Cover - Integrated Performance Report

Meeting:

 Public Board

Date:

 10.05.2023

Report Title:

Integrated Performance Report 

Agenda Item:

PUB23/4/09 

Author:

 Executive Directors

Lead Director:

Emma de Carteret, Director of Corporate Affairs and Performance 

X

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

X 

SR2: If we do not deliver operational and clinical standards then there is a risk of poor patient outcomes and experience

X 

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

X 

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

X

SR5: If we do not clearly define our strategic plans we will not have the agility to deliver the suite of improvements needed

X 

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

 X

Recommendation:

 Note the areas of improvement and decline and seek assurance on plans to improve

Previously considered by:

 Executive Leadership Team

Purpose

The purpose of this paper is to provide the Integrated Performance Report consisting of March 2023 data. The paper enables the Board to:

Discuss the performance areas identified and the actions offered to gain assurance or sufficient oversight.

Executive Summary

The Integrated Performance Report (IPR) this month comprises of March 2023 data across the key areas of people, education, operations, systems, clinical and finance.

Key positives in month are as follows:

• C1 and C2 performance has stabilised, although national standards were not delivered. Continued improvements have been seen in April. This continues to correspond to a simultaneous reduction in no send and cancelled at point of call cases, meaning that there has been a performance improvement as well as a greater proportion of patients receiving a response – this will positive impact on patient experience and ensure a greater level of safety.
• Serious Involvement volume remains at the reduced level as operational pressures sees a sustained improvement since the winter months. Arrival to handover time remains significantly off target. Collaboration of development of handover trajectories with systems is under way as analysis with the support of NHSE has demonstrated a clear interdependency between handover delays and delivery of C2 mean.
• There has been a further improvement in average handover to clear time in month, demonstrating the early impact of the operational improvement plan.
• Mandatory training and appraisal compliance continues to improve
• Safeguarding training is above target
• Improvement of access to stack acceptance demonstrating improving effectiveness of partnership working

Key areas of concern:

• Retention rate and the volume of leavers continues to be high which will impact delivery of the clinical workforce plan
• Whilst 22/23 QCIP delivery of the target succeeded, confidence remains low for the coming year based on the scale of the ask. This is mitigated by clear QCIP targets for all budget holders and confidence levels across each of the schemes is being evaluated.
• Sickness levels met the target level but remain a cause for concern in certain areas of the organisation, benchmarking suggests we are in the upper quartile compared with other ambulance trusts who have provided data. Focus on sickness management agreed via the OPIP and operational sprint cell.
• Delivery of 95% compliance with Information Governance training remains outstanding with levels stagnating at 88%. Active pushing through directors and deputies is taking place, as well as a cleanse of the system to ensure data accuracy.

In the executive summary slide, the executive team have identified seven critical underlying issues, that impact across multiple measures and therefore our ability to deliver on the organisational objectives. These are as follows:

1. Recruitment and training capacity to support an expedited workforce plan in line with the recovery fund
2. Leadership capacity and capability both in terms of delivery against role and the associated impact upon culture
3. The challenge associated with efficiency and improvement delivery and the need to review leadership, focus and prioritisation on efficiencies, moving to a culture of continuous improvement
4. Risk to delivery of compliance with clinical training whilst balancing the need to maximise patient facing staff hours
5. The impact of multiple external factors, in particular handover delays, has upon our ability to deliver a safe service
6. Lack of oversight of critical compliance and priority improvement areas – risk of de-railment
7. Culture across the organisation – inappropriate behaviour and lack of values-based behaviour

Metric Improvements

Board should note that in line with the commitment when the IPR was implemented, a series of refinements will be taking place to a number of metrics within the report. This will address the recognised gaps – including patient transport services, volunteers and integration, as well as amending some of the existing measures in order to enable improved Board monitoring and analysis. The details were circulated to the Board in April and publication is planned in the July report to the Board.

Note the areas of progress.