In Public Board Minutes - May 2025

Present

PUBLIC SESSION (Disclosable)

PUB25/05/1 WELCOME

The meeting commenced at 09:30.

1.1 Mrunal Sisodia, Trust Chair (TC) welcomed those present to the Public Board meeting of the East of England Ambulance Service NHS Trust (EEAST). He noted that some members of the Board had been delayed due to a serious road traffic accident; members would join the meeting as they arrived. The TC advised that any questions received from the public would be addressed at the end of the meeting. Two members of the public attended the meeting in person.

PUB25/05/2 APOLOGIES FOR ABSENCE

2.1 Apologies were received from:

• Catherine Glickman, Non-Executive Director
• Dr Hein Scheffer, Director of Strategy and Transformation

PUB25/05/3 DECLARATIONS OF INTEREST

3.1 There were no new declarations.

PUB25/05/4 PATIENT STORY

4.1 Bystander Response to Delays

4.1.1 Simon Chase, Chief Paramedic and Director of Quality (CP-DoQ) introduced a video that highlighted the issue of public response to perceived ambulance delays. The Patient Story focussed on Rhys Hibbert (a Community First Responder) who suddenly and unexpectedly collapsed in the street while out for a lunchtime walk. First aiders from a neighbouring business called for an ambulance and kept the unconscious patient safe and comfortable. The call was categorised as Category 2 (C2) and the caller was advised that there was a 40-minute wait for an ambulance. The call-handler remained on the call for 10-minutes, until one of patient’s colleagues arrived and decided to transport him to hospital in their car.

4.1.2 The CP-DoQ explained that the incident had occurred during the Winter, when the ambulance service had been under extreme pressure. The Winter 2024-25 debrief exercise had since been completed with areas identified for action and development in readiness for the coming Winter. The priority was to deliver a safe service, and the Trust was focussed on delivering improved performance through efficiencies.

4.1.3 To raise public awareness, the Community Engagement Group (CEG) planned to develop a Good Bystander campaign, advising members of the public on when to call for an ambulance and what to expect during the call. The team was focussed over the Summer on helping the public to understand how the ambulance service was responding to the changes in healthcare.

4.1.4 Neill Moloney, Chief Executive Officer (CEO) stated that the Patient Story highlighted the importance of public perception; the ambulance service was seen as being very busy and ambulance delays were expected. Clear public messaging was required.

4.1.5 Wendy Thomas, Non-Executive Director (NED-WT) asked if the call-handler might have offered clinical advice, knowing that the patient was to be moved? Mike Ward, Deputy Chief of Clinical Operations (DCCO-MW) agreed that adequate and responsive resource must be available to crews on the road and call-handlers within the Emergency Operations Centre (EOC). A call-handler should be able to ask a clinician to manage a call while it was in the queue and, if necessary, escalate the response.

4.1.6 NED-WT further enquired how the Board would receive feedback from the public engagement exercise to know if the Good Bystander campaign had been effective? The CP-DoQ advised that the CEG’s quarterly report to the Trust Board was the correct route for feedback. He added that discussion was ongoing around the Patient Safety Incident Response Framework (PSIRF) and whether decisions taken outside of EEASTs control could be monitored. Efficiencies within the Operations team, including a review of call-handlers’ scripts, would also help to drive these improvements.

4.1.7 Chris Brook, Non-Executive Director (NED-CB) reflected that EOC management were advocating for increased transparency around response times and updates for those waiting for an ambulance; he agreed that EEAST should be more transparent with patients and the public. Darren Meads, Interim Chief of Clinical Operations (ICCO) supported the need for transparency with the caveat that live information on the website indicating that the service was under extreme pressure may deter a patient from calling for an ambulance that was needed. The CEO considered that more meaningful conversations with patients through the call-handler were needed.

4.1.8 The TC concluded that, if a member of the public required an ambulance, they should call 999, and one would be provided with honest transparency around the expected response time. He expressed his thanks to Rhys who was a great supporter and champion of the ambulance service.

The Board noted the report.

PUB25/05/5 TRUST CHAIR AND NON-EXECUTIVE DIRECTOR’S REPORT

5.1 The Board received and considered the Trust Chair’s report which offered a summary of the work undertaken by the TC and Non-Executive Directors (NEDs) since the last meeting, closely aligned to the Trust’s priorities, identified risks and strategies. The TC addressed the key points:

5.1.1.

• The Trust was working hard to manage and improve performance; the Board was confident that the changes implemented were having an impact, however, there was still considerable work to do.
• EAST’s 2025-30 Strategy would be presented to the Board today; this had been co-produced with staff and patients.

The Board noted the report.

PUB25/05/6 CHIEF EXECUTIVE OFFICER’S REPORT

6.1 The Board received and considered the CEO’s report; the following points were highlighted: 6.1.1

• A Sexual Safety campaign had been launched across the Trust with a promise that action would be taken against inappropriate behaviour.
• The Big Conversation had commenced, launching the Trust’s values and areas of organisational focus; eleven in-person staff engagement meetings had been held to date with an online platform also available.
• Performance – good improvement had been recorded in recent months as a result of significant effort.
• Health and Safety Executive (HSE) audit – the HSE’s first engagement with an ambulance service; workplace stress was highlighted as an area of concern.
• The Association of Ambulance Chief Executives (AACE) had launched a campaign to address Violence and Aggression in the Workplace; this had increased and EEAST would respond proactively.

6.1.2 The TC observed that the organisation was managing a significant agenda with multiple challenges, including internal restructure, regulatory feedback, and unexpected changes to the NHS. He was assured that the 2025-30 Strategy was focused in the right areas:

• Staff wellbeing and culture
• Maximise production through increased efficiency
• Close working with partners and stakeholders

The Board noted the report.

PUB25/05/7 MINUTES OF THE PREVIOUS MEETING

7.1 The minutes of the meeting held on 12 February 2025 were approved as an accurate record.

PUB25/05/8 MATTERS ARISING AND ACTION TRACKER

The CEO reminded the Executive Directors that updates should be provided for all open actions in advance of the meeting.

8.1 PUB24/09/9.1.1.6 – (IPR) People Services – Sickness Benchmarking The TC requested that benchmarking be undertaken against the NHS and other ambulance Trusts for both sickness and Duty Sick absence.

8.1.1 Marika Stephenson, Chief People Officer and Deputy CEO (CPO) reported that a deep-dive report into sickness absence and duty sick had been presented to People Committee; she proposed that this action be closed.

8.2 PUB24/11/9.1.4.1 – (IPR) Strategy and Transformation Dr Hein Scheffer, Director of Strategy and Transformation, to review the purpose of Community First Responders (CFRs) and consider whether different levels of skill, knowledge and training could be accommodated.

8.2.1 The CPO confirmed that a CFR report had been submitted to People Committee; she proposed that this action be closed.

8.3 The Board resolved to close the following actions:

• PUB24/02/9.1 – Integrated Performance Report (IPR)
• PUB24/07/10.1.3.4 – (IPR) EOC Statistics and Performance
• PUB24/09/9.1.1.6 – (IPR) People Services – Sickness Benchmarking
• PUB24/11/9.1.4.1 – (IPR) Strategy and Transformation (CFRs)
• PUB25/02/9.1.4 – (IPR) People Services – Sickness Absence
• PUB25/02/9.1.4.4 – (IPR) Strategy and Transformation – Access to the Stack
• PUB25/02/9.1.5 – (IPR) People Services – Mandatory Training
• PUB25/02/10.1.8 – Freedom to Speak-Up (FTSU)

PUB25/05/9 PATIENTS

9.1 Care Quality Commission (CQC) Quality Improvement Plan Progress Report

9.1.1 The Board received and considered the CQC Quality Improvement Plan Progress Report. The CP-DoQ highlighted the following points:

9.1.2

• S29a Warning Notice – three Rapid Quality Review meetings had been held with regional quality leads, commissioners and other partners, including the CQC. EEAST was either improving or had met the requirements across all areas and exit criteria negotiations had commenced. With the CQC’s agreement, it was proposed that improvement should be monitored and shared with commissioners through the monthly Quality Report. -- Culture and Feedback – work was ongoing as immediate KPI measurement was more difficult to provide in this area. -- Mandatory training – the 85% target had been exceeded throughout the organisation and in all categories (currently maintained at 93%); to be reported monthly from June. -- The EOC recruitment pipeline was stable, and call pick-up times had improved. -- The Warning Notice deadline of 23 April had passed and the CQC had expressed no concerns.

9.1.3

• CQC 2024 inspection – engagement meetings had been held with the CQC, however, the draft report had yet to be received. The CQC had confirmed that the improvement notices issued in 2022 had been reviewed against the evidence submitted; an update was expected to confirm whether the notices had been lifted.

9.1.4 The TC welcomed the transparent report and enquired about learning; he asked what had been done differently, and if this could be sustained? The CP-DoQ replied that the Electronic Staff Record (ESR) system had been opened to all managers, giving them access to live mandatory training records for their staff. Also, in accordance with NHS England’s (NHSE) Core Training Skills Framework, eleven mandatory training modules had been agreed, reducing the requirement on staff and allowing them more time to complete other essential training. Local Clinical Managers would monitor and support Operational teams, providing a route for feedback and identifying the need for additional training. The CP-DoQ was confident that these changes offered stability that was previously missing.

9.1.5 The CEO recognised the significant progress made and the good feedback received from the Integrated Care Boards (ICBs) and the CQC. He reflected that the Trust must ensure that there were no other as yet undiscovered issues; appropriate action should be taken to strengthen internal processes and not wait for external regulatory intervention to identify areas of concern.

9.1.6 In addressing the Rapid Quality Review report, the CEO noted an error on page 9: the total number of call-handlers was 204, this included 44 agency staff. He also referenced the data reported for Medicines Management controlled drugs incidents (page 14) which indicated that few were being closed each month. Dr Simon Walsh, Medical Director (MD) replied that the CQC had expressed concern that incidents were being closed inappropriately on DATIX without any learning or action identified. This had been addressed via weekly meetings between the Deputy Clinical Director and the Trust Pharmacist to review all Medicines Management incidents; no incidents would be closed without learning or action identified. The MD added that there was a lag in the reporting; more incidents had been closed than the data suggested.

The Board noted the report.

9.2 Quality Governance Committee Assurance Report

9.2.1 The Board received and considered the Quality Governance Committee assurance report. In the absence of Catherine Glickman, Non-Executive Director and Committee Chair, NED-WT provided the following update from the meeting held on 26 February 2025:

9.2.2

• The Committee was assured that the issues raised through the CQC Warning Notice were being addressed.
• Complaints – 65% were closed within the agreed timescale.
• Handover 45 – strong assurance was offered.
• The Committee had received and approved three excellent annual reports: --Infection Prevention and Control (IPC) --Clinical Audit Plan -- Quality Account Priorities 2025-26

9.2.3 NED-CB acknowledged the “good news” story in receiving nine compliments for every one complaint; he recommended that this should be publicised to staff to recognise the good work undertaken. The ICCO confirmed that, wherever possible, compliments received were relayed to individual staff in person. The Board agreed that more focus should be given to compliments, not just complaints; recognition and reward were important to the organisation.

9.2.4 The CEO observed the year-on-year reduction in staff vaccination uptake (68% to 33%) and asked that this be addressed. The CP-DoQ advised that the Occupational Health (OH) service, previously outsourced, had transferred into the organisation during Autumn 2024. The onboarding of a new team and embedding the service meant that the team was not able to support the annual vaccination programme. It was also widely believed that staff were being vaccinated outside of the organisation but not communicating this information to EEAST.

9.2.5 The TC acknowledged and welcomed the ongoing improvement and learning reported through the handling of complaints

The Board noted the report.

PUB25/05/10 PRODUCTIVITY

10.1 Integrated Performance Report (IPR)

The Board received and considered the Integrated Performance Report. The TC asked the Executive Directors to focus their reports on key areas of improvement and concern.

10.1.1 The CPO highlighted the key points for People Services:

• Staff turnover metrics had improved: vacancy rate 4.42%, staff turnover 8.44%.
• Sickness absence – a considerable amount of work had been undertaken since December 2024 resulting in improved metrics (7.86%); this included Duty Sick.
• Employee Relations (ER) – the case volume remained an area of concern; 153 cases were recorded in March 2025, with 30 suspensions. The CPO confirmed that the increase in the number of ER cases correlated with the launch of the Trust’s Sexual Safety campaign and the roll-out of training to leaders. -- Staff surveys showed a significant increase in allyship where ER cases were raised by colleagues who had witnessed an incident rather than by the staff directly affected. -- The Trust’s Dignity at Work policy had been a focus of The Big Conversation and Leadership Days; the policy was being reviewed. -- The introduction of an Advice Line was also being explored as a result of The Big Conversation. -- A deep-dive was recently undertaken by the CPO with ER leaders and HR Business Partners; all cases were reviewed and an action plan created. It was hoped that the HR Business Partnering team could resolve informal cases before they were formalised. Process improvements had also been identified, and training offered to leaders to increase the number trained and therefore available to attend ER hearings. The CPO was confident that the hearing backlog would be quickly cleared.

10.1.1.1 In response to a question from NED-CB regarding the impact of the excessive workload on the ER team, the CPO confirmed that it was challenging for both the ER team and leaders; AACE trauma training was being sought.

10.1.1.2 The TC reflected that the improved metrics around staff turnover and sickness absence were critical to the future strength and effectiveness of the organisation.

10.1.2 The ICCO provided the Operations update:

• Call pick-up times – a substantial improvement was noted, due in part to a reduction in call volume and an increase in the number of call-handlers; 999 calls had been consistently answered within two seconds over the past two months. The trend for total incidents managed showed significant activity during March 2025, a considerable year-on-year increase.
• Hear & Treat – rates were progressively increasing; 13.5% of patients calling 999 were adequately and safely supported in March.
• EEAST’s commitment to reducing hospital and NHS system pressures was demonstrated through a 52% conveyance rate.
• Out of Service (fleet) – the protocols had been adjusted, resulting in a quick and positive outcome; out of service vehicles would be brought back into service as quickly as possible.

10.1.2.1 Omid Shiraji, Associate Non-Executive Director (NED-OS) asked why the number of incidents being managed year-on-year was so much higher; what was driving this, and what was EEAST doing to manage the increase in demand? The CEO replied that all ambulance services were seeing a growth in demand that exceeded population growth (6-7% actual v. 3% predicted), partly attributed to an increasing elderly population, however, long-term population growth was still lower than predicted pre-pandemic. He anticipated that a higher level of growth may also be seen during 2025-26. The ICCO added that the organisation was less reliant on the no-send protocol, used at times of extreme pressure; the Trust’s reliance on this protocol in March resulted in more patients being appropriately classified and assisted by telephone.

10.1.2.2 The TC proposed that demand be analysed over several years to identify from where the growth had come and the dynamics that supported it. The ICCO confirmed that detailed information was available, including patient type and location, which helped to inform the long-term workforce plan. The TC asked that the analysis include the nature of the call.

10.1.2.3 The CEO referenced the NHS Plan and the transition from treatment to prevention; EEAST had a role to play in ensuring that issues within the community were addressed so that patients could receive the treatment they required, thus avoiding a crisis that put unnecessary pressure on the ambulance service and the acutes.

ACTION: Interim Chief of Clinical Operations to analyse demand over several years to confirm from where the growth had come and the supporting dynamics, including patient type, location, and nature of the call.

10.1.3 The CP-DoQ provided an update on Clinical Quality and Safety:

• Mandatory training – recent focus had resulted in the highest level of compliance recorded.
• IPC metrics – although still below the 90% target for stations, improvement had been recorded for four successive months due to the new cleaning contract. More work was needed, and the target should be achieved by the July Board meeting. Vehicle IPC data was fluctuating, partly due to staff turnover in the Make Ready team and maintaining the cleaning schedule; refresher training was being delivered in the cleaning of vehicles.
• Areas of concern: -- Uniforms – a slight downturn was noted in bare below the elbow -- The shortage of hand-held sanitisers was being addressed.

10.1.3.1 The CPO advised that uniform infringement had been raised through The Big Conversation; it was proposed that the number of incidents had increased because the Trust issued three warning letters to repeat offenders, but not a formal letter. The CP-DoQ replied that the issue was being addressed by local managers through conversations with individual staff. The TC emphasised that all front-line staff should be bare below the elbows; it was a matter of professional standards and pride.

10.1.4 Kevin Smith, Director of Finance (DoF) delivered the Finance update at month 12 of the 2024-25 financial year, subject to audit:

• Year-end financial position – a £2m surplus was reported due to income received late in the year; the Cost Improvement Programme (CIP) target was achieved through savings from vacancies and cost-control measures. Some of the surplus was converted into operational performance during the Winter months but this was not sustainable going into the new financial year.
• Financial challenges: -- Operations Support – a decision was taken to invest in fleet maintenance -- Patient Transport Services (PTS) – performance improved within the year, resulting in a small contribution for the first time
• Capital allocation – £25m had been spent against an allocation of £27m, enhanced by additional funding for the Ipswich hub; operational handover was planned for late Summer 2025. The small underspend contributed to system capital.
• The Finance team was working closely with colleagues to identify and divert to the front-line all budgetary underspend in the 2025-26 financial year.

10.1.4.1 NED-OS enquired about the challenge that underpinned the “invoices received without complete governance” measure; he asked what EEAST was doing to ensure that staff followed the agreed procedure, and how this linked to the Trust’s cultural journey? The DoF acknowledged that this was a people challenge, not a process challenge, and he confirmed that managers would be held accountable for processing errors made by themselves and their teams; it was not the role of the Finance/Procurement team to correct errors to ensure compliance.

The Board noted the report.

10.2 Performance Committee Assurance Report

10.2.1 The Board received and considered the Performance Committee assurance report from the meeting held on 26 February 2025. Julie Thallon, Non-Executive Director and Committee Chair (NED-JT) reported the following key points:

10.2.2

• Transformation Programme Group – report to be discontinued.
• Partnerships – changes had since been communicated and would need to be navigated.
• Board Assurance Framework (BAF) – report not available.
• Group Assurance Reports – work was ongoing to improve these reports; continued improvement was noted in both trends and performance.

The Board noted the report.

10.3 Audit and Risk Committee Assurance Report

10.3.1 The Board received and considered the Audit and Risk Committee assurance report from the meeting held on 19 February 2025. George Lynn, Non-Executive Director and Committee Chair (NED-GL) was in attendance via the public feed but was unable to present the report; the TC therefore provided a summary of the meeting.

10.3.2 The DoF added that Audit Committee had noted the impact on the Committees of the changes that were being embedded across the organisation in relation to the Transformation Portfolio Group; the benefits should be seen in the coming months.

The Board noted the report.

10.4 Finance and Sustainability Committee Assurance Report

10.4.1 The Board received and considered the Finance and Sustainability Committee assurance report from the meeting held on 19 February 2025. NED-CB (Committee Chair) reported the following key points:

10.4.2

• A break-even financial outcome was forecast.
• PTS was in a much stronger position financially; this was attributed to the considerable work undertaken by the team.
• Sustainability – the Board Sustainability Workshop held in March 2025 would support and inform future plans.
• Transformation Programme Update and BAF – changes to the governance and reporting processes were being implemented; it was expected that future transformation updates would provide more clarity, and the new BAF would offer increased focus around financial risk.

The Board noted the report.

PUB25/05/11 PEOPLE

11.1 Freedom to Speak Up Report

11.1.1 The Board received and considered the Freedom to Speak Up (FTSU) report from The Guardian Service (TGS). FTSU Guardian, Kimberley Gillingham (TGS-KG) joined the meeting and reported the following points:

11.1.2

• 164 concerns were raised during the eight-month period to 31 March 2025, with three main themes identified: -- Systems and processes -- Behaviour and relationships -- Management
• Norfolk and Waveney (N&W) had the highest number of concerns raised.
• The majority of staff raising concerns felt that they had received impartial support from the Trust or had previously raised a concern that had not been listened to.
• The Trust was asked to consider the recommendations made within the report.

11.1.3 With regard to patient and staff safety, NED-WT asked how TGS obtained advice and identified the associated risks? TGS-KG replied that information was obtained through discussion with the individual who raised the concern and escalated as appropriate, in accordance with the National Guardians’ Office (NGO) guidelines. NED-WT further enquired if TGS were being invited to attend team meetings, to raise awareness of the service? TGS-KG confirmed that they were being invited to meetings across the Trust, however, the number of meetings attended could be increased. Board support and direction was requested, to cascade down through the organisation to ensure that all staff were aware of TGS and how to contact them.

11.1.4 The CEO confirmed that the Executive Leadership Team had considered the recommendations made by TGS and asked that these all be progressed. The Board agreed that People Committee should monitor the recommendations.

11.1.5 The CEO advised that more work was needed to raise the profile, purpose and accessibility of TGS with front-line staff. He asked TGS to include in future reports the data that showed the average time taken to address the concerns raised, so this could be monitored. TGS-KG agreed to this request and confirmed that prompt action was being taken to address concerns as soon as they were raised.

11.1.6 NED-JT reflected that the number of issues raised was small when considering the known cultural issues at EEAST. She asked how the organisation could ensure that staff knew there would be no detriment in speaking up? TGS-KG advised that detriment could not be promised, but any detriment suffered would be escalated and action taken. She proposed that the Trust could share case studies with its staff, confirming the lack of detriment and prompt timescale.

11.1.7 The TC acknowledged the challenges faced by a large organisation that was spread across a wide geographical area. He agreed that work must continue to ensure that TGS message was relayed to all staff, together with all other routes for speaking up. The TC supported the suggestion to publicise anonymised case studies.

11.1.8 In response to a question from the TC asking if she was satisfied that the support received from senior managers and the Trust Board, TGS-KG confirmed that all conversations were positive, and no negativity had been experienced.

The Board noted the report.

ACTIONS:

• CEO to ensure that The Guardian Service were invited to attend team meetings throughout the Trust, to raise awareness of the service.
• Recommendations made by The Guardian Service to be implemented and monitored by People Committee.
• The Guardian Service to include and monitor through future reports the data that showed the average time taken to address the concerns raised.
• Tom Bennett, Head of Communications, to action the request for anonymised FTSU case studies to be shared with EEAST staff.

11.2 People Committee Assurance Report

11.2.1 The Board received and considered the People Committee assurance report. NED-WT provided the following update from the meeting held on 29 January 2025:

• Volunteer Assurance Report, including the training and utilisation of CFRs:

• • processes were in place to address the issues experienced by volunteers in accessing eLearning
• • a dedicated volunteer would be located within the EOC to support the increased deployment of CFRs

• Occupational Health – the in-house service became operational on 1 January.

• Workers Protection Act – action plan reviewed; completion target 31 May.

• Education – the first cohort of 18 apprentices started in April.

The Board noted the report.

11.3 Remuneration and Nomination Committee Assurance Report

11.3.1 The Board received and considered the Remuneration and Nomination Committee assurance report. In the absence of NED-CG (Committee Chair), NED-WT provided an update from the meeting held on 26 February 2025; the following items were discussed:

• Organisational structure
• Executive and Deputy Director recruitment
• Challenging financial targets
• Performance Related Pay

The Board noted the report.

11.4 Community Engagement Group (CEG) Quarterly Report

11.4.1 The Board received and considered the quarterly report from the CEG. Stephen Rose, CEG representative (CEG-SR) reported on the following areas of engagement:

• The patient voice was heard through attendance at Healthwatch and ICB patient events; requests for CEG attendance at public events continued to increase.
• IPC audits had been conducted, and patient complaints reviewed.
• A project to increase engagement with young people and recruit younger members was ongoing; support was requested for the onboarding of these new members.
• The CEG requested: -- More engagement with the wider Patient Voice conversation; they offered two-way communication through their attendance at community events -- Updated presentations for use at public education events -- Involvement in the review of EOC scripts

11.4.2 The TC asked DCCO-MW to engage with the CEG on the review of EOC scripts, and for the Head of Communications to review the communications requests.

11.4.3 The CP-DoQ confirmed that a limited budget was allocated for CEG activity; he welcomed feedback from the CEG and engagement with both the patient and young person’s voice.

11.4.4 The TC extended his thanks to everyone involved in the CEG for everything they did to support EEAST.

ACTIONS:

• Mike Ward, Deputy Chief of Clinical Operations, to engage with the CEG regarding their offer to support EEAST in reviewing EOC call-handler scripts.
• Tom Bennett, Head of Communications, to engage with the CEG regarding their request to be more involved with the Patient Voice conversation, and to receive updated presentations for use at public education events.

The Board noted the report.

11.5 Staff Survey 2024 Report and Action Plan

11.5.1 The Board received and considered the Staff Survey 2024 Report and Action Plan. The CPO reported the following highlights:

• The NHS Staff Survey was conducted late in 2024

• 48% of staff responded (52% last year); below average

• 27.2% of Bank staff responded; above average

• 31 of the 100 questions showed considerable improvement, 66 stayed the same, 3 showed a decline

• Of the seven ambulance services, EEAST showed the best year-on-year improvement for the third consecutive year

• Key positives: -- Staff said that EEAST was a great place to work (+4%) -- There was improvement in staff views on patient care, and care for friends and family -- EEAST closed the performance gap on other ambulance Trusts, moving from seventh to sixth place -- Bank staff – strong results were seen in teamworking, work-life balance and negative experience; lower scores were recorded in leadership, personal development and involvement in innovation -- Improvement continued but the rate of growth was slow; the planned organisational changes may have a detrimental impact on the 2025 survey

• Priorities: -- An increase was needed in staff participation in the 2025 survey -- Actions plans should be strengthened.

• Three areas of focus had been agreed: -- Learning -- Recognition -- Staff wellbeing

• Although progress was being made, the challenge was larger than expected; increasing momentum and sustaining change would be difficult.

11.5.2 The TC recognised the volume of work undertaken for EEAST to be the most improved ambulance Trust for the third year running; this should be celebrated. The CEO added that action plans would link into The Big Conversation to ensure that staff were aware of the challenges faced by the Trust.

The Board noted the report.

11.6 EEAST Strategy 2025-30

11.6.1 The Board received and considered the final version of the 2025-30 EEAST Strategy. Libby Holdcroft, Deputy Director of Strategy (DDoS), reported the following points:

• Developed in collaboration with patients and staff, the work undertaken over the last 12-months clearly articulated the future direction of the Trust.

• The strategy had evolved, with four Missions adopted under the headings: -- People -- Patients -- Partnerships -- Productivity

• The Strategy was presented to the Board for approval, prior to publication.

11.6.2 The TC was encouraged by the continuation and evolution of the Trust’s strategic direction, acknowledging the importance of co-production in identifying and agreeing the Trust’s values; he would ensure that the Board had time to discuss key strategic decisions.

ACTION: Trust Chair to consult with the Deputy Director of Corporate Affairs and the Deputy Director of Strategy to ensure that the Board had time to discuss key strategic decisions.

The Board approved the report.

PUB25/05/12 GOVERNANCE AND RISK

12.1 Annual Self-Certification (Condition FT4 and G6)

12.1.1 The Board received and considered the Annual Self-Certification report. Stanley Mukwenya, Deputy Director of Corporate Affairs (DDoCA) highlighted the following:

• As part of the NHS oversight arrangements, all healthcare providers were required to confirm on an annual basis that they remained compliant with their provider licence.
• In considering the CQC findings and Warning Notices, the Trust could only confirm three of the six requirements; the approach taken was consistent with other NHS organisations.
• The Board was asked to confirm EEAST’s compliance with the requirements.

The Board approved the return.

12.2 Fit and Proper Person Compliance 2025-26

12.2.1 The Board received and considered the Fit and Proper Person (FPP) Compliance 2025-26 report. The DDoCA reported the following key points:

• The FPP checks were undertaken in April under the Health and Social Care Act; all Board members had satisfied the requirements.
• The annual FPP return would be submitted by 30 June 2025.

The Board approved the return.

PUB25/05/13 CLOSING ADMINISTRATION

13.1 Key Messages and Identified Risks

13.1.1 The TC noted the following themes from the meeting:

• Compliance and professional standards; progress was being made.
• The value and importance to the organisation of the staff and patient voice.

13.1.2 The TC acknowledged the dedicated service that Wendy Thomas had given as a Non-Executive Director of the Trust over the past 6-years; he extended his sincere thanks on behalf of the Board.

13.2 Items Referred to/from Other Committees

13.2.1 The following referral was agreed:

• FTSU – People Committee to monitor the progress made against TGS recommendations.

13.3 Questions received from the Public

13.3.1 Q1. (online) To what extent was EEAST addressing the impact on staff morale and pride resulting from the perception that it was powerless to change the situation regarding the handover of patients to Emergency Depts (EDs); culture was now waiting in the ED as part of the shift. Was EEAST in a position to assess staff satisfaction when compared to their expectation when they were first recruited to the service, and the impact on retention and effectiveness?

13.3.1.1 A. The CPO replied that feedback from staff surveys and site visits confirmed that hospital delays had a huge impact on staff; it also reduced learners’ exposure to patients. Welfare Wagons were in place at the EDs to support staff, and the MD and ICCO were working with commissioners to reduce hospital handover delays. The MD recognised that staff felt powerless, however delays had reduced across the region and the situation was improving.

13.3.1.2 The ICCO acknowledged the pressure experienced by staff and leaders in the acute hospitals. National Planning Guidance supported Handover 45 and a patient should wait no longer than 45-minutes to be handed over at hospital. The integration of ambulance managers into acutes was important, and consideration would be given to rotational posts, providing respite for staff. The CEO was encouraged by the messages received from NHSE regarding the Planning Guidance; he recognised the significant reduction seen in handover times and confirmed that EEAST would continue to work with partners to further improve.

13.3.2 Q2. Unison had surveyed the EOC staff about the decision-making process to be discussed at Private Board today; a report had been generated for distribution to the Board (hard copies were presented) containing six key recommendations:

• to improve conditions for call-handlers at the Bedford EOC
• to improve staffing to the Clinical Assessment Service and call-handlers
• to give clear timelines for EOC decision-making
• to build EOCs within commuting distance from existing centres
• to think about non-driving staff in the decision-making process
• to commit to three EOCs

13.3.2.1 It was unfortunate that EOC staff were unable to present the report and meet with Trust leaders in advance but, hearing the importance of accountability and partnership going forward, how could the Board demonstrate that to EOC staff in the decision-making process?

13.3.2.2. A. The CEO advised that Private Board would discuss the Unison recommendations alongside the EOC report that afternoon. He confirmed that staff engagement had been ongoing for several months, and EEAST was committed to further and continued engagement with staff.

13.3.3 Q3. Unison had observed that overtime spend had reduced with immediate effect from 7,000 to 3,000 hours; they asked what impact this would have on staff finishing their shift closer to their planned finish time?

13.3.3.1 A. The CEO explained that the reduction in overtime was planned: the Trust had successfully recruited a substantial number of additional staff, thus reducing the need for overtime. The Trust was aware that staff wanted to finish their shift on-time, this fed through from staff surveys and engagement events. He proposed that a Task and Finish Group be established to ensure that staff could be released as close to their shift end time as possible.

13.4 Reflection on Meeting

13.3.1 NED-CB offered the following reflection:

• Progression and momentum were noted across several areas due to the hard work undertaken in recent months; there was much to celebrate.
• Patient stories, staff surveys and the community experience were helping to shape and inform the Trust’s strategic plan.
• There was clear focus on the challenges ahead.

13.5 Date of Next Meeting: Wednesday 09 July 2025 (09:30 – 12:30)

The meeting closed at 12:26.