AGENDA ITEM 3.2 22 MARCH 2016 Emergency Ambulance Services Committee Report CHIEF AMBULANCE SERVICES COMMISSIONER S UPDATE REPORT Executive Lead: Chief Ambulance Services Commissioner Author: Chief Ambulance Services Commissioner Contact Details for further information: Robert Williams, 01443 744818 or email Robert.Williams@wales.nhs.uk Purpose of the Emergency Ambulance Services Committee Report The purpose of this report is for the Committee to receive an update on key matters related to the work of the Chief Ambulance Services Commissioner. Governance Link to the Commissioning Agreement The Committee s overarching role is to ensure its Commissioning Strategy for Emergency Ambulance Services utilising the five step patient pathway outlined within the National Collaborative Commissioning Quality and Delivery Agreement and the related outcomes for each care standard aligned with the Institute of Healthcare Improvement's (IHI) Triple Aim are being progressed. Supporting evidence This report focuses on all the above objectives, but specifically on providing strong governance and assurance. The development of this report has where appropriate been informed by updates provided through established governance processes. A number of the issues highlighted within the report are covered in more detail within the main agenda of the Committee meeting. Engagement Who has been involved in this work? The Emergency Ambulance Services Commissioning Team has contributed to the development of information contained within this report. CASC Update Report Page 1 of 5 Emergency Ambulance Services
Emergency Ambulance Services Committee Resolution To; APPROVE ENDORSE DISCUSS NOTE Recommendation The Emergency Ambulance Services Committee is asked to: NOTE the report. REVIEW and AGREE the key issues and key considerations, plus, identify any other issues requiring consideration REVIEW and AGREE the proposed actions to be taken, plus, identify and other actions required. Summarise the Impact of the EASC Report Equality and diversity Legal implications Population Health Quality, Safety & Patient Experience Resources Risks and Assurance Health and Care Standards Workforce Freedom of information status There are no equality and diversity implications contained within this report. There are no legal implications contained within this report. Ensuring the Committee and its Sub Groups make fully informed decisions is dependent on the quality and accuracy of the information presented and considered by those making decisions. Informed decisions are more likely to impact favourably on the quality, safety and experience of patients and staff. Ensuring the Committee is fully sighted on key areas of its business is essential to Board Assurance processes and related risks. The 22 Health & Care Standards for NHS Wales are mapped into the 7 Quality Themes; Staying Healthy; Safe Care; Effective Care Dignified Care; Timely Care; Individual Care; Staff & Resources within an overarching Governance Framework. Welsh Government Health & Care Standards Framework 2015 This report focuses mainly on Governance & Accountability but also spans some of the 7 quality themes. Open CASC Update Report Page 2 of 5 Emergency Ambulance Services
CHIEF AMBULANCE SERVICES COMMISSIONER S UPDATE REPORT 1. SITUATION / PURPOSE OF REPORT The purpose of this report is for the Committee to receive an update on key matters related to the work of the Chief Ambulance Services Commissioner (CASC). 2. BACKGROUND / INTRODUCTION Since the last Committee meeting progress has been made against a number of key areas which for ease of reference are listed below: Emergency Medical Retrieval and Transport Service (EMRTS) Non Emergency Patient Transport Service (NEPTS) Linking Health Board and Welsh Ambulance Services NHS Trust (WAST) Integrated Medium Term Plans (IMTP) Drafting a Memorandum of Understanding (MoU) between Welsh Government, EASC and the CASC. 3. ASSESSMENT / GOVERNANCE AND RISK ISSUES Emergency Medical Retrieval and Transport Service (EMRTS) Committee members will be aware that the responsibility for commissioning EMRTS will transfer from Welsh Health Specialised Services Committee (WHSSC) to Emergency Ambulance Services Committee (EASC) with effect from 1 April 2016. Work is underway to ensure that this transition takes place smoothly. At a recent meeting held with officers from WHSSC and the CASC s office it was agreed that WHSSC will prepare a legacy statement to ensure that those issues that require attention are identified and all risks are clarified and prioritized. It is understood that this is being presented to Welsh Health Specialised Services Committee (WHSSC) on 22 nd March 2016 and will then be available to the CASC and EASC. Not withstanding issues contained within the Legacy report I have met with colleagues from EMRTS and Abertawe Bro Morgannwg University Health Board (ABMULHB) and attended the EMRTS Delivery Assurance Group (DAG) which is chaired by Dr Grant Robinson and is part of the contractual governance and delivery arrangements put in place by WHSSC. A meeting has also taken place with the Deputy Minister. The outcome of these meetings is as follows: The shift in commissioning arrangements with effect from 1 st April 2016, will not affect the delivery of services and a business as usual approach will be adopted A collaborative commissioning approach will be adopted An independent evaluation of the service being undertaken by Swansea University is planned to be completed by July 2016 this will be used to CASC Update Report Page 3 of 5 Emergency Ambulance Services
inform any further commissioning decisions on enhancing the services provided and to identify how best value can be realised from the resources currently available to the service The CASC will receive an update from ABMU on the hosting costs currently being charged for EMRTS to help inform a formal agreement being finalised The CASC will receive an updated report from ABMU on the planned spend in 2016/17 against the agreed existing resource envelope to assist the development of the collaborative commissioning arrangements. Non emergency patient transport service (NEPTS) Committee members will recall that they have given their support to a business case which set out plans to modernize NEPTS. This business case was submitted to Ministers on 30 th October 2015. Ministers have agreed to the proposals set out in the business case and the Deputy Minister for Health has published a written statement to Assembly Members announcing the decision. As a consequence, EASC will be responsible for commissioning NEPTS for Health Boards and NHS Trusts from April 2016. Within the Deputy Minister s statement it is expected that plans for enhanced services for oncology and renal patients will be in place by September 2016. A series of other changes will be in place by March 2017 including: A national set of service standards and requirements The appointment of a dedicated management team in WAST The creation of a new expert commissioning group to assist EASC The creation of a new non emergency patient transport service brand. Each health Board and other key stakeholders have nominated their lead officers and a meeting has been arranged to confirm how a collaborative commissioning approach will be adopted to ensure that the enhancements and changes agreed by the Deputy Health Minister are delivered. I have sent a letter to WAST and Health Board leads and other key stakeholders to confirm these arrangements and the expectation that until we have an agreed commissioning plan and framework agreement, service provision will continue in its current form. Within WAST the Director of Finance has been confirmed as the responsible Director and meetings have taken place with myself and Health Boards and other key stakeholder colleagues to ensure that proper project management arrangements are in place to convert the commissioning plan and framework into operational practice CASC Update Report Page 4 of 5 Emergency Ambulance Services
Linking Health Board and Welsh Ambulance Services NHS Trust Integrated Medium Term Plans (IMTP) Committee members will wish to note that the CASC has been working closely with Directors of Planning from Health Boards and NHS Trusts and the WAST Executive Team to ensure that there is consistency between Health Board and Trust IMTPs and the Collaborative Commissioning Quality and Delivery Framework for Emergency Medical Services (EMS). When the WAST IMTP is submitted to the Welsh Government the CASC, on behalf of EASC, will be asked to provide comment. The CASC will continue to work closely with Directors of Planning to ensure that the Collaborative Commissioning approach, which has been developed over the last 12 months is maintained and enhanced. Members will also wish to note that financial assumptions within all IMTPs in respect of EMS services will be in line with the 128m recurrent financial envelope previously agreed. Memorandum of Understanding with the Picker Institute (Europe) Committee members will recall that they have previously agreed a Memorandum of Understanding with the Picker Institute (Europe). The Picker Institute have subsequently become members of the Quality Assurance and Improvement Panel (QAIP). Picker were requested by QAIP to outline options of how a Stakeholder Engagement & Communications Strategy could be undertaken for EASC which was considered at the December 2015 QAIP meeting. The Picker Institute were then requested by the QAIP to submit a specific proposal that would provide a baseline assessment of the public and staff awareness of emergency ambulance services and in particular the 5 step model to inform the development of an engagement and communications strategy. This proposal was considered and supported at the February 2016 meeting of the QAIP. 4. RECOMMENDATION The Emergency Ambulance Services Committee is asked to: NOTE the report REVIEW and AGREE the key issues and key considerations, plus, identify any other issues requiring consideration REVIEW and AGREE the proposed actions to be taken, plus, identify and other actions required. Freedom of information status Open CASC Update Report Page 5 of 5 Emergency Ambulance Services