Chief Executive Officer’s Report - February 2025

Meeting: Trust Board – Public Meeting

Date: 12 February 2025

Report Title: Chief Executive’s Report and Regulatory Update

Agenda Item: PUB25/02/1.6

Author: Liz Cunnell – Chief of Staff

Lead Director: Neill Moloney – Chief Executive Officer

Purpose: Information noting

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: The Board is asked to note the report.

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

Personal reflection

Many of you will have seen and heard the media reporting regarding the challenges in the system this winter. At the end of December, the Trust moved to the highest alert level in response to the high demand across the region to ensure we prioritised our patients with the greatest need. The following reports presented will detail the impact this has had on our performance targets and therefore patients. I wanted to share my personal experience to highlight the importance of working differently next year and over the coming months to keep our people and patients safe.

On Christmas Eve I visited crews at Norfolk Acutes who were queueing to handover patients – I saw up to 20 ambulances at one Acute. These delays have a significant impact on both patients and our people which I witnessed firsthand. Visits from the Welfare Wagons with hot drinks and snacks really help our people. Our crews are frustrated by the poor patient experience and concerned about the calls unanswered in the community. The delays across the region have been extreme this year but one example, although distressing, highlights a different approach next year as a necessity. In one of the ambulances I saw queueing, was a 90 year old man who had been in our ambulance for over 19-hours. Our crews are highly skilled and our ambulances kitted to a high specification but are not designed for long periods of care. This patient had cognition issues and had been unable to eat or drink during that period. This is simply not acceptable, and I am committed to working with our partners to prevent this happening again next year.

Organisational Improvement Plan (OPIP):

Response times for Category 1 (C1) and Category 2 (C2) patients have deteriorated in November and December which correlates with an increase in demand for our services and reflects the system challenges EEAST experienced during the winter period. The graphs below demonstrate the correlation between the number of hours our crews wait to handover patients and our C2 response times.

The Trust continues to focus on the key areas which provide the greatest opportunity for performance improvement and efficiency. This review has been aligned with the Organisational Performance Improvement Plan (OPIP) to maximise the potential for performance recovery.

The key areas of focus are as follows:

• Increasing Hear & Treat rates
• Reducing the Job Cycle Time
• Providing the right care first time – utilising care pathways in the community to avoid hospital admission.

More detail on our performance will be shared later in the agenda.

Regulatory Update:

Monthly meetings with regulators are now embedded and have helped us to progress projects requiring a system approach, like Handover in 45. Performance and our ability to manage demand will also be monitored.

Before Christmas the Trust was visited by the Care Quality Commission (CQC) and in recent weeks the Trust has provided additional information as requested. At the end of January the CQC provided some initial feedback which is detailed in a later paper but work has already started to address the areas of concern.

Planning Guidance 2025-26

The new NHS England (NHSE) 2025-26 priorities and operational planning guidance was released on 30 January 2025. Importantly for ambulance services, the priorities include the 45-minute maximum hospital handover time and the reinstatement of the 15-minute target for hospital handover.

The guidance also focuses on improving access to urgent care services both at home and in the community. Managing demand through Hear & Treat and increased clinical assessment services in the control rooms is an area we are already focused on improving as part of our winter preparation as we recognise the importance of providing the most appropriate care for our patients.

The C2 target remains at 30-minutes with a longer-term ambition to return to 18-minutes – national groups recognise the challenge in delivering this service.

Raising Concerns Forum:

The Raising Concerns Forum met on 20 January 2025. The following provides the highlights and discussion points from the meeting:

• The group acknowledged the high number of Employee Relations cases that are ongoing.
• It was noted that there remains a significant number of sexual harassment cases in the Trust.
• A presentation followed on the work to address this which includes leadership training, a campaign to assist in identifying behaviours, and the development of a risk assessment specifically for sexual harassment.
• The number of vacant posts in the Herts and West Essex area was noted and I am meeting with the local team for assurance on progress to address this.
• The group discussed the increasing number of Postventions being held and the mental health support available through the Trust. This will be discussed further at People Committee in terms of the amount of support in place and what is the appropriate support to have in place.

Executive Update:

Kate Vaughton – Deputy Chief Executive and Director of Integration

Following a successful secondment, Kate Vaughton has accepted a permanent role at the Cambridgeshire and Peterborough Integrated Care Board. Her new position is Chief Officer of Partnerships and Integration and we all wish Kate every success in her new role.

Marika Stephenson – Chief People Officer and Deputy Chief Executive Officer

After a recruitment process, I am delighted to be able to report that Marika has been appointed as the permanent Deputy Chief Executive Officer. I am extremely grateful for the support Marika has provided whilst in the interim role to support me in my first few months.

I am really looking forward to working further with her as we focus on improving our service for our patients, our staff and our volunteers.

Engagement:

Tragically we have lost a number of colleagues across the region over the last few months. It has been extremely challenging for our colleagues but I have been impressed by the support they have provided to each other and the families impacted. Anyone needing additional support can access confidential support though our wellbeing page.

In early January we lost colleague Julie Walker. Julie was a Make Ready supervisor at Peterborough ambulance station and had been with the Trust for over 19-years. Julie passed away at Addenbrookes Hospital following an accident at home.

In mid-January we lost our colleague Neil Galaud. Neil was a Leading Operations Manager based at Southend ambulance station and had served in the Trust for 25-years. He joined the Essex Ambulance Service in January 2000 as a trainee emergency medical technician, going on to complete his paramedic qualification before becoming a paramedic supervisor in south east Essex.

We also lost colleague Andy Stuart who worked in the Norwich Emergency Operations Centre. Andy dedicated 22-years to the Trust, beginning his journey as a technician at Mildenhall before qualifying as a frontline paramedic at Diss ambulance station. In 2016, he joined the Clinical Assessment Services team, where he served as a specialist clinician in Hear & Treat and as a team leader.

In late December we lost our colleague Emma Luise Williamson. Emma joined the Trust as an Emergency Care Assistant (ECA) in November, embarking on a new chapter in her career. Having recently completed her training, she began serving as an operational ECA in West Essex.

In November we lost our colleague George Coppin. George joined the Trust in 1997 in the voluntary sector as a Community First Responder and founded the first CFR team in the Trust in Brightlingsea. Later in 2004 he joined the north Essex Patient Transport Services team as a bank ambulance care assistant.

They will all be greatly missed and we thank them and their families for their service to our organisation and our communities.

Community First Responder Shift

In February I joined Community First Responders, Stuart Little and Gorden Wren, for a shift in Chelmsford. It was great to see them in action and learn more about their contribution to our patients. I was extremely impressed by their professionalism and care for our patients and am very grateful to all our volunteers for their free time, which they willingly give to us day in, day out, across our region.

Since funding a new role in EOCs dedicated to dispatching our volunteers, we have seen almost a 20% increase in the number assigned to calls. In fact, since January 2024, our clinical volunteers have provided over 221,000 hours on duty to respond to 999 calls and have responded to over 22,400 patients in this time. A huge thank you to all our volunteers for their work to support our patients and communities.

Steel Signing Ipswich Hub

We have celebrated the progress made at our new Ipswich Hub with a steel signing ceremony and are inviting colleagues to visit the site.

The MP for Ipswich, Jack Abbott, met with me and other stakeholders on Friday 17 January for a walkthrough of the site in Ransome Park and to sign a steel beam.

The £12.81m hub will house a 24/7 make ready and workshop service, which will keep more ambulances on the road and clean and restock vehicles. It will also have dedicated welfare spaces where staff can relax, including quiet spaces and a wellbeing garden.

Celebrations

Royal Humane Society Award

A LOM in Hertfordshire has received a Royal Humane Society award for his actions which helped to save a man's life in May last year.

Rob Allmey received a Resuscitation Certificate from the Royal Humane Society for the actions he took when he came across a man who collapsed on a road in Letchworth. Rob was travelling home from a night shift on 5 May 2024 when he noticed two people helping a man on the floor. Rob pulled over to see if he could assist. The man was in cardiac arrest and Rob immediately began CPR while a bystander called 999. He was soon joined by a police officer who had received a GoodSam app notification from the ambulance control room, and another bystander who got a community defibrillator. An ambulance crew arrived on the scene and began further life-saving interventions. The man regained a pulse and was transported to the hospital for treatment. He has since fully recovered.

A huge thank to Rob from us all and congratulations for this well-deserved recognition.

Emergency Services Awards

EEAST and Fire Service partners won awards in two categories at the Excellence in Fire and Emergency Awards, held on Thursday 5 December.

The first award was Emergency Services Collaboration of the Year, for the Community Wellbeing Officer project in partnership with Bedfordshire, Cambridgeshire, and Essex fire services. This initiative sees dedicated fire officers in these counties, trained by EEAST clinicians, responding to people who have had a fall – providing vital assistance to patients in their homes.

The second award was Collaboration of the Year, for EEAST's partnership with Norfolk Fire and Rescue Service (NFRS). This collaboration has seen firefighters at several fire stations across Norfolk trained to respond to life-threatening emergencies

Working with the Fire Service, EEAST can ensure medical help gets to patients who need it as quickly as possible. Since the start of the year, NFRS has responded to nearly 50 Category 1 emergencies – the most serious emergencies. In 40% of cases, they have arrived first on scene, ahead of ambulance crews, to begin life-saving treatment.

A huge congratulations to all those involved and we look forward to more partnership working in the future.

Engagement

I am committed to spending one day each week travelling around the organisation meeting with our people, listening to ideas and getting to know the patch. Thank you to all those I have met for the very warm welcome. I have visited the following stations:

• HART Melbourn, Cambridge, Huntington, Peterborough, Bedford EOC, Lakeview Bedford, Luton, Norwich EOC, Longwater, Kings Lynn, Chelmsford EOC, Halstead, Chelmsford, Ipswich, Brentwood, Letchworth, Stevenage, UCCH Stevenage, West Herts Ambulance Station, Harlow, Basildon, Southend, Waveney Depot, Bury St Edmunds
• CFR Shift Chelmsford
• Training and Education – Chelmsford, Bury St Edmunds, Welwyn Garden City

Given the extensive political changes across the region, I have also been meeting a number of our MPs to share information and build relationships. I have met with the following MPs:

• Andrew Pakes MP – Peterborough
• Haverhill Councillors
• James Cleverley MP – Braintree
• James Cartlidge MP – South Suffolk
• Jerome Mayhew MP – Broadland and Fakenham
• Jack Abbot MP – Ipswich
• Marie Goldman MP – Chelmsford
• Rupert Lowe MP – Great Yarmouth
• Essex MPs, Mid and South Essex ICB Chief and Essex Acute leaders – February