In Public Board Minutes - November 2025

Present:

PUB25/11/1.1 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 advised that any questions received from the public would be addressed at the end of the meeting.

PUB25/11/1.2 Apologies for Absence

1.2 Apologies were received from:

• Marika Stephenson, Chief People Officer

PUB25/11/1.3 Declarations of Interest

1.3 There were no declarations of interest related to the business of the agenda.

PUB25/11/1.4 Patient Story

1.4.1 Simon Chase, Chief Paramedic and Director of Quality (CP-DoQ) extended his thoughts to those affected by the recent stabbing at Huntington station. As executive on call he was informed an incident had occurred – nine patients were conveyed to Addenbrookes. He was encouraged to see how the response from the public and the joint emergency response had helped to ensure there were no fatalities.

1.4.2 Darren Meads, Chief Operating Officer (COO) recognised the role of the members of the public and all of the emergency response services who had helped to mitigate the situation and ensure a swift response to those affected.

1.4.3 The TC emphasised that the swift response was not by chance, crews were trained to respond to these incidents every day, this was testament to that training.

1.4.4 The CP-DoQ introduced the patient story, which was a montage of compliments received from patients over a one-month period. They focussed on respect, care and the Trust acting in the best interests of patients across a wide variety of roles. It demonstrated the Trusts commitment to excellence. The mission statement was to provide high quality, emergency care, focussed on the patient need. The Board had met with the patients association to consider further opportunities for collaboration to ensure public feedback was being used effectively to drive service improvement. It was important to continue to share internally the successes, and how the public perceive us. Over 500 certificates of excellence had been issued to staff since the scheme began – when feedback was received from the public it was important this was shared.

1.4.5 Susan Wilkinson, Non-Executive Director (NED-SW) reflected on the impact on staff when they were able to receive this feedback from patients which was essential. The CP-DoQ confirmed that there was a process in place to feed patients views back to the staff members which had been involved in their care, which was well received. 1.4.6 The Director of Strategy, Transformation and Governance, Hein Scheffer (DoSTG) recognised the importance of celebrating the successes within the organisation. It was important to recognise the dedication and compassion shown by staff during a challenging period.

1.4.7 The Public Board resolved to note the patient story.

PUB25/11/1.5 Trust Chair and Non-Executive Director’s Report

1.5.1 The TC reflected on the work the Trust was doing to ensure learning and development from patient feedback. EEAST was working alongside the patients association and also had a key programme on care inequalities focussed on ensuring patients informed the care provision. Approaching winter, demand was already increasing which was driving an increase in handover delays. The Board was committed to holding itself to account for areas within its capability of delivering, but was also reliant on partners delivering against their commitments to support the winter response, this particularly applied to hospital handover delays.

1.5.2 The Public Board resolved to note the update provided.

PUB25/11/1.6 Chief Executive Officer’s Report

1.6.1 The Chief Executive officer, Neill Moloney (CEO) provided an update on the activities underway since the last meeting:

• There had already been a significant increase in winter demand which was affecting performance. The Trust was committed to continuing to work with partners to ensure a safe service was provided to patients throughout the winter period.
• The Trust achieved 35.5 minutes C2 performance in September 2025, which was a 5 minute improvement compared to the performance in September 2024.
• There was a significant improvement in call pick up times in the EOC, delivering at 2s, which was an 18s improvement compared to September 2024 and met local and national targets.
• Hear and treat was delivering at 16.43%, ahead of the target of 16%.
• The NHS England NHS oversight framework had been received, there were key areas associated with C2 performance, financial performance and staff sickness. The report also recognised progress in C2 performance although there remained key issues relative to other organisations.
• The Trust had not yet received the CQC report from the inspection which had taken place 12 months earlier, this was a concern given the section 29a and section 64 warning notices issued following this inspection. The Trust continued to work to address these notices, with improvements seen in all areas and mandatory training maintained above 90% since January 2025.
• The Trust had launched time to listen, a campaign focussed on ensuring senior leaders were listening to staff and enacting changes based on this feedback. For one day per month senior leaders were out and about visiting the region, feedback from these visits helped to prioritise areas of change. As a result of this feedback, changes had been made to annual leave limits to enable employees to utilise their annual leave.
• Team based working had been stopped in its current format, the Trust would be engaging with staff on how outputs which were expected from team based working could be best achieved.
• The CEO acknowledged the sad, and sudden passing of Lorraine Cason, who worked in Norfolk. He extended his condolences to her husband and son.

PUB25/11/1.7 Minutes of Previous Meeting

1.7.1 The minutes from the meeting on 10.09.2025 were approved with no amendments.

PUB25/11/1.8 Matters Arising and Action Tracker

1.8.1 The action tracker was reviewed and updated.

1.8.2 The following actions were proposed for closure:

• PUB25/05/10.1.2
• PUB25/09/2.1
• PUB25/07/12.2.2
• PUB25/09/2.1
• FS25/05/3.1.3
• PUB25/07/9.1.1.4

PUB25/11/2.0 PERFORMANCE

PUB25/11/2.1 Board Assurance Framework Summary – SR1, SR2 and SR6

2.1.1 The CP-DoQ briefed on SR2 – Quality Governance, which had a current risk score of 9. There were some clear areas of continued focus, with regards ensuring the governance remained compliant, it was often clear that whilst there was a downward trajectory, a lot of the data received was historical. For instance, a five-minute improvement was being delivered on performance which directly impacted the service delivered to patients. Moving into winter there were already severe delays which presented an unknown risk to the ability to respond to patients waiting in the community. The IPR was demonstrating a relatively strong, stable position around the metrics, for instance clinical care continued to perform well. The challenge was to ensure the controls and supports in place to respond appropriately would deliver the same effective and equitable care across communities. Looking at the regulatory issue of the S29a there was a focus on mandatory training to ensure the delivery of a safe service, the Trust was not meeting this requirement at the time, but had since stabilised mandatory training compliance above 90% since January 2025. This training incorporated areas associated with clinical ability which would further mitigate the risk.

2.1.2 The COO presented on SR1 which incorporated demand and capacity, and efficiency. These risks were mapped based on productivity, demand and capacity and hear and treat. There were other elements which were outside of the Trusts control but had a sizeable impact on performance including hospital handover delays and the number of calls diverted into the service as part of the nationalised arrangements for standardised pick up across 999. It was reassuring to note the significant improvements in call pick up times, delivering below 2s which exceeded the national target. This was driven by a workforce plan for call handler recruitment, retention improvement of call handlers, and the productivity of call handler time. These improvements had enabled the Trust to response to just under 700 external calls which were imported into EEAST, providing support to other Trusts. The exported number of calls was only 26 over the same period, compared to 1004 in the same period in 2024. Hear and treat increased to 16.43% – this mirrored the commitment to safely increasing hear and treat to reduce pressures on acute services. Supporting this was the lowest level of conveyance ever reported by the Trust. This indicated that more patients were being supported through the 999 call system, however the COO emphasised that patients should only use 999 for life threatening emergencies.

2.1.3 Simon Walsh, Medical Director (MD) noted that handover delays correlated directly with increased C2 response times, which linked with harm in the community. Despite the region submitting handover plans these were not being met at this stage. The Trust had engaged with the ICBs most affected by delayed handovers and would be working in partnership with systems to address these issues.

2.1.4 NED-SW noted that there were a number of areas of positive improvement which the narrative did not always accurately reflect. She felt the intelligent narrative did not always reflect this positive improvement accurately and suggested it be reviewed.

ACTION: Narrative within the IPR to be reviewed to ensure it accurately reflected where there was a positive improvement. Lead: DDI

2.1.5 The TC reflected on the significant improvement delivered in Spring and Summer 2025 which was largely data, management and leadership driven. This was framed against a rapidly deteriorating external situation at present. He challenged how clearly this narrative was being put out to both internal and external partners, and the actions EEAST was taking to address these external challenges.

2.1.6 The CEO noted that the situation was challenging for all providers across the region. Some organisations had been able to resolve some of these areas, but the Trust was also learning from other ambulance services and Trusts to inform improvements. For instance, Watford and West Suffolk had significantly improved handover times, learning from these areas could inform development in other areas. The Trust had met with some of the most challenged organisations in Norfolk and ESNEFT. There was a contribution to be made by EEAST to support this position and manage demand such as by reducing conveyances which the Trust was already supporting through hear and treat and other internal initiatives. There had been some investments in community services which provided opportunities to better manage patients outside of the hospital. There had also been a reduction in investments in primary care – primary care was essential to reduce conveyance. Utilising clinical advice services and urgent and emergency care hubs (UCCHs) was essential to reduce conveyances to emergency care. The latest external report from PA consulting looked at the drivers behind variation across the region to support performance moving forward PA consulting had identified areas for improvement which included the increasing use of UCCHs. There was a set of plans these acute hospitals had put forward and regular meetings in progress with NHSE to identify the progress to deliver.

2.1.7 Non-Executive Director, George Lynn (NED-GL) reflected on how the BAF was being linked to the IPR which helped to provide a more rounded view of the risk scoring and demonstrated the justification for the mitigating risk scores. The CEO noted there remained further work required to provide confidence the ambition would be delivered. Despite the ORH report which articulated the additional capacity requirements, it was recognised the funding would not be available to fully meet this. This necessitated the need to consider new models of care, which had yet to be developed to mitigate the position.

2.1.8 The DoSTG noted that part of the restructure of the BAF would change the way the BAF was reviewed and would now include a collective check and challenge and alignment with the IPR. Refining the oversight to include the strategic overview, alongside the evolving risks and linking to the IPR was essential to ensure meaningful oversight.

2.1.9 Julie Thallon, Non-Executive Director (NED-JT) supported the alignment of the BAF with the IPR. She queried whether there was a need to develop charts or a development session for the Board to better understand SPC charts.

ACTION: Consider Board training on SPC charts. Lead: DDoCA

2.1.10 Associate Non-Executive Director, Omid Shiraji (NED-OS) noted the approaching risk posed by increased demand and handover delays. There was a finite limit to what the Trust could do to mitigate this position, he challenged where this was managed across the region to ensure the system owner was addressing the risk. The CEO advised that responsibility was shifting – every organisation had developed plans for handover delays, and would be held to account by NHSE. The Trust was also working with ICBs to ensure the services commissioned met the needs of the communities. A wealth of progress was being made, but there remained further opportunities which would be incorporated in business planning. Board Assurance Framework discussion continues later in the meeting.

2.1.11 The DoSTG presented on SR6, partnership working within the IPR:

• the Trust continues to engage with systems and partners, including NHSE.
• Updated guidance was received on commissioning across the ambulance service including how this would affect the ICB structure. Meetings had been scheduled with all three strategic directors of commissioning across the patch, including the newly appointed designated CFO.
• The target for access to the stack was a 95% acceptance rate, this was currently delivering 82.4% acceptance in September 2025. However, the more pressing challenge was not the stack transfers but how frequently these were returned to the Trust for management as there were not sufficient or appropriate services available in the community to support this response, with only 43% of transfers completed. Norfolk and Waveney and SNEE remains the highest performance area, and SNEE the lowest.
• A positive contribution was being delivered from PTS, providing £73k to the Trusts finances in M8. Disputed underpayments of £102k remained in negotiation in NEE. CFRs had attended 2500 patients over 17000 hours, contributing 17s to C1 response times.

2.1.12 The CEO emphasised that only 40% of patients the Trust referred to other organisations were effectively managed in these areas, meaning 60% were rejected either due to a lack of capacity or resources, resulting in unnecessary conveyances. Work was also being undertaken on the call before you convey process to ensure these calls were responded to in a timely manner.

2.1.13 Sian Clark, Director of Digital Innovation (DDI) confirmed work was being undertaken to explore opportunities for robotic process automation and artificial intelligence to support the patient response.

PUB25/11/2.2 Integrated Performance Report

2.2.1 The Integrated Performance Report and Board Assurance Framework were considered together due to the inter connectivities associated.

PUB25/11/3.0 PATIENTS

PUB25/11/3.1 CQC Quality Improvement Plan

3.1.1 The CP- DoQ presented the CQC Quality Improvement Plan:

• Following the warning notices raised in January 2025, the Trust was now focussed on delivering the exit criteria.
• All areas were progressing well – for instance mandatory training was delivering well above target and call pick up performance had improved.
• The regulators had informally recognised the Trusts ability to receive and enact feedback was improving.
• In the monthly meetings with commissioners and regulators they were supportive of the improvements being made.
• 95.7% of ‘must do’ actions were complete. Three actions remained open associated with C1 and C2 response times and the regulation 17 action associated with performance.
• With regards the Health and Safety Executive notice of contravention which was received, two timeframes were provided – to provide an updated risk assessment by April 2025, and update against all remaining actions by October 2025. Both actions were delivered on time, verbal feedback had been received and a formal response was pending. No further evidence had been requested to support the decision.

3.1.2 NED-GL enquired whether training of staff equated to ensuring staff were protected from verbal and physical abuse. The CP-DoQ clarified that the specific action was to review processes which had been completed. However, whilst the transactional response was complete, there remained increasing incidents of violence and aggression to ambulance staff from the public. As a result, whilst the Trust had met the requirements of the action, further work was being undertaken to minimise the risk of violence and aggression incidents.

3.1.3 The Public Board resolved to note the update.

PUB25/11/3.2 Quality Governance Committee Assurance Report

3.2.1 NED-JT presented the Committee Assurance Report from the Quality Governance Committee.

• Infection prevention and control had been a recurrent theme, as such the Committee would deep dive this topic at its next meeting.
• The Committee formally noted the closure of the clinical strategy. Patient involvement would be a key theme in the next clinical strategy.
• The initial learning from deaths report into safeguarding of patients with a learning disability did not address the expected risks and would be reviewed.
• Management of the increasing hospital handover delays was noted and the impact this would have on the provision of care.

3.2.2 The Public Board resolved to note the update from the Quality Governance Committee.

PUB25/11/4.0 PEOPLE

PUB25/11/4.1 Freedom to Speak Up Report

4.1.1 Dani Marshall, Freedom to Speak Up Guardian (FTSUG) provided a brief:

• Concerns had been raised across a range of specialties including by Allied Health Professionals and other clinical services.
• A total of 40 concerns were raised to the FTSUG between August and September 2025.
• Common themes remained systems and processes, and relationships.
• Cases in Norfolk were 30% higher than any other area within the Trust.

4.1.2 NED-CG noted that the key focus should be on ensuring awareness of the service remained high across all areas.

4.1.3 The TC reflected positively that there were few patient care concerns raised through FTSU which provided assurance on the safety and quality of care provided.

4.1.4 The CP-DoQ noted that FTSU awareness week had taken place and enquired whether there was anything arising from this which the Trust should be aware of. He also noted increasing activity in areas in which a focus visit was undertaken and enquired whether there was anything else which could be done to increase this contact with staff. The FTSUG-DM advised that there wasn’t yet any analysis of matters arising from FTSU week to inform themes. However individuals often felt more comfortable raising concerns in person, which was the driver behind increased reports following awareness visits. Given the disparate footprint it was difficult to undertake in person visits consistently.

4.1.5 NED-OS noted that one of the overarching themes of case was system and process issues and enquired what was being done to fix these. In relation to promoting the service, he enquired whether there were specific objectives for managers to embed and promote FTSU. The CEO advised that system and processes issues were predominantly associated with areas such as booking annual leave. There were a number of issues which may impact this, including the allocation of leave, or clashes when booking leave with a single shift crossover. The automated process would reject this where there was minimal crossover, which increased leave rejections over a manual process. Alternative solutions were being considered to address these areas.

4.1.6 Non-Executive Director, Chris Brook (NED-CB) suggested mandatory training was key to promoting the utilisation of the FTSU Service. The FTSUG-DM confirmed that systems and processes were consistently the highest cause of concerns. Quarterly meetings were in place with HR leads to discuss these concerns and recommendations. The FTSUG had also started joining the local meetings to support awareness of the service. Managers were encouraged to publicise this with their teams.

4.1.7 NED-SW noted that organisational learning from the concerns was essential and enquired how leaders and managers were supported to respond in a FTSU approach which enabled local resolution. It was essential staff could see and experience that leaders were listening and responding to their concerns. The FTSUG-DM confirmed managers and leaders were encouraged to approach the service for advice and support where they were managing a concern. Sudha Pavan, Deputy Chief People Officer (DCPO) advised that informal resolution was often pursued for grievances – this was essential to support good employee relations and confidence in local management.

4.1.8 The TC enquired whether the FTSU were satisfied they were being supported in their roles. The FTSUG- DM confirmed she had received strong support from managers and leaders across the Trust.

4.1.9 The Public Board resolved to note the update provided.

PUB25/11/2.1 Board Assurance Framework Summary – SR7, SR8 and SR9

2.1.14 The Deputy Director of People Services, Sudha Pavan (DDPS) presented on SR7, Workforce Sustainability, SR8 staff retention and SR9, Organisational Development,

• The vacancy rate was 5.3% which was the lowest it had been for a considerable period.
• Turnover was 8.2% which was also the lowest for the Trust.
• EEAST had worked with the HR business partners to undertake exit interviews to address any issues and identify whether there were opportunities to maintain these key skills.
• Within the disability standard there were key actions and learning. There had been an improvement in staff declaring their disability.
• Time to hire was 9 weeks which was testament to the improved on boarding of new workforce and support packages for these staff.
• Staff survey completion to date was 49.7%.
• Appraisal rates had increased to 85% following targeted support and interventions.
• Flu vaccination uptake was 36% since the launch in October 2025, against a 60% target.
• There had been improvements realised as a result of the in housing of the occupational health service, in particular in reasonable adjustments.
• Wellbeing champions were in place to support staff during major and traumatic incidents.
• Suicide ideation prevention work was underway due to the escalation of staff at risk – this ensured wrap around support for both those at risk and the teams supporting them.
• The Big Conversation had brought out some interesting themes from staff and local support requirements.
• A stress risk assessment and policy had been developed.
• There were 178 active ER cases underway, with 40 cases closed in October 2025. Following the CEO sexual safety letter there had been a peak in cases, as well as after a dispatches focus. Work was underway to implement additional resources to create a red cell to lead the investigations for cases which needed to be fast tracked and resolved.
• The pre-arm process had been strengthened.
• The leadership development framework introduced a sexual safety at work module. Coaching opportunities were being explored for leaders to provide a safe space to explore these conversations.

2.1.15 The CEO noted that the Trust had the worst sickness rates across all ambulance services and NHS organisations. This would need to be a particular focus on both local management, processes and policies.

2.1.16 The CP-DoQ expressed his concern regarding the level of casework associated with professional standards. He had been considering how this could be effectively addressed through both pro-active measures but also to ensure recruitment processes were sound before appointment. He also noted the Trust had operated in a challenged system for a considerable period, which drove an increase in staff pressures, and therefore could be affecting sickness absence rates. NED-SW advised that in a previous role they had engaged the Nursing and Midwifery Council in pro-active training for staff on what constituted gross misconduct and professional issues. The CP-DOQ confirmed that work was being undertaken with the HCPC around culture. Work had also commenced with the Royal College of Paramedics to look at how they could support this position.

Board Assurance Framework discussion continues later in the meeting

PUB25/11/4.2 Big Conversation Update

4.2.1 The DDPS advised that the Big Conversation was launched in April 2025. The Trust held 13 physical events and online events to receive and enact feedback directly from staff. This resulted in 600 contributions which informed 12 key priorities. Fix it fast clinics were also launched which identified quick fixes to address small areas of concern for staff. Local action plans were implemented for each sector, empowering leaders to work with HRBPs to address these areas, which was essential to build trust and confidence in local leadership teams.

4.2.2 NED-JT noted the level of engagement indicated a willingness from staff to participate and inform these areas. She was concerned there may be a loss of momentum since this point.

4.2.3 The TC challenged whether staff would recognise these changes. The DCPO advised that staff were starting to recognise these changes, and feedback was provided to teams on areas which had been delivered.

4.2.4 The COO advised that he had discussed with crews whether they recognised an improved ability to provide input in changes, and often they reported that their ability to inform development in their service area was recognised. He acknowledged the challenge regarding the loss of momentum, initial work had targeted the quick wins, as the more complex issues were addressed these had a longer lead time. Continuing with this would build confidence in the long-term delivery which was essential.

4.2.5 The DoSTG advised that the focus was on working closely with teams across the Trust to address blockages in the long term, to ensure the issue did not recur.

4.2.6 The CEO emphasised that this was not a one off initiative. It was intended further events would be held in the coming year to highlight the actions taken from the staff survey and big conversations, and to progress any new actions and issues arising.

4.2.7 The Public Board resolved to note the update.

PUB25/09/5.0 PRODUCTIVITY

PUB25/11/2.1 Board Assurance Framework Summary – SR4, SR5 and SR10

2.1.17 The Chief Finance Officer, Steven Course presented on SR4, finance and use of resource:

• A new risk was introduced in relation to the ongoing electrification of the fleet.
• The finance position continued to be monitored to ensure the Trust met the financial outturn position.
• There were some concerns associated with the level of underspend.-
• The financial position at the end of M6 was a surplus of £6.7m against a planned £1.3m, resulting in a £5.4m variation to plan. This was driven by restructuring costs within corporate teams, and a small increase in PAS expenditure. Other areas were favourable to position, for instance the use of overtime.
• The Trust was on track to deliver a break-even position but would continue to monitor this.
• The capital programme was behind plan, the Trust would be working with system partners to ensure it met the capital target and to mitigate any risk of underspend. Bottlenecks were being reviewed to ensure the timely payment of suppliers, this was largely associated with invoice receipt.

2.1.18 NED-GL noted the reference to electric vehicles and enquired who would set the criteria to determine whether the Trust progressed an electric fleet. The COO confirmed an operational protocol was being developed for patient transport in electric vehicles. The first phase would likely manage lower acuity patient transports, once the Trust understood the true range of these vehicles consideration would be given to extending this more broadly. These vehicles were already being utilised effectively and safely in other parts of the country.

2.1.19 The DDI presented on SR10, digital and SR5, cyber security.

• A digital roadmap would need to be developed.
• Discussions were underway with the southern ambulance services on digital collaboration which was essential. This could not be achieved without the appropriate funding to invest in the Trusts digital capabilities.
• Robotic process automation would be built into the IPR to demonstrate the impact of digital delivery.
• Defining the outcomes from the data security protection toolkit were essential to ensure EEAST was meeting these outcomes.
• The Trust was working with SASC to collaborate on a cyber provision.
• EEAST was performing well in cyber security but it was essential to ensure preparedness for a potential attack to mitigate any risks this posed.

PUB25/11/5.1 2025-30 Trust Strategy Implementation

5.1.1 The DoSTG presented on the Trust strategy implementation for 2025-2030. These were structured around the four missions for patients, people, partnerships and productivity. This had been developed through extensive stakeholder engagement, with over 2000 contributors providing input. The focus of the strategy was emergency response optimisation, ensuring the Trust was looking after its people, and integrated care models. Out of this process, a new behaviours framework was created with values set as accountable, respectful, excellent. The timeline and reprofiling of the mission phases ensured a realistic delivery and deeper engagement with stakeholders via the executive leads.

5.1.2 The Public Board resolved to note the update provided.

PUB25/11/5.2 Winter Plan Update

5.2.1 The COO provided an update on the preparations EEAST was making for Winter 2025/26. Call handler and CAS recruitment had been a focus to provide increasing PFSH and mitigate the position ahead of winter. EEAST was observing far more risk than initially expected at the point the plans were developed, with higher than planned handover delays which made it a challenge to safely respond to patients.

5.2.2 NED-CG noted a trial had taken place in the period in care homes. The COO confirmed that for patients in care homes with a moderate level of acuity, a provider to provider conversation would take place before transport to identify whether there were any additional support measures which could be put in place to support the patient to remain in the care home. Often for patients in care homes they did not need to come into hospital as they had nursing resources available to them.

5.2.3 The Public Board resolved to note the update provided.

PUB25/11/5.3 Green Plan Addendum

5.3.1 The CFO confirmed that new guidance was received in February 2025 to review the Green Plan, this was received following the publication of EEASTs green plan, resulting in an addendum. The requirement was to deliver net zero by 2045 and a 50% reduction in emissions by 2030. It was recognised that the green plan needed to be more action focussed, with smart objectives of the achievable. There were some areas which were performing well, particularly around the refurbishment of estates and facilities and energy efficiency. Areas for improvement included fuels and Entonox use. There were limited electric vehicle options which were being pursued. The next green plan would incorporate focussed engagement across the organisation to inform the development. The green plan addendum incorporated the essentials from the guidance received in February 2025, but the new green plan would incorporate a full assessment and engagement across the Trust, as well as the appointment of a clinical lead for the Green Plan.

5.3.2 NED-JT commended the wealth of sustainability activity which had been undertaken with limited resources. She challenged how consistent and effective clinical engagement could be provided to support the service. She also challenged whether the timescales outlined were sufficiently ambitious. The CP-DOQ confirmed there was a significant cost and supply challenge associated with the transition from Entonox to Penthrox, which had an associated lead time and target, which was the reason for the longer timeframe.

5.3.3 The CEO reflected on the progress demonstrated over the period. It was recognised there remained an ambition to expand this further. The addendum ensured the Trust met the minimum requirements whilst the Trust engaged on the broader opportunities with staff and stakeholders which would set the ambition for the coming years.

5.3.4 The TC accepted there was a strong green plan ambition but this was impacted by the practical considerations of delivery which needed to be considered. It was essential the environment and sustainability was embedded in everything the Trust was doing, particularly across the strategies.

5.3.5 The Public Board resolved to note the update provided.

PUB25/11/5.4 Performance Committee Assurance Report

5.4.1 NED-JT provided the updated form the Performance Committee:

• The impact of the uncertainty in the system was considered
• Consistency of reporting in the IPR was essential.

PUB25/11/5.5 Finance and Sustainability Committee Assurance Report

5.5.1 NED-CB presented the Finance and Sustainability Committee assurance report:

• The Committee had considered the strategy around fleet and the cost of maintaining certain vehicles which was driving an overspend.
• There was one referral associated with EOC recruitment and retention which was referred to People Committee to consider how staff could be attracted into these roles.
• The impact of system uncertainties was noted as a risk within the Committee given the ICB transition.

5.5.2 The Public Board resolved to note the update.

PUB25/11/6.0 CLOSING ADMINISTRATION

PUB25/11/6.1 Reflection on the Meeting

6.1.1 The DDI provided the reflection on the meeting. She noted the positive conversations but also challenged the necessity of maintaining the pace of change. The positive patient story was important to reflect on, but this was against the backdrop of winter pressures. She noted the importance of ensuring accessible language for member of the public joining.

PUB25/11/6.2 Any Other Business

6.2.1 There was no other business and the meeting closed.

PUB25/11/6.3

Date of Next Meeting: Wednesday 11 February 2026 (09:30 – 12:30).

The meeting closed at 12:30.