Minutes of the 2025 Annual General Meeting of the East Of England Ambulance Service NHS Trust

Public session

AGM25/09/101 OPENING ADMINISTRATION

1.1 Welcome 1.1.1 Mrunal Sisodia, Trust Chair (TC), welcomed those present to the Annual General Meeting of the East of England Ambulance Service for 2024/25.

1.2 Minutes of the Previous Meeting 1.2.1 The minutes from the meeting held on 09.07.2024 were approved with no amendments.

AGM25/09/2.0 TRUST CHAIR OPENING

2.1 The TC reflected that he had been with the Trust for five years and noted that the period had been characterised by ongoing challenges alongside continued progress. He advised that the purpose of the meeting was to review the previous year openly and honestly, and to look ahead to the next period. He confirmed that the session would be led by members of the Executive team, who would present key updates aligned to the agenda.

The TC expressed his thanks to staff, volunteers, patients, the public and system partners, recognising that the delivery of services was a collective endeavour across a complex health and care system. He emphasised that the achievements discussed during the meeting reflected the contribution of the wider organisation rather than solely the Executive team.

2.2 The TC noted that the Trust had operated under a clear strategy over the previous two years and that further work had been undertaken during the year to develop a refreshed strategic approach. He advised that this had resulted in a new set of priorities for 2025/26, with an anticipated timeframe extending to 2030.

He highlighted that the development of the new strategy had been undertaken through extensive stakeholder engagement, involving over 2,000 individuals and generating approximately 12,000 contributions. He noted that this had informed a co-produced approach to strategy development.

2.3 The TC advised that the Trust had defined four core missions to guide its future direction:

• Patient Mission
• People Mission
• Partnership Mission
• Productivity Mission

He further noted that new organisational values had been established, namely:

• To be Accountable
• To be Respectful
• To be Excellent

2.3 The TC provided an overview of Board changes during the year. He extended thanks to colleagues who had left the Trust, including Kate Vaughton and Melissa Dowdeswell, and paid tribute to Wendy Thomas, who had completed her term as Non-Executive Director, and Kevin Smith, who had retired as Director of Finance after long service.

He welcomed new Board members, including Darren Meads as Chief Operating Officer, noting this as an internal appointment and highlighting the importance of developing talent within the organisation. He also welcomed Steven Course as Chief Finance Officer, Sian Clark as Director of Digital and Innovation, and Susan Wilkinson as Non-Executive Director. He reflected on the importance of representation within the Board, noting that the appointment of Darren Meads increased paramedic representation at Board level in response to feedback from staff.

2.4 The TC concluded his opening remarks and handed over to the Chief Executive Officer to provide an update on his first year in post.

AGM25/09/3.0 CHIEF EXECUTIVE OFFICER UPDATE

3.1 Neill Moloney, Chief Executive Officer (CEO) reflected on his first year in post, noting that it had been just over a year since joining the Trust. He advised that he had set out three key priorities on arrival, and provided an update on progress against these areas:

• Performance
• Collaboration
• Organisational culture

3.2 In relation to performance, the CEO reported a significant improvement in C2 response times during 2023/24, with an 8-minute improvement across the year. This had been supported by the Operational Performance Improvement Programme, including improvements in Hear and Treat processes. He also noted sustained strong performance in clinical quality metrics, particularly cardiac arrest outcomes.

3.3 In relation to collaboration, the CEO highlighted progress in the development of Unscheduled Care Coordination Hubs (UCCH), which had supported the management of patients within the community without the need for ambulance conveyance. He emphasised the importance of collaboration across system partners, including hospitals, community services and social care.

The CEO reported improvements in hospital handover delays, with an average of 38 minutes across the year, and noted that actions taken during the winter period had provided a strong platform for further improvement into 2025/26. He highlighted positive engagement from system partners in addressing these challenges.

The CEO advised that the Trust had continued to develop its Clinical Assessment Service and to work with partners to address variation across the region, supporting the development of alternative community pathways and improved patient navigation.

He further highlighted continued collaboration with other emergency services, particularly fire service colleagues acting as first responders. During 2024/25, fire services responded to approximately 70% of calls more quickly than ambulance resources, contributing positively to C1 performance.

3.4 In relation to culture, the CEO reported the introduction of a 24-hour Freedom to Speak Up service, enabling staff to raise concerns confidentially. He noted continued improvement in staff survey results, with the Trust recognised as the most improved ambulance service in the country for the third consecutive year. Improvements in staff retention, flexible working arrangements and appraisal performance were also reported.

The CEO highlighted the importance of leadership development, noting investment in local leadership and the rollout of a Leadership Development Programme during the year. He also referenced the introduction of the ‘Time for Me’ wellbeing app, which had generated approximately 60,000 staff interactions.

3.5 The CEO reported delivery of a £16.3 million Cost Efficiency Programme, enabling the Trust to achieve a break-even financial position for the year.

He concluded that the progress made during 2024/25 had provided a strong platform for further improvement in 2025/26 and handed over to the CPO to present the People Mission.

AGM25/09/4.0 PEOPLE MISSION

4.1 Marika Stephenson, Chief People Officer and Deputy CEO (CPO) introduced the People Mission update and reflected on progress during 2024/25, noting that while significant achievements had been made, further work remained to achieve the Trust’s ambition.

4.2 In relation to culture and values, the CPO reported actions to strengthen communication and leadership visibility, including Executive Q&As, leadership engagement and improved internal communications. Leadership support had been enhanced through a leadership development framework, improved assessment centre processes and leadership learning circles. Staff empowerment had been strengthened through staff working groups, staff networks and renewal of the multi-union recognition agreement. The Trust refined its values - accountable, respectful and excellent - through engagement with over 1,000 colleagues and more than 100 workshops, and began embedding these within leadership development, appraisal processes and decision-making.

4.3 In relation to the People Strategy and engagement, the CPO reported delivery of year two of the three-year People Strategy aligned to the NHS People Promise. A total of 63 people-focused actions had been completed. The Trust had been selected as a People Promise Exemplar organisation. Engagement activity included over 1,000 staff interactions by the People Promise Manager. Initiatives included launch of a peer recognition platform, delivery of six service awards events, and policy updates in collaboration with trade unions.

4.4 In relation to recruitment, retention and inclusivity, the CPO reported that 684 staff were recruited during the year, achieving 99.5% of the clinical workforce plan target. A digital induction programme and the ‘Career for Life’ campaign were launched. Staff turnover continued to reduce. The Trust was awarded the British Dyslexia Association Silver Quality Mark and is progressing towards Gold. International Recruitment Day activity generated strong engagement and feedback.

4.5 In relation to staff experience and safety, the CPO reported a 50% response rate in the 2024 national staff survey, with 97% of responses improved or remaining stable. The Trust was ranked the most improved ambulance service for the third consecutive year. Listening into Action plans had been developed across departments. A focus on sexual safety included introduction of policy, training and awareness campaigns, supported by direct communication from the CEO and establishment of a sexual safety working group. Improvements were noted in workplace behaviour survey results, including reductions in reported harassment and bullying.

4.6 In relation to health and wellbeing, the CPO reported expansion of support networks, including 180 TRiM practitioners, 173 mental health first aiders, 303 wellbeing champions and 153 menopause mentors. The ‘Time for Me’ app demonstrated strong engagement and received a PPMA award. Six welfare wagons were deployed, and the TRiM process is under review.

4.7 In relation to education and career development, the CPO reported 726 staff on apprenticeships with a 93% achievement rate. The paramedic degree apprenticeship had expanded, supported by £5 million in levy donations. There were 250,000 hours of student placements and £631,000 invested in continuous professional development. A new training facility was opened, and the Trust was approved as an independent training provider. Leadership development programme participation reached 75%.

4.8 In relation to Freedom to Speak Up, the CPO reported transition to an outsourced 24/7 provider - The Guardian Service - in August 2024. A total of 144 concerns were raised during the year, with key themes relating to systems, behaviours and management. A proportion of 45.83% of cases requested anonymity. The Guardian Service provides regular reporting to the Board and works with leaders to support resolution.

4.9 In relation to volunteers and community impact, the CPO reported that over 130 new Community First Responders were trained following launch of the unified volunteer platform. Volunteers contributed over 230,000 hours and attended 26,110 patients. Collaboration with fire services and other responder schemes continued. A total of 6,700 people were trained in life support. The Trust led development of a national volunteer policy template for AACE.

4.10 The CPO concluded the update and handed over to the CP-DoQ to present the Patient Mission.

AGM25/09/5.0 PATIENT MISSION

5.1 Simon Chase, Chief Paramedic and Director of Quality (CP-DoQ) introduced the Patient Mission update and confirmed that patients remained central to the way in which the Trust aimed to deliver all clinical services. He advised that the work currently being undertaken across all aspects of clinical care reflected the Trust’s commitment, together with staff and volunteers, to improve the quality of every patient contact. He noted that this commitment enabled the Trust to maintain its focus on quality and safety, with the aim of improving pre-hospital clinical outcomes and the overall patient experience delivered to communities.

5.2 The CP-DoQ advised that staff and stakeholder collaboration had informed the shaping of the Trust’s new clinical strategic vision, which would be known as the Patient Plan. He noted that this would be launched in the coming months and would set out the clinical ambitions of the Trust over the next five years.

5.3 Reviewing clinical performance against the previous year’s priorities, the CP-DoQ reported that the clinical supervision model established in the previous year continued to develop for all patient-facing staff. He also advised that the Trust continued to improve its responses to complaints, clinical incidents and patient, staff and community feedback, using these to provide constructive learning.

5.4 The CP-DoQ reflected on the continued dedication and contribution of volunteers. He advised that the volunteer workforce included Community First Responders (CFRs), co-responders including military and other blue light personnel, car drivers within patient transport services, chaplains, faith representatives, welfare wagon volunteers, the Community Engagement Group (CEG) and British Association for Immediate Care (BASICS) doctors and paramedics.

The CP-DoQ reported that the Trust now had over 1,200 active volunteers supporting communities and that, in addition to patient-facing roles, other volunteers had contributed over 30,000 hours of support to communities. He advised that further work was underway to review volunteer roles within the health and wellbeing umbrella and to explore how these roles could further support the diverse organisation and its colleagues.

The CP-DoQ was pleased to report that the Trust had appointed its first under-18 Community Engagement Group member, which he described as a positive addition that would help shape future services for all age groups.

5.5 The CP-DoQ advised that feedback received from patients, carers, family members and professional colleagues remained critical to learning and improvement. He reported that complaint numbers had continued to reduce towards the end of the year and that the Trust’s performance in responding to complainants in a timely way had almost doubled compared with the previous year.

He reported that the Trust continued to receive over four times as many compliments as complaints. During the year, the Trust had received 3,849 compliments, equating to an average of around 320 per month, representing an increase of over 100 compliments per month compared with two years previously. He also noted that complaint levels had decreased while maintaining this high level of compliments, although he stressed that the Trust should not become complacent.

5.6 The CP-DoQ advised that during 2024/25, 0.05% of interactions with patients had resulted directly in complaints or concerns. He reported that the main complaint themes remained delay, transport or driving, and attitude, and confirmed that work continued in all three areas to improve performance and reduce complaint numbers further.

The CP-DoQ handed over to the MD to continue the Patient Mission update.

5.7 Dr Simon Walsh, Medical Director (MD) introduced the clinical update and advised that clinical priorities were determined by the priorities agreed by the Board, together with performance against mandated national quality metrics and regional targets. He confirmed that standards were set to ensure that the level of care provided to patients was what would be wanted for family and friends.

5.8 In relation to patient safety, the MD reported that since adoption of the Patient Safety Incident Response Framework (PSIRF) in October 2023, there had been a further significant decrease in patient safety events during the last year compared with the previous year, particularly in relation to system delay incidents. He advised that this could be partly attributed to work with partner NHS organisations to improve system delays, alongside in-depth thematic reviews undertaken by the patient safety team. He noted that the majority of reported incidents continued to be assessed as low or no harm.

The MD advised that the patient safety team had completed thematic investigations into missed STEMIs and non-conveyance. He noted that a patient injury report was due to be completed in August 2025 and that the resuscitation decision-making report was in its early stages. He further reported that since completion of the missed STEMI report in June 2024, the Trust had seen no new patient safety incidents relating to that theme.

5.9 In relation to priorities for patients, the MD reported that significant progress had been made in providing greater structure to the Learning from Deaths framework. He advised that a dedicated module had been introduced on the DATIX incident reporting system to provide greater consistency of review, stronger identification of themes and improved reporting functionality.

The MD confirmed that clinical supervision had been embedded within the patient-facing workforce across all six operational sectors, delivered by approved supervisors in a relationship-based education and training system designed to manage, support, develop and evaluate clinical practice.

5.10 In relation to patient experience, the MD reported that the Trust had continued to develop its patient experience and engagement activity, including exploring new methods of obtaining feedback and ensuring that the voices of patients within seldom-heard groups were heard. This included, as previously noted, expanding Community Engagement Group membership to include 16- to 17-year-old members.

5.11 Turning to national Ambulance Clinical Quality Indicators, the MD advised that these indicators allow ambulance services to benchmark performance against one another for specific patient groups. He was pleased to report that, for the fifth consecutive year, the Trust had exceeded the national ambulance average for quality indicators relating to heart attack and cardiac arrest survival to discharge for bystander-witnessed cardiac arrests where the initial rhythm was ventricular fibrillation or ventricular tachycardia, known nationally as the Utstein comparator.

The MD reported that the Trust continued to be the highest performing Trust nationally for the care bundles for STEMI and for the newly implemented care bundle for falls in older people who were not conveyed to hospital. He also advised that EEAST had maintained its ambulance care quality indicators well above the national average and had seen improvement across ambulance responses, particularly in relation to Category 2 calls, which in turn had improved call-to-needle times for STEMI patients and call-to-hospital times for stroke patients.

5.12 The MD confirmed that the Trust had continued to work closely with partner organisations across the region to improve outcomes from cardiac arrest. He reported that the Trust was about to launch a pilot for a dedicated cardiac arrest desk within the Emergency Operations Centre and that he continued to represent the Trust on the National NHS England Expert Advisory Group for Cardiac Arrest.

The MD concluded by reaffirming the vision of outstanding care, exceptional people, every hour of every day, and handed over to the COO.

AGM25/09/6.0 PATIENT MISSION

6.1 Darren Meads, Chief Operating Officer (COO) introduced the operational element of the Patient Mission and advised that his responsibilities included the Trust’s operational services, emergency control rooms and specialist response teams.

6.2 The COO explained that ambulance services across England are measured against Ambulance Quality Indicators, which allow performance to be compared across ambulance services nationally. He reported that the Trust responded to Category 1 (C1) calls in an average of around 9 minutes 8 seconds, and to Category 2 (C2) calls, which make up the majority of demand, in an average of just under 43 minutes.

The COO noted that the Trust has limited resources and that it is not always possible to reach all destinations as quickly as desired. He advised that the Emergency Operations Centres use experienced clinicians to assess patients thoroughly and ensure the right level of prioritisation is given to each call.

6.3 The COO reported that part of this work included the creation of Unscheduled Care Co-ordination Hubs (UCCHs), which had been referenced earlier in the meeting. He explained that these hubs provide access to services that support non-life-threatening patients and are largely run by Integrated Care Boards (ICBs), with contributions from the Trust and other providers. He advised that, since their inception, the UCCHs had successfully diverted calls away from ambulance dispatch, thereby improving patient outcomes and overall system efficiency.

He highlighted that one of the Trust’s UCCHs had been recognised with the Best Contribution to the Improvement of Urgent and Emergency Care Award at the HSJ Partnership Awards.

6.4 The COO also highlighted the contribution of the Trust’s Community First Responders (CFRs), noting that these volunteers are based in local communities and play a fundamental role in delivering potentially life-saving care while an ambulance is on route. He encouraged members of the public interested in becoming a Community First Responder to visit the Trust’s website.

6.5 The COO advised that ambulance services are also measured on the time taken to answer 999 calls, noting that the quicker calls are answered, the sooner help can be arranged. He reported that the Trust’s work during the year to improve call answering times included workforce expansion, technological advancements, and retention and wellbeing initiatives for staff working in control rooms.

He recognised that a number of people who call 999 do not require an ambulance but do require advice, guidance or signposting to other services. He stressed that while 999 should be used for life-threatening situations, it remained important that callers who did not require an ambulance were appropriately supported so that the Trust’s limited resources could be prioritised for the most seriously ill patients.

6.6 The COO reported that during the last year around 11% of all 999 calls taken by the Trust were safely managed by telephone through the Clinical Assessment Service (CAS). He noted that this process, known as Hear and Treat, had seen a steady and safe increase in performance since October of the previous year.

6.7 The COO advised that increased demand and hospital handover delays had contributed to delays in attending patients. He reported that, to improve performance, the Trust had worked closely with system partners and implemented a number of actions, including Handover 45 (HO45), to release ambulance clinicians back into the community. Alongside hospital teams, the Trust had also implemented a wider handover escalation protocol to rapidly identify patient offloading issues and work collaboratively to accelerate care.

6.8 The COO reported that towards the end of the year a positive reduction had been seen in operational Out of Service (OOS) times, helping to make ambulances available more quickly and improving response to emergencies. He advised that one of the more successful initiatives had been the implementation of automatic stand downs and automatic clearing of hospitals, which enabled paramedics and ambulances to become ready more quickly than previously.

6.9 The COO also updated on the work of the Trust’s resilience and specialist operations teams, advising that these teams had been involved in preparing for, and where necessary responding to, large-scale incidents. He reported that during the year these teams had engaged with a number of local resilience forums and safety advisory groups across the East of England.

The Hazardous Area Response Teams (HART) respond to patients requiring medical care in extreme environments, including incidents involving height or water.

6.10 The COO reported that, as part of the statutory annual self-assessment against the NHS Emergency Preparedness, Resilience and Response framework, the Trust maintained an overall compliance rating of substantial, which demonstrated the work undertaken behind the scenes to help keep the population of the East of England safe.

The COO concluded his presentation and handed over to the DoSTG.

AGM25/09/7.0 PARTNERSHIP MISSION

7.1 Dr Hein Scheffer, Director of Strategy, Transformation and Governance (DoSTG) introduced the Partnership Mission update and reported that, over the previous 12 months, the Business and Partnership Team had been instrumental in bringing the urgent care co-ordination hubs to life across the East of England.

7.2 He emphasised that partnership working remained a key enabler for improved patient outcomes and experience. He noted that the Trust must work closely with partners across the East of England and that the Business and Partnership Team, as the outward-facing part of the organisation, operated within a complex environment involving not only NHS partners but also a wide range of external organisations.

The DoSTG advised that this work required strong relationship management and the ability to navigate different priorities and expectations across organisations.

7.3 Beyond partnership working, the DoSTG reported that the Business and Partnership Team played an important role in ensuring that the right governance arrangements were in place to support new patient pathway changes. He noted that this included ensuring that partners were aligned and adhering to agreed changes, working closely with Integrated Care Boards and other stakeholders to support consistency, accountability and effective delivery across the system.

7.4 The DoSTG explained that the Business and Partnership Team holds a diverse portfolio in its engagement with system partners across the region. He noted that this reflected both the team’s expertise and the importance of collaborative working across regional and system levels.

He advised that, over time, the role of the Business and Partnership Team had evolved significantly, positioning team members as local experts within their systems and as key points of contact for the Trust at system and place level, including in relation to non-999 income and patient-centred outcomes.

7.5 The DoSTG highlighted a number of achievements over the previous 12 months, including the Trust being shortlisted for two HSJ awards. He also reported that the Stansted Airport contract had now moved to a 24-hour service for non-999 income.

7.6 The DoSTG noted that, as the NHS continues through a period of change, the Business and Partnership Team remains vital in helping the Trust navigate the current position and future reconfiguration of partnership working.

The DoSTG concluded the update and handed over to the CFO.

AGM25/09/8.0 PRODUCTIVITY MISSION

8.1 Steven Course, Chief Finance Officer (CFO) introduced the Productivity Mission update, outlining the Trust’s focus on improving productivity, efficiency, and sustainability, both financially and environmentally.

8.2 The CFO reported on progress towards Net Zero targets, noting the statutory requirement for the Trust to achieve Net Zero emissions by 2040 for emissions within its control and by 2045 for those it can influence. He advised that fleet emissions remain the largest contributor and that a 22% reduction had been achieved against the 2019/20 baseline, narrowly missing the 25% target.

8.3 The CFO highlighted wider sustainability initiatives delivered during 2024/25, including:

• achievement of BREEAM Excellent rating at the Bury St Edmunds hub
• installation of solar PV panels and battery storage across multiple sites
• introduction of an offensive waste programme, achieving the 60% target
• delivery of the Trust’s first tree planting programme, with 425 trees planted
• development of a social value framework for procurement.

In 2024/25, the Trust delivered a £1.9m surplus against a break-even plan and achieved £16.3m in efficiency savings against a £16.2m target.

8.4 The CFO advised that £25m had been invested in capital assets during the year, including:

• £17.9m in estate developments and refurbishments
• £3.3m in vehicles and equipment
• £2.1m in medical devices
• £1.7m in IT infrastructure, including electronic patient records and cybersecurity.

The Trust is planning for a break-even financial position in 2025/26.

8.5 He also provided an update on charitable activity, noting that the Trust’s charity continues to support staff, volunteers and communities through donations. This included funding for welfare initiatives, training and equipment, volunteer support, and community education programmes such as basic life support training.

The CFO concluded the update and handed back to the TC.

AGM25/09/9.0 CLOSING REMARKS

9.1 The TC reflected on the progress made over the past year and noted that, alongside significant achievements, there remains substantial work to deliver the Trust’s priorities. He emphasised the role of the Board in maintaining focus on key strategic priorities that will have the greatest impact on staff, patients and partners.

9.2 In relation to the People Mission, the TC highlighted the importance of leadership development and confirmed that future priorities include the implementation of team-based working structures to strengthen leadership, engagement and delivery of the Trust’s values.

He acknowledged ongoing cultural challenges, including issues relating to sexual safety, bullying and harassment, and reaffirmed the Trust’s commitment to addressing unacceptable behaviours through strengthened leadership capability and organisational response.

9.3 In relation to the Patient Mission, the TC welcomed improvements in response times, particularly for Category 2 calls, while noting that national standards have not yet been achieved. He emphasised the importance of continued focus on reducing delays and improving patient navigation through initiatives such as Hear and Treat.

9.4 The TC reiterated the importance of the Partnership Mission, highlighting the role of Unscheduled Care Co-ordination Hubs and collaboration with system partners to improve patient flow and reduce hospital handover delays. He noted ongoing work to strengthen integration with 111 services and expand community-based care pathways.

9.5 In relation to the Productivity Mission, the TC emphasised the importance of delivering efficiency and productivity improvements in line with wider NHS developments, including the emerging 10-year plan, and confirmed the Trust’s commitment to continuous improvement both internally and through partnership working.

9.6 The TC concluded that, while demonstrable progress had been made, further work is required to deliver the level of service expected by patients and staff.

He extended thanks to staff, volunteers, partners, patients and the public for their contribution and engagement over the past year and for attending the meeting.

AGM25/09/10.0 QUESTIONS FROM THE PUBLIC

10.1 There were no questions received from the public and the meeting closed.

The meeting closed at 10:28am.