% from 2017 and 2016 respectively). The percentage of responders (38%) who in 2018 have taken part in surveys and consultations has decreased 1 from previous years. However, those who took part had the opportunity to make a difference with the following consultations and focus groups: CQC research in Oxfordshire, Berkshire and Buckinghamshire which involved testing a questionnaire about people s experience of staying in hospital. Focus group in Milton Keynes for a SCAS and Open University project which involved pulling together a research question around elderly care and the complexity of decision-making when managing older patients, looking at both the clinicians and carers experiences. University of Portsmouth project on dementia (see copy of minutes from the CEF at http://www.scas.nhs.uk/wp-content/uploads/scas-hants-cef-minutes-21-june- 2017-1.pdf See SCAS 2017/18 Annual Report from pg 70 to 75 for more details at http://www.scas.nhs.uk/wp-content/uploads/scas-annual-report-2017-18-dps.pdf 3

In the last 12 months how have you been involved as a Trust Member? (please indicate one or more of the following) - I always read Foundation Times, the members' newsletter 65% 55 66% 108 69% 55 I have attended at least one of the events organised for members 15% 13 15% 24 14% 11 I have taken part in surveys and consultations 46% 39 47% 77 38% 30 I have encouraged at least one friend, family member or work colleague to join as a member 9% 8 13% 22 8% 6 I have joined SCAS 100 Virtual Club 0 0 1% 1 I have joined one of the Trust's Community Engagement Forums 0 0 5% 4 I have voted in the election to the Council of Governors 19% 16 28% 46 21% 17 I have enquired about becoming a Governor 7% 6 9% 15 8% 6 I have stood for election to the Council of Governors 2% 2 1% 1 6% 5 I have attended a public meeting of the Council of Governors 6% 5 3% 5 8% 6 I have attended a public meeting of the Board of Directors 5% 4 3% 5 6% 5 I have spoken with people representing SCAS at public events 6% 5 None of the above 2 17 15% 24 15% 12 Other (please specify) 4 5 8% 6 8 7 6 5 4 3 2 1 I always read Foundation Times, the members' newsletter I have attended at least one of the events organised for members I have taken part in surveys and consultations I have encouraged at least one friend, family member or work colleague to join as a member I have joined SCAS 100 Virtual Club I have joined one of the Trust's Commmunity Engagement Forums I have voted in the election to the Council of Governors I have enquired about becoming a Governor I have stood for election to the Council of Governors I have attended a public meeting of the Council of Governors I have attended a public meeting of the Board of Directors I have spoken with people representing SCAS at public events None of the above Other (please specify) 4

21% of responders have voted in the election to the Council of Governors, a 7% decrease from last year. The majority of non-voters did so because they either forgot or were not aware that it was happening. Other reasons given vary from Finding online voting complicated, Being too busy to thinking that Governors cannot help. On the plus side, the percentage of responders who put themselves forward as governors has increased by 5%. 2. What do you find most beneficial about being a member? Being kept up to date about what is happening at the Trust through the members' e-newsletter, email, etc 75% 60 83% 126 84% 65 Opportunities to be more involved if I wish (e.g. attend events, become a governor) 45% 36 45% 68 27% 21 Showing support for the Trust and influencing future direction 31% 25 43% 65 3 23 Being able to vote for who I think can best represent me, as a member, on the Council of Governors 26% 21 31% 47 38% 29 Other (please specify) 1 8 3 3% 2 9 8 7 6 5 4 3 2 1 Being kept up to date about what is happening at the Trust through the members' e-newsletter, email, etc Opportunities to be more involved if I wish (e.g. attend events, become a governor) Showing support for the Trust and influencing future direction Being able to vote for who I think can best represent me, as a member, on the Council of Governors Other (please specify) The above table and chart show that 84% are happy with being kept up to date with what is happening in the Trust through the members' e-newsletter, email, etc and this denotes a minimal change from last year. 27% find that being given the opportunity to be more involved if they wish is most useful. This represents an 18% drop from the previous years and could be a sign of membership fatigue and the desire to just being an armchair observer as confirmed by the Acorn (A 5

Classification Of Residential Neighbourhoods) profile of our members, based on the average attributes and behaviours of Acorn types across the UK (see Figure 1 below). Figure 1 Acorn group profile SCAS FT members Members are often happy to be engaged when there is a topic that concerns them directly, but otherwise they are reluctant. As the amount of involvement requests from many different organisations increases, there are progressively fewer people willing to participate and this is common in all Trusts. 3 of our survey responders find that showing support for the Trust and influencing future direction is most beneficial for them as a member (down 13% from 2017 and back to 2016 figures). Members got involved with SCAS in different ways, from talking about their inspiring book Flight of a Lifetime (http://ow.ly/dkc3l) at a SCAS Community Engagement Forum in Bucks, attending a couple of SCAS Community Engagement Forums in Hampshire when able to get a lift to Voting for governors on who was best in my mind to represent Hampshire. Finally, the responders who benefit as a member in being able to vote on the Council of Governors have steadily increased in the last two years (up 7% from 2017 and 12% from 2016). 6

3. As a member how would you like to be more involved in your local health services in the future? (please indicate one or more of the following) As shown below, 54% of responders would like to receive more regular communication, compared to 47% last year and 41% in 2016. 61% expressed an interest in being involved with consultations and questionnaires (up 6% and 19% from 2017 and 2016 respectively). 18% would be interested in attending a Community Engagement Forum and other events compared with 31% in 2017 and 32% in 2016. This considerable oscillation reiterates the change in members need to be more involved with the Trust online rather than face-toface. More regular communication 41% 28 47% 60 54% 31 Consultations and questionnaires 42% 29 55% 71 61% 35 Volunteering 19% 13 32% 41 14% 8 Attending Community Engagement Forums and other events 32% 22 31% 40 18% 10 Getting involved with SCAS 100 Virtual Club 0 0 9% 5 Fundraise for the South Central Ambulance charity 0 0 9% 5 Becoming a governor 0 0 16% 9 Help the Trust with organising events 0 0 7% 4 7 6 5 4 3 2 1 More regular communication Consultations and questionnaires Volunteering Attending Community Engagement Forums and other events Getting involved with SCAS 100 Virtual Club Fundraise for the South Central Ambulance charity Becoming a governor 7

4. What type of events or meetings would you like to see more of for members? Presentations on specific health issues by professionals 74% 49 76% 93 87% 47 Joint events with other trusts 29% 19 36% 44 33% 18 Other (please specify) 3% 2 4 4% 2 10 8 6 4 2 Presentations on specific health issues by professionals Joint events with other trusts Other (please specify) 87% of responders would like to see more presentations on specific health issues by professionals while 33% would like to attend more joint events organised with other trusts. Suggested themes include health events on cancer, back pain, sleep and healthy eating. The SCAS Community Engagement Forums which were held with a dementia theme and the events which other trusts held on specific health issues proved popular with our members. However, due to lack of resources in the Trust s Membership Office, the number of health awareness events on offer are limited and this might explain the appetite from members for more of these in the future. 5. Do you know the names of the governor(s) that represent you on our Council of Governors? Yes 27% 21 21% 31 28% 18 Yes and I would like to be able to contact/talk with/receive communications from the Governors 0 0 5% 3 No, but I would like to 34% 26 41% 60 28% 18 No, but it doesn't matter to me 39% 30 37% 54 4 26 Total 77 145 65 8

5 4 3 2 1 Yes Yes and I would like to be able to contact/talk with/receive communications from the Governors No, but I would like to No, but it doesn't matter to me As shown in the above table and chart 28% of responders said they know their names (up 7% and 1% from 2017 and 2016 respectively). 41% said they don t but would like to (up 7% and 6% from 2016 and 2015 respectively). 4 don t but it does not matter to them, while 28% would like to know their names. 6. If you did not vote in the election to the Council of Governors in 2017, please can you indicate why? Lastly, we asked responders who did not vote at the 2017 Governors election to specify the reason. The figures below show that most responders either forgot, did not think that governors can help them or were not aware that it was happening. Others cited being too busy or not seeing the communications in time. 2018 Voting online was complicated 9% 3 I forgot 26% 9 I do not think governors can help me 12% 4 I was not aware that it was happening 26% 9 Other (please specify) 26% 9 Total 34 30.0 25.0 20.0 15.0 10.0 5.0 0.0 Voting online was complicated I forgot I do not think governors can help me I was not aware that it was happening Other (please specify) 9

Recommendations Revisiting the recommendations from 2017 Survey Report In 2017 the following recommendations were submitted with the report: 1. Although the vast majority of members who responded to the survey are happy with just receiving information via email, they have also expressed an appetite for seeing more bespoke events. Due to operational pressure, together with time, financial and physical constraints, the Trust currently offers a limited amount of this type of events to our members, with some being offered as part of the programme of events from other NHS Trusts. SCAS should consider other ways of offering events where health professionals give presentations on specific health issues. These could include: Organising four annual regional Health events (one in each of the counties which SCAS covers) in partnership with local CCGs, NHS Trusts and other key stakeholders for members only from all NHS Trusts in SCAS coverage area. This will ensure that we can: o divide the event management equally with other organisations o reach a wider area and audience o offer FT members from different Trusts the opportunity to meet and exchange views and experience o give governors from different trusts the chance to meet and discuss joint working opportunities Organising a pilot SCAS conference where SCAS FT members and countrywide members of the public, health professionals, student paramedics and people interested in joining the ambulance service can find out more about SCAS, PreHospital Emergency Care and Critical Care, with demonstrations from HART (The Hazardous Area Team), FACT (First Aid and Clinical Training) department and speakers from SCAS Consultants and other NHS organisations such as NHS England. This event will be an opportunity for SCAS to inform and involve a wide audience, recruit new people, give student paramedics the chance to get hands-on specialist training and offer members of the public, FT members and aspiring paramedics and call takers the chance to take part in live debates and demos. If proved successful, the event could be held annually and financially supported by either a main sponsor or by various sponsors. 2. Responders would also like to be more involved with consultations and questionnaires and the Trust should take this opportunity to promote and form SCAS 100 Virtual Club (as per SCAS 2017-2019 Membership and Public Engagement Strategy-separate document). 10

What happened next? 1. Due to lack of resources it was not possible to organise the annual regional Health events with our partners. With regard to a SCAS conference, the idea has been put forward and will look at the possibility of opening the current internal RESEARCH & YOU CONFERENCE to an external audience. 2. In January 2018 the trust launched the SCAS 100 Virtual Club with the aim of appealing to the Armchair Activists i.e. people who are happy to be kept informed or participate in convenience activism (e.g. responding to surveys or consultations issued by the Trust) without having to attend meetings/events. The club has now 59 members (as at August 2018). Recommendations for the future As aforementioned the Trust will look at the possibility of opening the current internal RESEARCH & YOU CONFERENCE to an external audience. SCAS will also look more closely at the skills which each Virtual Club member has and assign members to different projects accordingly. 11

Patient survey Summary of responses In this section we asked responders if they had been either a patient or a caller in the last year. The breakdown is as follows: 1. Have you been one of the following in the last year? (Please select one only and refer to the most recent experience) 999 Caller 24% 73 999 Patient 15% 46 Non-Emergency Patient Transport Service (NEPTS) Caller 4% 11 Non-Emergency Patient Transport Service (NEPTS) Patient 4% 11 NHS 111 Caller 11% 33 NHS 111 Patient 7% 22 None of the above 35% 106 Total 302 2. Are you the patient? Yes 42% 50 No, I am completing this on behalf of the patient 58% 70 12

999 Area where the incident has occurred: 1. Please tell us which area of SCAS the incident occurred in (please answer) Berkshire 9% 11 RESPONSE PERCENT Oxon 14% Berks 9% Buckinghamshire 21% 26 Milton Keynes 4% 5 Hampshire 52% 64 Oxfordshire 14% 17 Total 123 Hants 52% Bucks 21% Milton Keynes 4% We asked those who called 999 if they contacted another service before dialling 999. 13 FIGURES GP surgery 23% 18 12% 15 18% 19 Hospital 3% 2 4% 5 2% 2 NHS 111 16% 12 24% 29 21% 22 Out of Hours GP Service 6% 5 5% 6 7% 7 Pharmacy 4% 3 2% 2 1% 1 Dentist 1% 1 0 0 Walk-in Centre 1% 1 1% 1 1% 1 Self-care 4% 3 2% 2 3% 3 Not Applicable 43% 33 5 61 49% 52 Other (please specify) 25% 19 13% 16 11% 12 Total 97 137 107

Did you contact any of the following before contacting 999? 6 5 4 3 2 1 GP surgery Hospital NHS 111 Out of Hours GP Service Pharmacy Dentist Walk-in Centre Self-care Not Applicable Other (please specify) The above results show that the percentage of responders who contacted a GP surgery before dialling 999 has picked up from 2017 when it nearly halved from the previous year. There is a 3% decrease compared with last year of responders who contacted NHS 111 before calling 999. 11% tried different methods of care from the list in the survey before dialling 999 (down 2% and 14% from 2017 and 2016 respectively). These vary from mental health team calling on the patient s behalf to using Careline and Telemed services. For the fourth year running we added some questions pertaining to mental health as part of our commitment to meet the needs of patients who make contact with us following a mental health crisis. None of our responders had an ambulance called for them/the patient because they had been detained under the Mental Health Act 1983. We also asked all responders to rate their 999 experience and certain aspects of the call as shown in the following pages. 1. When the call was put through to the ambulance service, how would you rate how quickly we answered? FIGURES Excellent 7 63 72% 98 67% 81 Good 18% 16 21% 28 21% 26 Poor 3% 3 1% 2 1% 1 Don't know/can't remember 9% 8 6% 8 11% 13 Total 90 136 121 14

8 6 4 2 Excellent Good Poor Don't know/can't remember As shown above the callers perception with which 999 calls are being answered has seen a 5% decrease from last year s survey in the Excellent score. On a positive side, the Poor score has remained stable at 1%. 2. How carefully did the call taker listen to you? Excellent 61% 55 63% 84 55% 66 Good 28% 25 28% 37 3 36 Poor 0 3% 4 5% 6 Don't know/can't remember 11% 10 6% 8 9% 11 Total 90 133 119 8 6 4 2 Excellent Good Poor Don't know/can't remember The above results show that 55% of responders rated the carefulness with which the call taker listened to their call as excellent (down 8% and 6% from 2017 and 2016 respectively). The Poor score has been gradually increasing since 2016. FURTHER ANALYSIS AND COMPARISONS WITH INTERNAL CONTROL CENTRE DATA IS RECOMMENDED. 15

3. How reassuring was the advice given by the call taker? Excellent 5 45 6 80 53% 64 Good 28% 25 29% 39 3 36 Poor 8% 7 4% 6 7% 8 Don't know/can't remember 14% 13 7% 10 1 12 Total 90 135 120 7 6 5 4 3 2 1 Excellent Good Poor Don't know/can't remember The above results show that 53% of responders rated the advice given by the call taker as excellent (down 7% from last year). The Poor score is up 3% from last year. FURTHER ANALYSIS AND COMPARISONS WITH INTERNAL CONTROL CENTRE DATA IS RECOMMENDED. In terms of reasons for calling 999 there are no notable differences from 2016 and 2017, with medical (illness) being the main cause. 16

4. Please can you tell us how long you had to wait for an ambulance? Less than 5 minutes 12% 11 11% 15 9% 11 Less than 10 minutes 31% 28 38% 51 34% 41 Less than 20 minutes 19% 17 23% 31 19% 23 Less than 1 hour 19% 17 13% 18 17% 21 More than 1 hour 15% 14 11% 15 17% 21 Don't know/can't remember 4% 4 4% 5 3% 4 Total 91 135 121 4 35% 3 25% 2 15% 1 5% Less than 5 minutes Less than 10 minutes Less than 20 minutes Less than 1 hour More than 1 hour Don't know/can't remember In terms of waiting time for an ambulance, the trend above indicates a steady decline in the percentage of responders who had to wait less than 5 minutes. The majority of responders (34%) had to wait less than 10 minutes (down 4% from 2017). There has been a decrease of 4% from 2017 in responders who had to wait less than 20 minutes and this mirrors 2016 figures. The percentage of responders who had to wait less and more than one hour has increased by 4% and by 6% respectively from last year. 17

We also asked responders to rate the advice, care, helpfulness and cleanliness of the ambulance crew staff. Results are below. 5. How would you rate the advice and care given by the ambulance crew staff? Excellent 72% 65 78% 105 81% 96 Good 21% 19 17% 23 12% 14 Poor 3% 3 3% 4 6% 7 Don't know/can't remember 3% 3 1% 2 2% 2 Total 90 134 119 9 8 7 6 5 4 3 2 1 Excellent Good Poor Don't know/can't remember The above table and chart show an increase for the Excellent score of 9% and 3% from 2016 and 2017 respectively. The Poor score has doubled from the previous two years. 6. How would you rate the helpfulness of the ambulance crew staff? Excellent 77% 69 83% 112 82% 97 Good 19% 17 13% 18 11% 13 Poor 2% 2 2% 3 4% 5 Don't know/can't remember 2% 2 1% 2 3% 4 Total 90 135 119 18

9 8 7 6 5 4 3 2 1 Excellent Good Poor Don't know/can't remember 2016 2017 2015 Again, 82% of responders awarded frontline staff with the Excellent score (no discernible difference from last year). However, the Poor score has doubled and this trend might need to be checked against other survey results. 7. How would you/the patient rate the cleanliness and tidiness of the ambulance service vehicle? Excellent 49% 44 57% 75 57% 67 Good 24% 21 17% 23 14% 16 Poor 0 1% 1 2% 2 Don't know/can't remember 27% 24 25% 33 27% 32 Total 89 132 117 7 6 5 4 3 2 1 Excellent Good Poor Don't know/can't remember As shown above, this year the Excellent score with regard to the cleanliness and tidiness of emergency ambulance vehicles has remained stable at 57%. We also asked responders to tell us what happened to them/the patient once seen by the ambulance staff. Results are below. 19

8. Please tell us what happened to you/the patient once seen by the ambulance staff Taken to hospital in an ambulance 82% 74 81% 108 81% 97 Went to hospital, but was not taken by the ambulance service 6% 5 2% 3 1% 1 Did not go to hospital 11% 10 16% 21 18% 21 Don t know/can t remember 1% 1 1% 2 1% 1 Total 90 134 120 9 8 7 6 5 4 3 2 1 Taken to hospital in an ambulance Went to hospital, but was not taken by the ambulance service Did not go to hospital Don t know/can t remember The above shows that 81% of responders were taken to hospital in an ambulance (same as last year). 1% went to hospital, but were not taken by the ambulance service (down 1% and 5% from 2017 and 2016 respectively). 18% DID NOT GO TO HOSPITAL (UP 2% AND 7% FROM 2017 AND 2016 RESPECTIVELY). This could be attributed to one of the following reasons: Improved See and Treat performance. There are many patients who attend A&E that could be better treated elsewhere, close to their homes, giving them a better experience while reducing unnecessary pressures on busy A&E departments. Patients with manageable conditions such as epilepsy, asthma, diabetes with non-serious complications can be managed at home by an ambulance crew, without a trip to the hospital. Patients being referred to other care pathways outside of hospital treatment. We also asked responders to rate whether they/the patient were treated with dignity and respect by the ambulance staff. 20

9. Overall, how would you/the patient rate whether the ambulance staff treated you/the patient with dignity and respect? Excellent 8 72 88% 117 83% 100 Good 16% 14 8% 11 1 12 Poor 2% 2 2% 3 3% 4 Don t know/can t remember 2% 2 1% 2 4% 5 Total 90 133 121 10 8 6 4 2 Excellent Good Poor Don t know/can t remember The above figures shows that the Excellent score has decreased by 5% from last year. The percentage of responders who rated it poor is up 1%. Finally we asked our responders how likely they would be to recommend the 999 service from SCAS to friends and family if they needed similar care or treatment. 10. How likely are you to recommend the 999 service from SCAS to friends and family if they needed similar care or treatment? Extremely likely 72% 64 84% 112 79% 96 Likely 16% 14 1 14 7% 8 Neither likely nor unlikely 4% 4 1% 1 5% 6 Unlikely 6% 5 1% 1 4% 5 Extremely unlikely 1% 1 3% 4 3% 4 Don t know 1% 1 1% 1 2% 2 Total 89 133 121 21

9 8 7 6 5 4 3 2 1 Extremely likely Likely Neither likely nor unlikely Unlikely Extremely unlikely Don t know The breakdown shows that the percentage of responders (79%) who would be extremely likely to recommend the 999 service is down 5% from last year. However, this score was 72% in 2016. The percentage of responders who are indifferent has increased by 4% from last year. In addition to our 999 service we were also interested in the responders experience with our partners at the Air Ambulance and we asked them how they rated the service they received if they had been air lifted to hospital as part of their treatment. 11. In addition to our 999 service we are also interested in your experience with our partners at the Air Ambulance. If the Air Ambulance Team was called out to you as part of your treatment, how would you rate the service you received? Figures are shown below. Excellent 11% 3 14% 5 3% 4 Good 4% 1 3% 1 0 Poor 0 0 1% 1 Don't know/can't remember 85% 23 83% 29 0 Not applicable 96% 109 Total 27 35 114 10 8 6 4 2 Excellent Good Poor Don't know/can't remember 22

For the third year running we also asked responders to rate the level of care provided by Community First Responders if they were the first on scene. 1. Do you know if a Community First Responder was one of the people who arrived in response to your call? If yes, please let us know what you thought about the level of care provided by the Community First Responder? Excellent 41% 23 51% 36 41% 32 Good 16% 9 7% 5 1% 1 Poor 2% 1 0 3% 2 Don't know/can't remember 41% 23 41% 29 56% 44 Total 56 70 79 6 5 4 3 2 1 Excellent Good Poor Don't know/can't remember The above table and chart show that the level of care provided by our volunteer Community First Responders has gone back to 2016 figures, with a 1 decrease in the Excellent score from last year. However, it is important to note that CFRs attend mainly heart attacks and strokes and this is reflected in the high percentage of the don t know/can t remember score. Some of the comments from survey responders Please tell us one thing that would most improve your experience of 999 It is already excellent. If there were more of them that would help everyone not just me, but I know budgets do not allow. Knowing that an ambulance is on its way whilst so many details are being taken. I don t think improvement is needed. I have always been impressed by the staff you employ. 23

NEPTS (Non-Emergency Patient Transport Service) The number of responses received for NEPTS is very low (30 in total) and this is consistent with previous annual survey results, as detailed below. However, it s important to emphasise that this survey sample might be useful to compare trends against the high number of patients feedback which SCAS receives from bespoke online and face-to-face NEPTS surveys. 3 of responders have used the NEPTS only once (36% in 2017), 33% have used it occasionally (3 in 2017), while 27% have used it on a regular basis (up 15% from last year). 86% has used NEPTS for medical (illness) reason (was 82% in 2017). The majority of responders (5) live in Buckinghamshire while the remaining ones reside in Hampshire (26%), Berkshire (13%) and Oxfordshire (1) 46% book the NEPTS by themselves (25% in 2017), 36% has their transport booked by the hospital (32% in 2017) while only 11% is booked by a GP (down 32% from last year). The remaining is booked by a carer/relative. 67% who booked the transport by themselves found it easy to do (same as last year). The waiting time for responders who were collected on time at their pre-arranged pick-up time has slightly deteriorated compared to last year. We have also seen an increase in the number of responders who waited up to ten minutes and those who waited between 31 and 60 minutes. However, there has been a notable improvement in other waiting times as shown below. When you used the NEPTS, how long, if at all, did you wait for the transport to arrive from the pre-arranged pick-up time? 4 3 2 1 23% 23% 9% 11% It was early 33% 32% It was on time Waited up to ten minutes 12% 7% 6% 6% 3% 3% Waited 10-16 minutes 21% 7% Waited 17-30 minutes 12% 14% 6% Waited 31-60 minutes 21% 18% 18% Waited longer than one hour 11% 3% Don t know/can t remember 24

If your appointment was longer or shorter than anticipated, was your planned return ambulance transport journey re-arranged? 6 4 2 Yes No Not Applicable Were you given an estimate of the waiting time for your return journey? 8 6 4 2 Yes No It is recommended that all the aforementioned percentages are checked against other surveys conducted this year with NEPTS users. We also asked responders to rate their NEPTS experience and certain aspects of the service. 8 6 4 2 How would you rate the advice and care given by the ambulance service? Excellent Good Poor Don't know/can't remember 48% of responders rated the advice and care given by the ambulance staff as excellent (was 62% in 2017 and 53% in 2016). 31% rated it as good (up 6% from 2017 but down 16% from 2016). The percentage of responders who rated it as poor (17%) has increased by 11% from last year and 17% from 2016). 25

How would you rate the cleanliness and tidiness of the ambulance vehicle? 6 5 4 3 2 1 Excellent Good Poor Don't know/can't remember Total 48% of responders rated the cleanliness and tidiness of the ambulance vehicles as excellent (same as last year). 34% rated these as good (was 32% in 2017 and 53% in 2016). No responders rated them as poor. 5 4 3 2 1 How likely are you to recommend NEPTS from SCAS to friends and family if needed similar care or treatment? Extremely likely Likely Neither likely nor unlikely Unlikely Extremely unlikely Don t know As shown above, the most notable changes from the previous two years regards the Extremely likely rating which has decreased by 14% and 11% from 2017 and 2016 respectively and the Extremely unlikely score. This has progressively increased from in 2016 to 9% and 14% in 2017 and this year respectively. IT IS RECOMMENDED THAT THIS SCORE IS CHECKED AGAINST OTHER SURVEYS CONDUCTED WITH NEPTS USERS. Some of the comments from survey responders Please tell us one thing that would most improve your experience of NEPTS A phone call to let us know what was happening Nothing, everything was perfect Often given a 2 hour pick up time range, 1 hour would be better A better idea of when the transport is likely to arrive, and not having to wait so long to be taken home. 26

NHS 111 service: Area where responders used the NHS 111 Which NHS 111 area do you live in? Berkshire 15% 13 Buckinghamshire (excluding Milton Keynes*) *NHS 111 in MK is not run by SCAS 2 18 Hampshire 48% 42 Oxfordshire 17% 15 Total 88 Oxon 17% Hants 48% RESPONSE Berks 15% Bucks (excl MK) 2 We asked responders to rate their NHS 111 experience and certain aspects of the call if they had used the service. Results are below. 1. How quickly was your call answered by a NHS 111 advisor? Call answered within 1 minute 54% 48 62% 79 64% 59 Call answered after more than 1 minute 32% 28 24% 30 26% 24 Don't know/can't remember 14% 12 15% 18 1 9 Total 88 127 92 27

How quicky was your call answered by a NHS 111 advisor? 8 6 4 2 Call answered within 1 minute Call answered after more than 1 minute Don't know/can't remember As shown above the callers perception with which NHS 111 calls are being answered within 1 minute has seen a constant increase year on year. On the contrary, the percentage of calls which responders view as having been answered after more than more than 1 minute has slightly increased from last year. 87% of responders called NHS 111 for medical reasons (illness) and 11% due to trauma (injury). There are no significant changes from previous years. We asked responders to rate their 111 experience and certain aspects of the service. 2. How reassuring did you find the NHS 111 service? Very 43% 38 45% 57 39% 36 Quite 3 20 27% 35 32% 29 Slightly 11% 10 14% 18 14% 13 Not at all 16% 14 11% 14 14% 13 No view 0 3% 4 1% 1 Total 82 128 92 5 4 3 2 1 Very Quite Slightly Not at all No view The above table and chart show that this year the scores are less favourable than in previous years in the Very and Not at all scores. 28

3. How relevant were the questions asked by the NHS 111 service? Very 39% 34 39% 50 45% 41 Quite 38% 33 33% 42 32% 29 Slightly 12% 10 17% 21 12% 11 Not at all 1 9 1 13 11% 10 No view 1% 1 1% 1 0 Total 87 127 91 5 45% 4 35% 3 25% 2 15% 1 5% Very Quite Slightly Not at all No view As shown above, nearly half of the responders felt that the questions asked by the NHS 111 service were very relevant. This is a 6% improvement from the previous two years. 4. After you called NHS 111, did you feel your problem had been: Resolved 23% 20 28% 35 27% 25 Improved 26% 23 23% 29 24% 22 Remained the same 38% 33 38% 48 3 28 Got worse 8% 7 9% 12 16% 15 No view 5% 1 2% 3 2% 2 Total 84 127 92 29

4 35% 3 25% 2 15% 1 5% Resolved Improved Remained the same Got worse No view As seen above, there has been an 8% decrease of responders who feel that the problem remained the same after contacting NHS 111 and a 1% increase of those who feel the problem improved. However, this is offset by a 1% decrease in the Resolved category and a 7% increase in those who feel that the problem got worse... 5. Did the NHS 111 service help you to make contact with an appropriate health care service (e.g. GP, Dentist, 999, A&E etc)? 10 8 6 4 2 Did the NHS 111 service help you to make conctact with an appropriate health care service (e.g. GP, Dentist etc)? Yes No As per previous years, the majority of responders feel that the NHS 111 helped them to make contact with an appropriate health care service, as shown above. The following tables and charts show the service which responders would have used before ringing NHS 111 and what they used as a result of ringing NHS 111. 30

6. Without the NHS 111 service, which one of the following actions would you have taken first? Without the NHS 111 service, which one of the following actions would you have taken first? BEFORE AFTER BEFORE AFTER BEFORE AFTER Without the NHS 111 Without the NHS 111 service, which one of the service, which one of the As a result of ringing 111, what following actions would As a result of ringing 111, what did following actions would did you subsequently use? you have taken first? you subsequently use? you have taken first? Called 999 41% 999 42% Gone to A&E 35% A&E 26% Called your GP Surgery 19% GP Surgery 18% Called your GP's Out of Hours Service GP s Out of Hours service Called your Community/District Nursing Team Community/District Nursing Team up 1% Called 999 3 999 38% down 9% Gone to A&E 24% A&E 2 down 1% Called your GP Surgery 13% GP Surgery 19% Called your GP's Out of Hours Service 28% GP s Out of Hours service Called your Community/District Nursing Team 1% Community/District Nursing Team As a result of ringing 111, what did you subsequently use? up 8% Called 999 36% 999 47% down 4% Gone to A&E 25% A&E 31% up 6% Called your GP Surgery 14% GP Surgery 15% Called your GP's Out of Hours Service 26% GP s Out of Hours service Called your Community/District Nursing Team 2% Community/District Nursing Team up 9% up 6% up 1% Contacted or visited a local pharmacy 4% Pharmacy 3% down 1% Contacted or visited a local pharmacy 2% Pharmacy 4% up 2% Contacted or visited a local pharmacy 3% Pharmacy 4% up 1% Called your dentist 4% Dentist 1% down 3% Called your dentist 5% Dentist 4% down 1% Called your dentist 2% Dentist Gone to a local Walk-In Centre/Minor Injury Unit 16% Walk-in Centre/MIU 12% down 4% Gone to a local Walk-In Centre/Minor Injury Unit 11% Walk-in Centre/MIU 15% up 4% Gone to a local Walk-In Centre/Minor Injury Unit 8% Walk-in Centre/MIU 6% down 2% Ask for help from friends, family, carer or neighbours Friends/family/carer/neighbours Ask for help from friends, family, carer or neighbours 4% Friends/family/carer/neighbours Ask for help from friends, family, carer or neighbours 3% Friends/family/carer/neighbours Ask for help from other people/bystanders Other/Bystanders 0 Do nothing Nothing 1 Ask for help from other people/bystanders Other/Bystanders up 1 Do nothing 2% Nothing 8% Ask for help from other people/bystanders Other/Bystanders up 6% Do nothing 3% Nothing 6% up 3% 31

1% 3% 4% 4% 4% 6% 1 8% 6% 18% 19% 15% 12% 15% 2 26% 31% 42% 38% 47% 2016 45% 4 35% 3 25% 2 15% 1 5% 41% 42% Service which responder would have used before ringing NHS 111 Service which responder used after ringing NHS 111 35% 26% 19% 18% 16% 12% 4% 3% 4% 1% 1 2017 4 35% 3 25% 2 15% 1 5% 3 38% Service which responder would have used before ringing NHS 111 Service which responder used after ringing NHS 111 28% 24% 2 19% 15% 13% 11% 4% 5% 4% 4% 1% 2% 2% 8% 2018 Service which responder used after ringing NHS 111 (by year) 5 45% 4 35% 3 25% 2 15% 1 5% 36% 47% 25% Service which responder would have used before ringing NHS 111 Service which responder used after ringing NHS 111 31% 26% 14% 15% 4% 8% 6% 6% 2% 3% 2% 3% 3% 32

The bottom right chart shows that the percentage of responders who used 999 after ringing NHS 111 has increased by nearly 1 from last year and by 5% from 2016. Equally, 11% more responders used A&E after contacting NHS 111 than in 2017 where it was down 6% from the previous year. The percentage of responders who used a GP after ringing NHS 111 has decreased in the last year. This trend is also notable in the decrease of responders using a Walk-in Centre/MIU, a dentist or doing nothing compared to the previous two years. IT IS RECOMMENDED THAT THESE TRENDS ARE ANALYSED FURTHER. Furthermore we asked responders to rate their satisfaction level with the way the NHS111 service handled their call. 7. Overall, how satisfied or dissatisfied were you with the way the NHS 111 service handled your call? Very satisfied 45% 39 49% 62 49% 45 Fairly satisfied 3 26 27% 34 25% 23 Neither satisfied nor dissatisfied 8% 7 11% 14 8% 7 Fairly dissatisfied 7% 6 7% 9 9% 8 Very dissatisfied 1 9 6% 7 1 9 Total 87 126 92 6 5 4 3 2 1 Very satisfied Fairly satisfied Neither satisfied nor dissatisfied Fairly dissatisfied Very dissatisfied As shown above, the percentage of responders who feel very satisfied with the way the NHS 111 service handled their call has remained stable at 49%. On the contrary the percentage of those who feel very dissatisfied has increased by 4% from 2017. Finally we asked our responders how likely they would be to recommend the NHS 111 service from SCAS to friends and family if they needed similar care or treatment. The breakdown is shown below. 33

8. How likely are you to recommend the NHS 111 from SCAS to friends and family if they needed similar care or treatment? Extremely likely 43% 38 46% 58 43% 40 Likely 32% 28 31% 40 28% 26 Neither likely nor unlikely 8% 7 12% 15 12% 11 Unlikely 2% 2 5% 6 5% 5 Extremely unlikely 13% 11 6% 8 11% 10 Don t know 2% 2 0 0 Total 88 127 92 5 45% 4 35% 3 25% 2 15% 1 5% Extremely likely Likely Neither likely nor unlikely Unlikely Extremely unlikely Don t know The above table and chart show a decrease in the Extremely likely and Likely scores. After a 7% decrease in 2017 from the previous year, the Extremely unlikely score is up 5% from last year. Some of the comments from survey responders I am out of SCAS 111 area but there needs to be further nationwide publicity of the service if people are to use A&E appropriately. I have to say that the call handler could not have been more efficient unless she had been a fully qualified doctor herself - good work. The whole experience more than met my expectations. 34

Website All responders were also asked if they would recommend our website at www.scas.nhs.uk to their friends and family. Results are below. 1. Would you recommend our website at www.scas.nhs.uk to your friends and family? Yes 3 92 46% 192 45% 123 No 4% 12 2% 10 3% 8 Never visited the website 66% 200 52% 216 52% 140 Total 304 418 271 7 6 5 4 3 2 1 Yes No Never visited the website 35

Responders demographics s to the equality and diversity questions were purely voluntary but helped us understand more about how members view their membership and how patients rate our services. 1. How old are you? 14-16 0 2% 7 0 17-21 1% 3 2% 6 2% 5 22-29 2% 5 3% 11 5% 13 30-39 5% 15 6% 24 4% 9 40-49 13% 37 12% 47 9% 24 50-59 17% 51 21% 81 21% 54 60-74 45% 135 38% 151 37% 95 75+ 17% 49 17% 66 21% 54 Total 295 393 254 5 4 3 2 1 14-16 17-21 22-29 30-39 40-49 50-59 60-74 75+ As shown above, the highest proportion of responders (37%) is in the 60-74 age group (same as 2017 and 2016), followed by the 50-59 and the 75+ (both at 21%). 2. What is your gender? Female 59% 175 58% 229 57% 145 Male 41% 120 42% 166 42% 106 Transgender/transsexual 0 I would rather not say 1% 3 Total 295 395 254 10 5 Female Male Transgender/transsexual I would rather not say 36

As seen above, the percentage of female responders remains higher year on year. 3. Do you consider yourself to have a disability? Yes 22% 66 24% 93 25% 62 No 77% 225 74% 291 73% 184 Prefer not to say 1% 2 2% 9 3% 7 Total 293 393 253 10 8 6 4 2 Yes No Prefer not to say 37 4. Your ethnicity White - English, Welsh, Scottish, Northern Irish, British 92% 269 88% 344 89% 223 White - Irish 1% 2 1% 4 1% 2 White - Gypsy or Irish Traveller 0 1 0 White - Any other White background 2% 7 3% 11 3% 8 Mixed - White and Black Caribbean 0 0 1 Mixed - White and Black African 0 1 0 Mixed - White and Asian 1 1% 3 1 Mixed - Other Mixed 1 1 Asian or Asian British Pakistani 0 1 1 Asian or Asian British Bangladeshi 0 0 0 Asian or Asian British Chinese 1 0 0 Asian or Asian British - Other Asian 1% 2 1% 4 1% 2 Black or Black British African 0 2 1% 2 Black or Black British Caribbean 1% 2 1% 3 1 Black or Black British - Other Black 0 0 0 Other Ethnic Group Arab 0 1% 2 0 Other Ethnic Group - Any Other Ethnic Group 0 1% 2 0 Prefer not to say 2% 6 3% 12 4% 9 Total 291 390 251 As shown above, the majority of responders remain White British year on year, with a small percentage of responders from other ethnicity groups (same as 2017 and 2016).

5. Your county of residence Berkshire 14% 40 16% 63 1 25 Buckinghamshire 26% 74 25% 99 19% 48 Milton Keynes 2% 5 6% 23 5% 13 Hampshire 43% 122 37% 146 49% 122 Oxfordshire 15% 41 16% 61 15% 38 Surrey 0 Sussex 1 Other (please specify) 16 6 5 Total 298 398 247 6 5 4 3 2 1 Berkshire Buckinghamshire Milton Keynes Hampshire Oxfordshire Surrey Sussex As shown above, Hampshire responders remain the highest percentage. 6. How did you hear about this survey? Email from SCAS 44% 111 11% 7% Email from SCAS Email from GP surgeries Email from GP surgeries 27% 68 Email from other organisation 11% 29 1% 11% 43% Email from other organisation Printed letter Printed letter 1% 3 Social media 11% 28 Other (please specify) 7% 19 Total 252 27% Social media Other (please specify) Most responders (44%) received the communication about the survey directly via SCAS email, with GP surgeries being the second largest at 27%. It s also good to see that the communication from other organisations and via social media is also helping in spreading the word. Some responders received the 38

information via other various means such as local newspaper, paramedic at an event, care home manager or friend. 7. Finally, please tell us whether you consider yourself to be any of the following (please tick all that apply) SCAS staff member 2% 6 3% 11 5% 13 SCAS volunteer 4% 10 7% 26 4% 10 Foundation trust public member 16% 43 23% 87 13% 31 Member of the public 68% 186 65% 245 59% 140 Governor 1% 2 1% 3 2% 4 Staff member from another NHS organisation 9% 25 8% 30 5% 11 Councillor 2% 5 2% 6 5% 12 Patient - infrequent use of the ambulance service 2 55 16% 60 22% 52 Patient - regular user 2% 5 3% 11 6% 14 Local Healthwatch member 5% 13 5% 19 3% 8 GP 2% 6 2% 8 2% 4 MP 1 0 1 Mayor/Chairman of a Town, District or Borough Council 1 0 1 Member of a private/public/third sector organisation 1 26 9% 35 8% 20 Total 274 379 321 8 7 6 5 4 3 2 1 The above table and chart show that the percentage of Foundation Trust members who responded to the survey is decreasing year on year and it might now be suffering from survey fatigue. 39

Overall, the number of responders has decreased from last year and the Trust should look at the following options: offering an incentive conducting the survey every two years rather than annually involving the Virtual Club members in revising the survey and renaming it. 40

Recommendations It is recommended that the responses to the following questions from the survey are investigated further: 999 Carefulness with which call takers listened to service users calls (see page 15 for details) Advice given by the call takers (page 16) NEPTS Likelihood of recommending the service to friends and family (page 26). This was also part of last year s recommendations. NHS 111 Services which responders would have used before ringing NHS 111 and what they used after ringing NHS 111 (pages 31 to 33). Demographics The Trust needs to look at: ways of improving BME groups participation the survey proposition as listed on page 40 Next step The results will be presented in full to our Board and also to the Membership and Engagement Committee who will work with the Trust on improving our membership and patient experience. The Trust would like to thank all our Foundation Trust members and members of the public who took part in our survey. This will help us to improve and support the health and wellbeing of the local population and contribute to the Trust s vision and values. August 2018 South central Ambulance Service NHS Foundation Trust 41