Chief executive officer’s report

Meeting: Trust Board – Public Meeting

Date: 7 May 2025

Report title: Chief executive officer’s report

Agenda Item: PUB25/05/1.6

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.
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: 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.

Purpose: To provide an update from the chief executive to the Board of Directors on the activities of the Trust since its’ last meeting.

Recommendation: The Board is asked to note the report.

Personal reflection:

In the last month I have written to all our people regarding our values: Accountable, Respectful and Excellent, highlighting behaviours which fall short of these values relating to sexual misconduct. This is the start of our sexual safety campaign. The number of sexually related misconduct cases illustrates that not all our people are adhering to these values, and I am committed to rooting these behaviours out and taking meaningful action.

I am asking all our people to be active allies, being an ally means stepping up when you see inappropriate behaviour. It means challenging unacceptable comments, calling out misconduct, supporting those who experience it, and ensuring that every member of our team can do their job without fear or discomfort. Silence is not neutrality; it is complicity. We all have a moral obligation to support those that experience this behaviour.

In April I started our Big Conversation and have planned 12 listening events across the organisation. Continuing our culture change journey and in the pursuit of improved patient care I am keen to listen to our people and act on the feedback.

I am extremely grateful for those that have attended to date and really appreciate the open approach to feedback. It has highlighted to me again that we have some truly committed people in our organisation – alongside areas requiring change.

I will provide further updates on the outcomes in the coming months.

Organisational Performance:

Response times for C1 and C2 patients have improved for January, February and March which correlates with a reduction in demand for our services. However, we are continuing to work with regulators and providers to bring our performance closer to the national target of 30 minutes for C2 patients.

We have established productivity targets which replace the extensive priorities that were previously listed in the 2024 OPIP. These align to the recommendations of the 2024 PA Consulting report and form the basis of the 2025/26 performance requirements and national planning returns. Improving these productivity metrics is recognised as one of the leading operational priorities.

Operational performance metrics:

Out of Service
On-scene Times (Conveyed and Non-Conveyed)
Average Hospital Handover Times
Handover to Clear
Hear & Treat
Resources Per Incident for DSA to C2 calls
Sickness Absence %

In addition, we will require the support of the system to enable us to achieve sustained improved C2 performance and providers have been tasked with achieving an average hospital handover below 30 minutes.

Regulatory update:

Care Quality Commission (CQC) The Care Quality Commission (CQC) during their visit last year found areas requiring significant and rapid improvement.

Our C2 performance meeting national standard of 30 minutes
Bringing all staff up to date with mandatory training
Driving down waiting times to pick up calls in line with national standards
Improving staffing in EOCs, which the CQC assessed as insufficient to keep service users safe from avoidable harm or to provide the right care and treatment.
Tackling longstanding cultural issues across the three emergency operations centres sites and the emergency and urgent care sites.
Undertake an investigation into controlled medicine incidents.
Ensuring ambulance stations act on staff feedback for their service, developing plans and taking actions for improvement.
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.

Actions have been taken and the outcomes reported during regular review meetings with CQC colleagues. We have made significant progress in the required areas and eagerly await the full report for the visit.

Planning Guidance 2025/26 An operational plan has been negotiated with regulators based on the guidance provided and our financial envelope. This includes the productivity targets mentioned earlier in the report which will assist in returning clinician hours to our patients. It will also require the support of providers to reduce handover delays at acute hospitals.

Health and Safety Executive (HSE) Following an inspection in September 2024 we received a letter from the HSE in April identifying areas for improvement. The Trust has been asked to review and take action on the following areas:

• Managing the causes of work-related stress • Assisting in our people finishing their shift on time • Protecting staff from abuse by patients • Improving mandatory training compliance • Suitable line management and development • Enable direct engagement with senior leaders and frontline staff

The HSE believed the measures that are in place require improving and the Trust will be working with the Inspectors to improve in all of the areas detailed in the notification. Whilst these findings are really concerning for our people and the potential for an impact on our patients, I and the Health and Safety team will be closely working with the HSE. Therefore, actions are being undertaken to address these concerns and a meeting has been arranged with the HSE to discuss their findings in more detail. A verbal update can be provided at the Board meeting.

Assaults on our people EEAST like other Trusts across the UK are seeing an increase in the number of recorded assaults/incidents of abuse towards our Operational Workforce. The Trusts reporting categories have changed recently in line with recommendations of the NHS Violence, Prevention & Reduction Standard. Themes will now be covering physical, sexual, verbal and other threatening or disruptive behaviour.

Average reported incidents across date range April 2022 – October 2024:

Physical Assaults (31), Non-Physical Abuse (44) & Verbal Abuse (47).

This is entirely unacceptable and we are working with national colleagues to protect our people.

Executive Update:

Melissa Dowdeswell – Chief of Clinical Operations Melissa has accepted a secondment as the Director of Nursing for the Suffolk and North Essex ICB. We all really appreciate everything Melissa has done at EEAST and wish her every success with her new role.

Darren Meads – Interim Chief of Clinical Operations Following a process Darren has been appointed as the interim CoCO while we recruit to the substantive role. Darren has worked for EEAST for over 20 years in various operational roles and has a wealth of experience to offer. I look forward to working with him over the coming months.

Engagement:

It is with deep sadness that I share the sad news of the passing of our colleague Pauleen Custance. Pauleen has worked in the Finance Team as an Accounts Payable Officer for the last 15 years and was a great character and a valued member of the team, she will be greatly missed by us all.

Celebrations

Innovation or Change Champion from AACE – March 2025 An EEAST paramedic working closely with a Norfolk hospital has had her work improving care for frail patients recognised in national ambulance service awards.

Jaynie Sheen was recently given an award at the Association of Ambulance Chief Executives Ambulance Leadership Forum in Leeds. Jaynie has improved the ambulance service’s care for its most frail patients and helped hundreds avoid unnecessary stays at the Queen Elizabeth Hospital King’s Lynn.

Outstanding Service Award for Excellence in the field of Diversity – March 2025 Sylvester Mathias, HR Business Partner, has been recognised nationally and received an Outstanding Service Award for Excellence in the field of Diversity in March 2025.

Sylvester received the award at the Ambulance Leadership Forum in front of colleagues from other ambulance services and senior leaders from EEAST.

A humble, calm, kind and compassionate member of our team, Sylvester dedicates a lot of his own time as Co-Chair of the Men’s Wellbeing Network (MWN). He always makes himself available to listen to, encourage, and support colleagues across the Trust, supporting improvements to mental health and wellbeing for our people.

Art competition winners Two children have been named as the winners in our competition to design the quarter-light windows on the new Skoda Karoqs used for rapid response vehicle driver training.

More than 30 entries were received from children around the east of England region. The standard was extremely high and it was very hard to choose just two, but Alena Hart was the winner in the 10-16 category, and Charlotte Hutchings was our winner in the under-ten category.

Congratulations to our winners and we look forward to seeing these great designs on our new Skodas.

Norfolk and Waveney Unscheduled Care Co-ordination Hub (UCCH) The Norfolk and Waveney Unscheduled Care Co-ordination Hub (UCCH) has won a national industry award for its work in improving urgent and emergency care.

The UCCH, which is a joint collaboration between EEAST, Norfolk and Waveney ICB and Integrated Care 24, won the ‘Best Contribution to the Improvement of Urgent and Emergency Care’ award at the HSJ Partnership Awards 2025.

The purpose of the hub is to review 999 calls and coordinate alternatives to ambulance dispatches, enabling patients to receive appropriate care in their home and thus freeing up ambulance capacity to attend other emergencies.

Since its launch in the Norfolk and Waveney sector in September 2023, it has diverted 62% of calls from the stack, avoiding unnecessary ambulances responses while improving patient outcomes and system efficiency.

HART training observation Earlier in the year I had the opportunity to join our HART colleagues on a training exercise. I was hugely impressed by their steadfastness and professional approach to looking after our patients in challenging environments. I have a new appreciation for their dedication to fitness, small spaces and heights. Thank you for the warm welcome.

**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:

Bedford EOC, Colchester, Ipswich, Sudbury, Bury S Edmunds, Southend, HART Great Notley, Cambridge and Peterborough, Huntington
University of Bedford, Eid collaboration with LAS
Matthew Warren – Chief Fire Officer Cambridgeshire
Big Conversations: Norfolk and Waveney, Norwich EOC, Herts and West Essex, Fleet and Make Ready, Cambridge and Peterborough, Corporate services, HART, Resilience and Special Operations, Bedford and Luton, Bedford EOC, Chelmsford, Chelmsford EOC,

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:

Mohammad Yasin, MP
David Burton Sampson, MP
Ben Obese-Jecty, MP