Trust Chair and Non-Executive Director Report - February 2025

Meeting: Public Meeting

Meeting Date: 12 February 2025

Report Title: Trust Chair and Non-Executive Report

Agenda Item: PUB25/02/1.5

Author: Mrunal Sisodia, Trust Chair

Lead Director: Mrunal Sisodia, Trust Chair

Purpose: Information/noting

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

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: If we do not deliver operational and clinical standards then there is a risk of poor patient outcomes and experience
• SR3: If we do not ensure we have the ability to plan, influence and deliver across our systems to secure change, we will not be able to meet the needs of our public and communities
• SR4: If we do not resolve long standing organisational inefficiencies, we will be unable to deliver an effective, sustainable, value for money service to our public
• SR5: If we do not clearly define our strategic plans, we will not have the agility to deliver the suite of improvements needed
• SR6: If we do not deliver sustainable regulatory compliance and develop positive relationships, we will have limited ability to deliver our strategy

Equality Impact Assessment: No negative impact identified

Recommendation: Report for noting.

Purpose: To update the Public and the Board on Chair and Non-Executive Director activity since the last Public Board meeting in November 2024.

Executive Summary:

The report identifies:

• Key areas of Board focus since the last report
• Key areas of Board focus in the coming months
• Non-Executive Director additional activities providing wider assurance and Board visibility
• Key activities by the Chair since the last Public Board meeting

Introduction / Background:

Winter Pressures and Performance

I would like to start by acknowledging the huge pressures that the ambulance service and the whole of the NHS has been under over the last few months. The cold weather plus the high incidence of flu, covid, norovirus and RSV meant that our front-line staff faced an incredibly challenging period. The stresses in hospitals and emergency departments meant that, at its peak, we were losing over 9,500 hours a week to handover delays and over half of our ambulance fleet was queued up outside hospitals.

This placed a huge strain on our staff and I would like to take a moment to recognise their dedication and commitment over what are very dark, long and challenging winter shifts. I would also like to recognise the strain and worry that long waits for ambulances places on the public.

Despite this being the worst winter for ambulance handover delays during my tenure on the EEAST Board (during January we lost an average of over 5,100 hours per week to handover delays compared to 4,200 hours per week in January 2024), some of the plans we have put in place did insulate the public from the worst elements of the crisis – we had more staff and ambulances on the road than in previous years with less time lost through out of service and vehicle issues. During January (at the time of writing) patients waited an average of 41-minutes for a Category 2 response. Despite the pressures, this is a 10-minute improvement on last January but we continue to work internally with our community and hospital partners and commissioners to bring this to the 30-minute national standard.

As a Board we continue to focus very sharply on the staff and patient experience, for example, the approval of 300 new MAN ambulances to replace our aging Fiat fleet.

Care Quality Commission Visit

During this period, we also hosted a visit from the Care Quality Commission (CQC) who performed a core inspection in November and December. As a Board, we welcome scrutiny and have worked hard to maintain an open, transparent relationship with the CQC in which we discuss our concerns and issues as well as our plans to address them. This was reflected in the letter that we have received from the CQC that acknowledges this and thanks us for this engagement.

However, the findings from the visit highlight the stark reality of where we are on our cultural journey and some of the profound performance challenges that we face. As a Board we are satisfied that we have an approach to both of these areas that is working and this has been recognised by the CQC. There were, however, some items that we found disappointing that are within our own gift to address – we will be working with the executive team to improve visibility and gain additional assurance in these areas going forwards.

A fuller update on the CQC visit is tabled later in the agenda.

Culture and Freedom to Speak Up

In December, we held a two day Board session, a key element of which was to review our cultural journey as an organisation. As a part of this we held sessions with the National Guardian’s Office (NGO) for Freedom to Speak Up and with the Association of Ambulance Chief Executives (AACE) on sexual safety. The sessions provided a very stark reminder to the Board that, whilst we have made huge efforts as an organisation to address cultural issues, poor behaviour is still very present at EEAST. The scrutiny provided by both the NGO and AACE on our work is very welcome and I was pleased that both organisations praised the commitment and approach of the Board to addressing issues. Things are definitely improving but there is no complacency, and this remains an area of focus.

The NHS 10-year plan and EEAST strategy

We have also been very engaged in the work launched by the new government to look at the future of the NHS. We have made clear representations both through regional workshops and as a national ambulance sector of our approach to managing urgent and emergency care. This work dovetails with our work on our own strategy 2025-2030 and I have been working with members of the NED and Executive teams to frame the key strategy decisions that we need to make over the next 12-months to deliver this.

Changes in Board responsibilities

I am pleased to say that Marika Stephenson has been appointed as our permanent Deputy CEO. Marika has been acting as our interim Deputy CEO since September. Her appointment recognises the contribution she has made in this capacity.

Also a note from the Company Secretary – we have amended the standing orders to add Dr Simon Walsh, our Medical Director, as a voting member of the Board under my authority as Board Chair.

Staff and Stakeholder Engagement

The NEDs and I undertook the following activities since the last Public Board meeting over and above our core Board, Committee and working group commitments: