PATRIMONI ARQUITECTÒNIC

Nine CQUINs for 2012/13 have been agreed with Commissioners and represents 2.0% (£1.993m) of the Trust block contract for Emergency 999 Ambulance Services (A&E).

Emergency 999 Ambulance Services (A&E) CQUIN - 2012/13

CQUIN Target Description Target Name Contracted

value £ Delivery of the 2012/13 non-conveyance trajectory. In line with the Trust

philosophy to keep patients at or closer to home when it is clinically and socially safe, the Trust will target a number of clinical and operational areas to reduce the number of conveyances to A&E departments. The three key areas are health promotion, triage and skills

Right Care, Right Place,

Right Time 500,000

Develop a targeted approach to gather feedback on patient experience, utilising discovery interviews, telephone questionnaires, feedback clinics and a feedback leaflet to enhance organisational learning

Patient

Experience 119,607

Establish the clinical rationale behind re-contacts with the 999 service, in order to ensure patient safety. The project will identify trends, manage associated risks and develop potential means to reduce re-contact rates, leading to the agreement of a re-contact rate performance threshold

Re-Contacts with the 999

Service 199,345

Deliver high quality and clinically safe care to patients under two years old who are not conveyed to hospital

Non

conveyance of patients under 2 years of age

CQUIN Target Description Target Name Contracted _{value £} Support the avoidance of unnecessary admissions to hospital for people at

the end of life by evaluating the provision and utilisation of 'just in case' boxes in end of life care. Improve the knowledge base and awareness of palliative care for clinical staff

Improving the quality of end of life care delivered to patients 199,345

Provide structured interventions to promote a healthy, fit workforce, with

the longer term aim of reducing staff sickness rates Staff Wellbeing 114,623 Increase staff awareness of the identification and reporting of pressure

sores, according to NICE guidance Pressure Sores 99,673

Support the implementation of a clinically safe and appropriate major trauma system across the South West. Evaluate the impact of the system on the Trust, following the major trauma business case

Trauma training and mental health urgent care evaluation 311,420

Evaluate the care delivered to patients requiring mental health urgent care, which does not result in a Section being applied

Trauma training and mental health urgent care evaluation 250,000 Total 1,993,358

Patient Transport Service (PTS) CQUIN - 2012/13

The following CQUIN targets have been agreed for 2012/13 with the total value of the 2012/13 CQUIN £94,423.

Target Description Target Name Contracted

value £ The Trust is to devise a mechanism whereby PTS crews are utilised to

disseminate health related information, based on at least 3 National or local schemes in particular, but not restricted, to health improvement initiatives

Distribution of health improvement information

9,442

The Trust is to devise a mechanism whereby information relating to carer support groups is handed out as a mail shot and undertake a short questionnaire on receipt and usefulness of information supplied

Leaflet drop relating to carer support and survey to evaluate usefulness & effectiveness 9,442

The Trust is to design an awareness training programme in dementia and ensure all staff are trained by 31st March 2013

Dementia awareness

training 56,654

The Trust is to provide a deep cleaning schedule for PTS vehicles and undertake sampling checks and report outcomes

Vehicle deep clean

programme 18,885

Total 94,423

Urgent Care Service (UCS) CQUIN - 2012/13

Our Commissioners are currently considering the Urgent Care Service CQUINs for 2012/13 and once established and agreed they will be published on the Trust website www.swast.nhs.uk.

Risks

The Trust is committed to developing a responsible risk management culture to empower all staff to make sound judgments and decisions concerning risk and risk taking for promoting the safest possible environment for patients and staff. The Trust’s Risk Management Strategy is subject to annual review. It was revised and approved by the Trust Board of Directors in March 2012 and was updated to ensure it met best practice requirements.

Risks are identified at all levels of the Trust and the triangulated approach to risk management is led by the Trust Risk Manager with a clear escalation process in place. Risks are scored on a 5 x 5 matrix, the first relating to the impact of the risk and the second to the likelihood of it occurring. One represents low impact or likelihood and five represents high impact or likelihood. Where the risk value exceeds 14, risks are included on the Corporate Risk Register ensuring the Board of Directors are aware and able to assure themselves that appropriate actions are addressing and mitigating the risks. It is important to recognise that all organisations face risks all the time. The key issue is that the risks are assessed and addressed and, in particular, high level risks where the impact and likelihood are elevated receive robust management attention to reduce the risk. The Corporate Risk Register is reported at each Director’s Meeting, Board of Directors’ Meeting, and at each Quality and Governance Committee. The following table sets out the Trust’s highest risks as at 31 March 2012.

Key Risks Mitigating Actions

Call Answering Performance

❚ Clinical Hub restructure;

❚ Recruitment and training of additional Call Takers;

❚ Implementation of Demand Management Protocol;

❚ Improved call audit feedback to improve performance;

❚ Reconfiguration of ICCS database to support prioritisation of represented calls.

Ambulance Clinical Quality Indicators (AQIs) and New Response Targets

❚ AQI action plan with trajectory;

❚ AQIs incorporated within Corporate Objectives and monitored by the Corporate Performance Review Group;

❚ Clinical Hub restructure;

❚ Implementation of version 6.4.2 of NHS Pathways;

❚ Re-modelling exercise.

Impact of Resource Escalatory Action Plan (REAP) Levels, and Summer, Winter and Peak pressures

❚ Gold Resource Escalatory Action Plan meetings in place if required;

❚ Monitoring by Corporate Performance Review Group;

❚ Business Continuity Policy in place with plans developed for each function;

❚ Member of Local, Regional and National Resilience Forums;

❚ Handover procedure agreed with Commissioners.

Attendance and Wellbeing

❚ Attendance trajectory monitored by Corporate Performance Review Group;

❚ Sickness Absence Work Programme developed;

❚ Introduction of operational manager scorecard;

❚ Tightened procedures relating to sickness absence notifications.

Industrial Action

❚ Resilience and mitigation plan in place;

❚ Mutual aid arrangements;

❚ Guidance developed for managers;

❚ Service exemptions agreed with staff side;

❚ Ongoing communication and involvement to engage positive industrial relations.

Tender Application

❚ Dedicated Senior Project Manager;

❚ Project Board established;

❚ Mobilisation Plan developed.

Fuel Price Increases

❚ Escalation process for expenditure overspend;

❚ Fuel Reduction Action Group;

❚ Fuel Reduction Action Plan with identified lead monitored by Corporate Performance Review Group.