Chief Executive Officer’s Report and Regulatory Update - May 2024

Meeting: Trust Board – Public Meeting

Date: 08.05.2024

Report Title: Chief Executive Officer’s Report and Regulatory Update

Agenda Item: PUB24/05/1.6

Author: Tom Abell, Chief Executive

Lead Director: Tom Abell, Chief Executive

Purpose: Information

Link to CQC domain:

• Responsive
• Well Led

Link to Strategic Objective:

• Be an exceptional place to work, volunteer and learn
• Provide outstanding quality of care and performance
• Be excellent collaborators and innovators as system partners
• Be an environmentally and financially sustainable organisation

Link to Strategic Risk:

• SR1a: If we do not ensure our people are safe and their wellbeing prioritised, there is a risk that we will be unable to attract, retain and keep all our people safe and well
• SR1b: If we do not ensure our leaders are developed and equipped, there is a risk that we will not be able to change our culture, and value, support, develop and grow our people
• SR2: Failure to achieve continuous quality improvements and high-quality care delivery
• SR4: Failure to deliver an efficient, effective and economic service
• SR5: If we do not clearly define our strategic plans, we will not have the agility to deliver the suite of improvements needed
• SR6: Ability to ensure sufficient capacity and capability to ensure sustainable change

Equality Impact Assessment: No negative impact identified

Recommendation: Board members are asked to note the report.

Purpose: To provide an update from the Chief Executive to the Board of Directors on the activities of the Trust since its’ last meeting.

Operational Improvement Plan (OPIP):

Response times for C1 and C2 patients improved in March, but we know more work is required to meet the national target of 30-minutes for our C2 patients.

We continue to drive improvement through our Organisational Performance Improvement Plan (OPIP) and the provision of staffing hours over 90,000 hours per week. A summary of our progress against the OPIP is shown in the table below:

The refreshed OPIP for the new financial year has been shared with colleagues in NHS England and our Integrated Care Systems, and we will be discussing this further elsewhere on the agenda today.

Trust Recruitment Plan:

We ended 2023/24 having recruited 717 people over the course of the year, compared to our target of 775. As a result of lower than anticipated turnover within the organisation, we ended up 35 Full-Time Equivalent (FTE) short against our total frontline target of 3,516.

Time to Lead:

The consultation for the Time to Lead transformation is progressing in line with plan.

Our teams are currently progressing the recruitment process for the Local Operational Managers, with assessment centres being held across the organisation.

The team are also running roadshow events across the Trust to promote the new team leader role which are the next stage for recruitment. These new roles are the first step on the clinical operations career pathway for our people.

In addition, discussions have started to work through the benefits realisation for the project and an update will be provided with the next report.

Executive Team:

Emma De Carteret, Director of Corporate Affairs and Performance, has sadly left the organisation after a 14-year career at EEAST. In her words, it was a difficult decision taken to enable a focus on her health and family.

I would like to take the opportunity to thank Emma for her many years of hard work, commitment, and the contribution she has made to our improvement. Emma played a critical role in our organisation throughout all her roles, and I know will be missed by all of us.

Jo Cripps has been appointed as Interim Director of Corporate Affairs and Performance, overseeing the programme management office (PMO), informatics, corporate governance, communications and information governance.

Sustainability:

An update on sustainability is provided in Appendix A to this paper.

Regulatory Update:

Four conditions to the Trust’s CQC registration have been lifted relating to safeguarding, allegations, DBS and pre-employment checks. At the time of this report, the Trust is awaiting the outcome of a fifth relating to how HR manages complaints about staff.

The evidence to close two further conditions relating to the contract of private ambulance services and sexual harassment/assault is planned to be submitted during Quarter 1. of this year. The Trust has been advised that the remaining two; action plans and HR governance will be assessed during the next inspection and are not required to be applied for.

Engagement and Celebrations:

CEO Commendations

Last month I visited St Peters Church of England school in Coggeshall to award an incredibly brave child caller with a CEO Commendation. Aged just 6 he called an ambulance for his mum, stayed calm when asking for help and was able to provide his home address and “What three words” so that we could arrange help to the right place. It was an honour to join him and his parents at the school assembly to present such a highly deserved award.

In addition I have met with the EEAST team who provided exceptional care during a difficult birth in Chelmsford to present them with an award and offer my personal thanks for the incredible work they did in really difficult circumstances. Thank you to Kevin Huggins, Rachel Watts, Henry Quick, Taylor Robinson, Bethany Staff and Mark Olive for everything you did for these patients and everything you do for our patients every day.

RAF Honington Volunteer Co-responders

A team of dedicated volunteers at RAF Honington have received a new emergency rapid response vehicle to help the ambulance service respond to serious medical incidents.

The fully equipped emergency vehicle has been kindly donated by Triple9, a specialist company which converts vehicles for blue-light use.

The new rapid response vehicle (RRV) will allow the team to provide a first response to more 999 calls in the area.

Armed Forces Covenant Gold Re-accreditation

I am delighted to report that EEAST has received gold award re-accreditation for the armed forces covenant. The role of veterans within EEAST is extremely important to us as an organisation in providing fantastic care to the communities we serve. We are only the second ambulance service to receive the gold award, and it is worthy recognition of the high standard of care and support we provide to the armed forces community, through the work of our Armed Forces Champion, Terry Hicks and others.

Welfare Wagons

On Friday 3 May our teams are showcasing the Welfare Wagon Scheme with aligned presentations across our organisation. This provides the opportunity to showcase the vehicles and the services available to support our people. I know from personal experience that the Wagons are extremely popular with our people during a long shift. We would welcome anyone who would like to volunteer on one of our wagons – please follow the link for more information.

I have continued to visit Ambulance Stations, Acutes and blue light colleagues, and met with external stakeholders since my last report.

• Colchester, Ipswich, Martlesham, Longwater, Cromer, Norwich EOC, Barton Mills, Clacton, Wheely, Chelmsford, Chelmsford EOC, HART Great Notley
• Met with Lesley Dwyer, CEO at Norfolk and Norwich Hospital
• Chelmsford Training Centre
• Provided an MP briefing for the Mid and South Essex area in partnership with Acute and ICB colleagues
• Meeting with Joanne Segasby, CEO at James Paget Hospital.

Annexe A. EEAST Sustainability Report for May 2024

The detail below outlines the progress made with the Sustainability Programme since our last report to the Trust Board.

Recommendations for decision

• Board to request full participation in sustainability initiatives, carbon footprint data acquisition and working groups, particularly Sustainability Working Group and weekly electric vehicle infrastructure project group.
• Request Medical Director/Pharmacist to develop clinical advice to reduce Entonox waste.
• Committee restructure needed to ensure accountability of Sustainability Working Group.

Trust Carbon Footprint

We continue work to improve the data acquisition, analysis and reporting of our carbon footprint. We cannot currently provide a full footprint of our directly controlled emissions (NHS Carbon Footprint) and emissions we can influence (NHS Carbon Footprint Plus). We have significant gaps in Trust-derived data, including but not limited to hybrid working, non-telematics fleet, business travel, staff commuting, supply chain, etc.

Targets for our directly controlled emission sources: 5% annual reduction, total 47% reduction by 2028-2032 (2019/20 baseline) – NHS Carbon Footprint target is net zero emissions by 2040.

Fleet emissions:

• Due to increasing vehicle numbers to fulfil national response targets, our Trust-procured fuel emissions from bunkered fuel stores and fuel cards for 2023/24 have increased to 16,122 tCO2e (tonnes of carbon dioxide equivalent), 1.8% above 2022/23 levels (15,830 tCO2e). Emissions are 23% below the 2019/20 baseline, so we are still on track for net zero by 2040.
• Fleet makes up between 40-85% of our direct carbon footprint.
• We have significant gaps in data to produce our full fleet emissions footprint and have limited business travel data, particularly for business travel submitted through expenses.

Gas and electricity emissions:

• Year-end data was not available at time of writing, but projections suggest an overall reduction in electricity and an increase in gas emissions since last year.
• Transfer to electricity and gas automatic meter reading is 99% complete. This will increase bill accuracy and enable us to target further energy efficiency projects.

Nitrous oxide emissions from Entonox:

• We receive monthly Entonox (mixed nitrous oxide) usage data from our supplier which enabled us to measure our nitrous oxide emissions (which totalled 1,521 tCO2e in 2023/24), this was a 12% reduction compared with last financial year and a 27% reduction since the 2019/20 baseline.
• Anaesthetic gases, such as mixed nitrous oxide, are targeted as a priority for emissions reductions by the NHS as they are extremely potent greenhouse gases (nitrous oxide is 265 times more potent than carbon dioxide at trapping heat in the atmosphere).
• Clinical advice needs to be developed to reduce Entonox waste (estimate up to 30%).
• From April, an alternative analgesic, Penthrox, will be trialled in Norfolk and Waveney. This has a significantly lower climate change impact when compared with nitrous oxide.

Electric vehicle strategy

EV infrastructure:

Sustainability Manager is mobilising EV charge point management system and installation of twenty-seven dual 40kW EV chargers for operational fleet.

• Seventeen chargers are being installed at five sites across the Trust. These are initially for Rapid Response Vehicles (RRVs) and Mental Health Response Vehicles (MHRVs).
• We are identifying suitable sites for installation of the remaining ten EV chargers. These will be dependent on operational need, site electrical infrastructure and fire risk assessments.

Fleet EVs:

• Fifteen Skoda Enyaq RRVs and twelve Mercedes eVito Tourer MHRVs coming soon.
• Double-staffed ambulances (DSAs) – three Ford E-Transit are in Germany awaiting conversion and to be delivered in 2025. Further six vehicles for 2025/26.

Reporting/Assurance

• Greener NHS Quarterly Return: Q3 completed (no changes), Q4 in progress.
• Trust Annual Report: in progress.
• NHS ERIC return: Energy and Waste sections due by 20 May, final submission 15 July.
• NHS Standard Contract (SC18 & SC19): last review was in February, with the 2023/24 year-end review to commence.
• Greener NHS Green Plan Self-Assessment: Sustainability Manager to liaise with subject matter leads for 2023/24 year-end review.

Other updates

• Sustainability Team: two roles appointed (B4 Sustainability Engagement Co-ordinator and B5 Environment and Sustainability Assistant) and Trust inductions completed.
• Engagement: planning sustainability pilot site programme. Now publishing regular Need to Know articles and establishing an engagement plan with Communications.
• Green Champions Network: 27 active members, 16 new, contacting a further 15.
• Procurement: NHS net zero supplier roadmap revised – carbon reduction plan requirements proportionally extended from April 2024. Delay in award of new Trust cleaning contracts.
• Waste: new offensive waste stream is progressing well since its introduction in January. Segregation rate from clinical waste has moved from 4.8% in January to 31.9% in March. We are on track to achieve national target of 60% by June/July 24.
• People Services: IT Spring Clean amnesty completed at 22 sites in March. All gathered equipment was returned to Hellesdon for data cleansing and recycling.
• Capital projects: electricity-producing solar PV panels with battery storage are being installed at Peterborough and Longwater.

Author: Katherine Middleton, Environment and Sustainability Manager Approver: Zoe May, Head of Business Relationships Published: 25th April 2024