Performance and safety committee assurance report - July 2024

Meeting: Trust Board – Public Meeting

Date: 10 July 2024

Report Title: Performance and Safety Committee Assurance Report

Agenda Item: PUB24/07/3.3

Committee date: 26 June 2024

Meeting chair: Julie Thallon – Non-Executive Director

Meeting quorate: YES

Purpose: Assurance

Link to strategic objective(s):

• Provide outstanding quality of care and performance
• Be excellent collaborators and innovators as system partners

Recommendation The Board is asked to receive assurance from the business discussed at the meeting and to review the matters for escalation and referral.

Summary of Items Considered at the Meeting

Opening remarks

• Consideration: Second meeting of the Performance and Safety Committee discussed its function and governance.
• Resolution/Outcome: Still needs further consideration with QGC particularly but other Committees too. Also need to ensure we are clear what elements of safety we are considering enabling the provision of assurance to the Board. Further discussion about metrics to be arranged.
• Assurance:

Committee IPR & Metrics

• Consideration: A generally improving picture but struggling to get sustainable improvement. Continued concern around C2, sickness levels (particularly in the EOCs) and hospital handover delays.
• Resolution/Outcome: Align performance to the pillars of the OPIP to ensure we can see what actions will deliver improvements. Current safety metrics are not relevant to this Committee and further work needs be undertaken to determine which ones are. Development of the Committee IPR is continuing and Committee Chair to meet with colleagues to agree format and metrics. ICS level information to be shared with NEDs to feed into local meetings.
• Assurance: Moderate

Fleet Availability Improvement Plan

• Consideration: The Improvement Plan is tackling several issues to address the performance of our fleet. The Committee discussed progress so far and the challenges to improvement. We noted the good progress being made, including the increase in workshop hours from 8/5 to 16/7, paying market rates to mechanics and servicing intervals increasing to improve reliability. A paper on contracts is delayed and will come to the next meeting in September.
• Resolution/Outcome: Work is ongoing but factors including an ageing fleet, workforce and a full understanding of what is required to meet increasing need, is making this challenging. A full report around our contracts is coming to the September meeting to outline how best to support the service.
• Assurance: Moderate

Transformation Programme Group Update

• Consideration: Paper discussed as presented. Risks remain around prioritisation and available resources to support programmes. Still concern around data and analytics to support programmes.
• Resolution/Outcome: Transformation governance being reviewed. Mitigations are in place to address the risks. CC to meet with colleagues to ensure full understanding of the programmes and how they are reporting to ensure they are meeting the needs of the Committee.
• Assurance: Moderate

Non-emergency Patient Transport Service (PTS)

• Consideration: Ongoing and emerging issues around PTS were considered against a background of substantial work from the team and progress being demonstrated. However, the commissioning landscape is changing and EEAST is carrying increased risk. The current contracts are noted as out of date, and don't reflect what the ICBs are asking of the service: EEAST are over-delivering and carrying risk.
• Resolution/Outcome: Concerns about tendering plans and continued over-performance, costs and quality concerns were discussed. The Committee agreed to support the bottom-up modelling and costings needed to enable re-negotiation with the ICBs. For escalation to Private Board for full consideration and to agree next steps.
• Assurance: Limited

Private Ambulance Service Internal Report

• Consideration: The report was presented to Committee.
• Resolution/Outcome: No urgent actions were identified within the report and most of the other actions have been concluded or are in progress.
• Assurance: Good

Integration update

• Consideration: Good progress was noted across the areas covered. UCCH Hubs – continue to demonstrate impact but staffing remains a challenge. This is compounded by secondments that are due to finish over the Summer and we are still looking to recruit the APs that we have agreed to supply to the Hubs. Community First Response – further work was needed to ensure our Volunteers are deployed effectively and in line with their availability and expectations. Blue Light collaboration – providing significant support and enabling early intervention at C1 calls ahead of EEAST resources.
• Resolution/Outcome: Refer staffing issues back to People Committee for consideration of the staffing model and recruitment issues. Continue to monitor progress.
• Assurance: Good

Board Assurance Framework

• Consideration: Due to operational issues, a BAF was not available for the Committee meeting.
• Resolution/Outcome: This will be circulated when available for Committee members to consider and comment.
• Assurance: Limited

Sub-group Assurance Reports

• Consideration: The report included an update from the Transformation Programme Group which is the only group to meet since the last Committee.
• Resolution/Outcome: At the last meeting it was felt that the structure of this report did not provide the detail the Committee needs to gain assurance. The terms of reference of the various groups were shared with the Committee members for their review. A review of all sub-groups is to be carried out via the Governance team to ensure alignment with new Committee reporting, alignment and administration.
• Assurance: Limited

Matters for escalation or referral

Patient Transport Service (PTS)

• To: Private Board
• Reason: The risks around financial and operational performance continue, and safety concerns are also now emerging. The Trust is carrying risk and the Board needs to take a view on how this is managed and/or escalated outside the organisation.

Staffing for the UCCH

• To: People Committee
• Reason: There are high levels of vacancies in HWE.

Committee business

• To: Chair of the Quality Governance Committee and Director of Governance; NEDs.
• Reason: The new Committee remits still need refinement to ensure alignment and avoiding duplication or omission. There is particular concern that this Committee understands its Safety remit and gains the correct assurance around its responsibilities in this regard.