Our
Quality
Account
2009/10
Published in June 2010
Contents
Part 1
An introduction
4
Board Assurance Statement
4
Chief Executive’s Quality Statement
5
Part 2
Our future priorities
7
Our current quality performance
11
Part 3
Review of Quality performance
20
Our local improvement priorities
25
An overview of our Trust
East Midlands Ambulance Service NHS Trust
(EMAS) provides emergency and urgent care
and patient transport services for the 4.8 million
people within the six counties of Derbyshire,
Leicestershire, Rutland, Lincolnshire,
Northamptonshire and Nottinghamshire.
We employ over 3,500 staff at more than 70
locations, including two control rooms at
Nottingham and Lincoln, with the largest staff
group being our accident and emergency crews.
Every day we receive around 2000 calls for help
from members of the public calling 999 and
healthcare professionals such as GPs. Our
accident and emergency crews respond to over
500,000 emergency calls every year, while our
Patient Transport Service (PTS) and volunteer
ambulance car drivers provide care and
transport on over 5,000 journeys to and from
routine appointments each day.
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Our
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Part 1
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Introduction
We have compiled this document to provide readers with information about EMAS’ past,
current and future activities on the important subject of quality.
The EMAS Trust Board (the Board) is fully committed to embedding quality within the organisation and
can demonstrate its ambitions by the support given for the introduction of new ways of working and the
creation of new, specialised posts.
In addition, the Board is intent on bringing about a culture change within the organisation which will give
staff, stakeholders and the general public a much greater say in how the service operates.
The Board has used this approach to help develop many of the initiatives laid down in this Quality
Account and the Board will continue to follow this course in future as EMAS strives to become one of the
country’s top performing and safest ambulance services – with a culture of continuous quality
improvement and innovation at its heart.
Board assurance statement
Every member of the EMAS Trust Board has been involved in identifying the quality indicators,
agreeing the content and endorsing the content of this Quality Account.
We have identified two Executive Directors with specific responsibility for safety, clinical effectiveness
and patient experience and they will play a vital role in assessing performance and developing our future
strategy.
We have shared our quality indicators with our commissioners and aligned our quality indicators with the
Commissioning for Quality and Innovation (CQUIN) framework.
We have developed our metrics (measures, quality indicators) in consultation with our staff and involved
many external stakeholders in the overall process of quality improvement.
Board members will closely monitor the organisation’s performance in this crucial aspect of our affairs as
an integral part of their overall responsibilities.
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Chief Executive’s quality statement
Welcome to East Midlands Ambulance Service’s (EMAS)
first annual Quality Account which provides:
A summary account of our performance against selected
quality metrics (measures) for 2009/2010.
Details of our quality priorities for 2010/2011.
As Chief Executive, I am determined to champion that quality
is central to everything we do and this is therefore the
governing principle in our business strategy.
Our vision is to sustain our position as one of the country’s
top performing ambulance services whilst becoming the
safest ambulance trust with a culture of continuous quality
improvement and innovation at its core.
We will strive to embed quality in all we do and endeavour to achieve value for money. Also, we have a
duty to innovate so we deliver the best care now and in the future. Continuous quality improvement will
secure financial cost efficiencies which we can reinvest into our patient services and thus achieve the
Trust’s priorities.
The delivery of excellent patient care is a core value for EMAS and to achieve this we are reliant on our
greatest asset - our staff. We recognise their on-going commitment, dedication and passion is a vital
ingredient in the delivery of our objectives. In consultation with our workforce, we developed a set of
‘core values’ which reflect our commitment to delivering high quality care so that our patients have the
best possible experience whilst in our care. These core values are Respect Integrity Contribution
Teamwork and Competence.
We have achieved high levels of patient satisfaction year-on-year and aim to build on this foundation by
being an organisation in which every member of staff understands their role in delivering safe clinical
care. We will achieve this through our ambitious programme ‘Driving Quality, Delivering Change’.
I am confident that the Trust’s strategy which has quality and safety at its core will lead to further
improvements in patient’s experiences. This approach is fully endorsed by the EMAS Trust Board and at
every level of the organisation.
The improvements we have delivered to date demonstrate the level of engagement and active
participation of all staff who recognise the financial benefits and positive impact that quality
improvements have on our patients’ experience. We will continue to develop our quality plans by
benchmarking our performance against those achieved by other Trusts which have successfully
embedded patient experience within their performance culture. We will also introduce new systems to
ensure we obtain effective feedback from stakeholders and patients to allow us to further develop and
refine our approach.
The years 2010/2011 will be an exciting and challenging. Exciting because we have the opportunity to
offer an even better service to our patients; challenging because of the worldwide economic climate that
makes it an imperative to continue to identify and introduce the most efficient and effective ways to
support care delivery.
In conclusion, I am confident we will achieve our vision of delivering the highest level of quality care and am
pleased to have the opportunity to confirm my personal commitment in this, EMAS’ first Quality Account.
To the best of my knowledge, the information contained in this Quality Account is accurate and reflects a
balanced view of EMAS’ current position and future ambitions.
Paul Phillips
Chief Executive
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Our
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Part 2
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Our future priorities
This section contains information relevant to the quality of NHS services provided or sub-contracted by
EMAS during the reporting period which is prescribed for the purposes of section 8(1) or (3) of the Act by
paragraph (2).
In association with patients, staff and other stakeholders, most notably the East Midlands
Strategic Health Authority (EM SHA) and our lead commissioners, Derbyshire County PCT we
have identified a broad range of key priorities for 2010/2011. These cover what are considered to
be the most relevant factors given the role EMAS performs in providing high-quality patient care.
Listed below are these key priorities and all have equal status in relation to their importance. The tables
beneath each section show what our performance measures are, how we will assess our performance,
who is responsible for delivery and how we will monitor progress:
1.
Improving patient safety
We are committed to improve the safety of our patients and demonstrated this by signing up to
the Patient Safety First campaign in December 2009. Through this, we have pledged to focus on
six actions (as a minimum) to improve quality and reduce harm. These are:
1.
2.
3.
4.
5.
6.
Develop explicit strategic priorities and goals
Provide demonstrable leadership
Ensure executive accountability
Establish and monitor safety metrics
Monitor progress and drive executive plans
Build patient safety and improvement knowledge and capability.
To meet our pledges we are carrying out a substantial portfolio of work which includes:
Assessing what the organisation’s ‘safety culture’ level is now and developing an action
plan to move towards an improved level
Making a commitment at Board level that patient safety is our highest priority
Introducing a Patient Experience Lead post to engage with patients and the public and use
the feedback received from patients to learn and improve
Developing a staff training programme to ensure the organisation and its staff continuously
improve performance
Identifying high level aims and demanding targets for 2010/2011 and setting up workstreams to ensure we achieve our goals.
The appointment of a Deputy Director of Nursing and Quality (who has specialised knowledge
and experience in patient safety) has improved our capacity to meet the challenges ahead and a
robust Patient Safety Strategy has been developed covering important issues such as infection
control, safeguarding vulnerable adults and children and a number of other aims linked to
delivering our quality agenda.
We developed this strategy in consultation with staff and we will use it to measure and monitor
our performance. It builds on the following four work streams:
Safe care
Safe fleet
Safe staff
Safe service.
We have identified three priorities:
To move EMAS towards a safety culture (reporting, learning and a just culture)
To provide demonstrable leadership from Board level to front-line staff
To increase capability in improvement science.
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Our ultimate goal is to become the safest ambulance trust in the country which means
NO cases of avoidable harm and NO avoidable deaths.
Sustaining compliance with the Hygiene Code
During 2009, the Care Quality Commission (CQC) inspected EMAS and found us non-compliant
in some areas. We developed an action plan and in December 2009, were found to be fully
compliant with the regulations. We have since introduced additional infection prevention and
control specialists and this, along with the commitment of our staff, will ensure on-going
compliance in this vital area. Our focus in 2010/2011 is to do everything necessary to reduce risk
to patients and ensure the cleanliness of our vehicles and premises is to the highest possible
standard.
Safeguarding vulnerable adults and children
We declared non-compliance with the CQC registration process in relation to the requirements
for safeguarding. We learned a number of lessons through the CQC Health Care Acquired
Infection (HCAI) inspection and have translated these to our safeguarding agenda. As a result,
we have developed a robust and ambitious action plan which will support achieving full
compliance by 31 Dec 2010.
We will use the following metrics to assess and improve performance:
Our priorities
To be measured by
Responsibility
lies with
To be monitored by
4 work streams:
Patient safety
- Safe care
- Safe fleet
- Safe staff
- Safe service
Trust Board
Commissioners
Director of Nursing
CQUIN schedule.
Each workstream will
identify demanding
goals
Quality Indicators
Audits of observed
practice
Sustaining
compliance with the
Hygiene Code
Audits of vehicle
cleanliness
Audits of Cleanliness of
premises
Trust Board
Director of Nursing
Lead Commissioner
Training in infection
prevention and control
figures
Number of referrals to
social services
Safeguarding
vulnerable adults and
children
Trust Board
Number of staff trained
Audits of staff
awareness against
safeguarding policies
and procedures
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Quality indicators
Commissioners
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2.
Improving the patient experience
The development of a Patient Experience Strategy and the introduction of a new ‘Head of Patient
Experience’ post will allow us to broaden the methods we use to capture feedback from patients.
This will lead to an improved understanding of their needs. The new measures will include:
the development, use and learning from patient stories
mapping patient journeys through the system
gathering data from surveys, interviews and face-to-face contacts with patients and/or
through other NHS organisations.
We recognise that the experiences of patient whilst in our care is extremely important if we are to
learn from those we provide care to and thus improve our services.
We will use the following metrics to assess and improve performance:
Our priority
To be measured by
Responsibility
lies with
To be monitored by
Trust Board
Patient experience
Number of surveys
undertaken
Director of Nursing
Number of patient
stories
Strategic Learning
Review Group
CQUIN schedule
Quality Indicators
3.
Improving clinical effectiveness
National Clinical Performance Indicators (CPIs) allow Trusts to assess their performance against
other Trusts and to identify areas where improvement is needed. Another important aspect of the
CPI process is the development of a local improvement plan which allows Trusts to assess
current performance against historic base-line achievements. We have carried out four CPI
assessments and identified asthma care as a priority area for improvement. We continue to work
with staff to develop appropriate interventions to achieve better care for asthma patients such as
the recording of peak flow rates (which measure a patient's maximum speed of expiration readings are higher when patients are well, and lower when the airways are constricted) and
oxygen saturations (a measure of how much oxygen the blood is carrying as a percentage of the
maximum it could carry).
We will use the following metrics to assess and improve performance:
Our priority
To be measured by
Clinical effectiveness
All clinical performance
Indicators to be
measured every 6
months
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lies with
To be monitored by
Trust Board
Medical Director
CQUIN schedule
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4.
Valuing our staff
We have introduced an organisational development approach to service transformation through
our ‘Driving Quality, Delivering Change’ programme. This programme, which builds on feedback
received from staff in the National Staff Opinion Survey has six key elements:
Clinical leadership and clinical education
Driving quality
Engaging with staff
Leadership and management development
Service and workforce strategies
Employment relations.
Our results in the NHS Staff Opinion Survey 2009 also revealed other areas for improvement, in
particular the way the organisation communicates and consults with staff and a need to further
develop our clinical, leadership and management skills. In response, we have further developed
our ‘Driving Quality, Delivering Change’ programme.
We will use the following metrics to assess and improve performance:
Our priority
Valuing our staff
5.
Responsibility
lies with
To be measured by
The metrics in our
Service Improvement
Plan (linked to the
Driving Quality,
Delivering Change
agenda)
Director of Workforce
and Strategy
To be monitored by
Trust Board
Review of Operational Performance Delivery plan
During 2009/2010, EMAS experienced an unprecedented increase in call volume across the
Region with every Division experiencing peaks in demand of both Category A and B Calls.
To address the challenges, we introduced a Performance Improvement Team to drive
Sustainable Performance Improvement by providing additional support to operational
performance delivery.
Many of the objectives of the team are concerned with data collation, analysis and performance
improvement. In the longer term, consideration will be given to integrating the team’s outputs into
other organisational initiatives, for example, the Driving Quality, Delivering Change programme.
Our priority
Category A calls National target: 75%
responded to within 8
minutes.
Category B calls National target: 95%
responded to within
19 minutes.
To be measured by
Reported by
To be monitored by
Executive Team
Performance Indicators
(national)
Director of Operations
Trust Board
Please see the end of this document to find out how you can contact us for more information on
any of the programmes or strategies we have developed and introduced.
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Our current quality performance
During 2009/2010 EMAS provided NHS services. EMAS has reviewed all the data available to
them on the quality of care in all of these NHS services.
EMAS proves 4 service lines (specific operational or organisational roles):
Accident and Emergency services
Patient Transport Services
Operational Support Functions (Control, Fleet, Estates)
Corporate Functions (Specialist Directorates: Human Resources, Organisational Learning, Nursing
and Quality, Clinical, Finance).
All of these service lines have been reviewed for the purposes of the Quality Account.
We use a broad range of techniques to assess our performance, for example:
a ‘dashboard’ monitoring system which allows us to track performance against key activities daily
by carrying out unannounced ‘spot checks’ of our stations, vehicles and equipment
Patient stories are reviewed by our Board
Members of our Executive team conducting ‘safety walkrounds.’
The income generated by the NHS services reviewed in 2009/2010 represents 100% of the total income
generated from the provision of NHS services by EMAS in 2009/2010.
The following information identifies what we did during the year to monitor and assess our quality
performance outcomes. The information demonstrates that we have made good progress in many areas
whilst acknowledging that there is scope for further improvement in others during 2010/2011:
Participation in Clinical Audits
During 2009/2010, 3 national clinical audits and 1 national confidential enquiry covered NHS services
that EMAS provides.
Pre-hospital Thrombolysis (Pht)
Clinical Performance Indicators
Number of cardiac arrests, number of patients treated with public access defibrillators (British Heart
Foundation)
Head injuries in children (Confidential Enquiry into Maternal and Child Health)
During that period, EMAS participated in 66% and 100% respectively of the national clinical audits and
national confidential enquiries which it was eligible to participate in.
The national clinical audits and confidential enquiries that EMAS participated in during 2009/2010 were:
Pre-hospital Thrombolysis
Clinical Performance Indicators
Head injuries in children (Confidential Enquiry into Maternal and Child Health.
The national clinical audits and national confidential enquiries which we participated in during 2009/2010
(for which data collection was completed during 2009/2010) are listed below alongside the number of
cases submitted to each audit or enquiry as a percentage of the number of registered cases required in
the terms of that audit or enquiry:
Treatment
Number of cases identified
Percentage sampled
Pre-hospital Thrombolysis
503
100%
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Clinical Performance Indicators
The National Clinical Performance Indicators are drawn from a one month sample of up to 300 cases for
each indicator that is repeated every 6 months. In some cases there are less than 300 patients who will
have presented with a specific condition. Where this is so, the sample consists of all patients known to
have the condition. In all cases the sampling size was 100% (300 cases or ALL patients presenting with
a specific condition).
Treatment
Number of cases identified
Percentage sampled
Asthma
242
100%
Cardiac Arrest
217
100%
Hypoglycaemia
300
100%
STEMI
165
100%
Stroke
300
100%
Confidential enquiry into
Maternal and Child Health:
Head injuries in children
35
100%
We reviewed the reports of two national clinical audits in 2009/2010 and intend to take the following
actions to improve the quality of healthcare provided to patients:
Pre-Hospital Thrombolysis (PHT)
Results from our Pre-hospital Thrombolysis audit are monitored by our Quality Assurance Group which
is chaired by our lead commissioners. The introduction of alternative treatment pathways, such as
Primary Percutaneous Coronary Investigation - a treatment which removes the blockage to the heart
which has caused the heart attack (PPCI) has resulted in the numbers of patients we treat with PHT
reducing. However a project to lower our ‘call to needle’ time commenced in April 2010 and this will
improve the outcome for patients who are suitable for PHT treatment.
Clinical Performance Indicators
Results from the Clinical Performance Indicators are analysed and fed into our educational programmes.
We reviewed the results of 5 local clinical audits in 2009/2010 and took the following actions to improve
the quality of healthcare provided:
Non-Conveyance to a treatment centre: A project to improve the safety of patients who are not
conveyance commenced in April 2010. This included introducing a ‘calling card’ for patients who
are either treated at the scene or do not need any treatment. Non-conveyance of patients who
experience a fall forms part of the CQUIN (Commissioning for Quality and Innovation) schedule.
Infection Prevention and Control: We carry out monthly audits to monitor compliance against
the Hygiene Code. All actions are assessed through an internal meeting structure and then
reviewed by the EMAS Board and our lead commissioners on a bi-monthly basis. To further
improve our quality standards, during the year we introduced:
a four-weekly deep clean cycle for vehicles
a ‘bare-below the elbows’ campaign
a review of signage and checklists to ensure cleaning cycles are met
improved communications with staff
a four-day mandatory training programme for all employees
additional posts within our management structure and appointed staff with expertise in
infection prevention and control.
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Safeguarding: We reviewed and strengthened our infrastructure to provide a range of expertise.
We reviewed and updated our Policies and Procedures. We commenced a training programme
focussing on safeguarding vulnerable adults and child protection issues.
Patient Report Forms (PRF): We increased the numbers of forms audited to make the sample
size more representative.
Inappropriate Cannulation: We introduced an educational programme to reduce the number of
inappropriate intravenous cannulations – where a needle is inserted into a vein to deliver
medicines or fluids.
Participation in Clinical Research: The number of patients receiving NHS services provided by
EMAS in 2009/2010 that were recruited during that period to participate in research approved by
a research ethics committee was 12. The research exercise was on pre-hospital pain
management (all patients live in Lincolnshire).
Goals agreed with our lead commissioners
Use of the Commissioning for Quality and Innovation (CQUIN) framework
We consulted with our lead commissioners and agreed a number of goals as an integral part of our
contracting process and CQUIN schedule. These goals were set to allow us to demonstrate quality - they
are demanding and will be a stimulus for improvement. They were set partly in response to our
performance and partly to provide our commissioners with assurance that EMAS is achieving year-onyear improvements.
A proportion of EMAS’ income in 2009/2010 was conditional on achieving quality improvement and
innovation goals agreed between EMAS and Derbyshire County PCT (our lead commissioners) through
the Commissioning for Quality and Innovation payment framework. Further details of the agreed goals
are available on request (see the end of this document for contact details).
What others said about us
Statements from the Care Quality Commission (CQC)
EMAS is required to register with the Care Quality Commission and its current registration status, as of
31 March 2010, is fully registered with no conditions.
The Care Quality Commission has established, in accordance with the Health and Social Care Act 2008,
a new registration process effective from 1 April 2010. EMAS has been informed that it is now registered
to carry out the regulated activities applied for which cover Treatment of disease, disorder or injury and
Transport services, triage and medical advice provided remotely.
EMAS is subject to periodic reviews by the CQC and a visit took place on the 11 and 12 August 2009.
The CQC reported:
During the inspection against the risks of acquiring a healthcare associated infection, 17 measures were
inspected and there were no concerns about 10. For four measures, the CQC identified a breach of the
regulation and made requirements of the Trust. For the other three measures the CQC found areas for
improvement and made recommendations to the Trust.
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On a follow up inspection on the 4th November, the CQC reported:
The CQC visited to gain assurance that EMAS had implemented these recommendations and
requirements. The result was the trust had not addressed the seven areas for improvement. Although the
trust had made some progress, it did not provide adequate assurance that it had fully addressed all
requirements and recommendations. For five measures, the CQC identified a breach of the regulation and
made requirements of the trust. For the other two measures the CQC found areas for improvement and
made recommendations to the trust. The CQC issued a warning notice to the trust on 26 November 2009
and made specific requirements of the trust. The Care Quality Commission has taken enforcement action
against EMAS during 2009/2010.
As a result of the first CQC inspection, actions were taken to achieve compliance. We:
introduced a comprehensive 4-weekly deep cleaning programme for all our vehicles
developed audit tools and an audit programme (commenced August 2009)
analysed our audit findings and introduced changes to practice (agreed via our Strategic Learning
Review Groups)
worked closely with our partners in acute trusts to ensure EMAS staff are compliant with the ‘Bare
Below the Elbows’ initiative to reduce patient infection risk
introduced a communications strategy to raise staff awareness on the importance of infection
prevention and control
recruited a specialist lead nurse for Infection Prevention and Control
introduced a robust vehicle decontamination programme
On a follow-up inspection on the 17 and 18 December 2009, the CQC visited EMAS to gain assurance
that we had implemented these recommendations and requirements and complied with the warning
notice. The CQC reported:
When the CQC carried out a follow-up inspection in December 2009, they found no evidence that EMAS
has breached the regulation to protect patients, workers and others from the risks of acquiring a healthcareassociated infection. We confirm that EMAS has provided assurance that all seven areas for improvement
have been addressed and that EMAS is fully compliant.
Statements from Local Involvement Networks (LINKs)
Leicestershire Local Involvement Network (LINK) response to the East Midlands Ambulance
Service NHS Trust
Leicestershire LINk welcomes the opportunity to comment on the East Midlands Ambulance Service NHS
Trust’s first Quality Account which we would commend as addressing all the requirements of the
Department of Health. We would congratulate the programme of work the Trust has undertaken on
improving patient safety, which demonstrates their commitment to patient safety. We would also highly
commend the priorities for local improvement and look forward to seeing the outcome in next year’s report.
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Nottinghamshire County and Nottingham City LINks response to the Quality Account of East
Midlands Ambulance Service
The Nottinghamshire County and Nottingham City LINKs are delighted to provide our comments on the East
Midlands Ambulance Service (EMAS) Quality Account. Below is a list of four key points that we would like to
make:
1. We feel that the clinical audit indicators need more clarification to justify the 100% rating that has been
given, especially given the very large area covered by EMAS
2. The document explains the use of patient surveys conducted every 6 months. The Nottinghamshire
County and Nottingham City LINks would like to see the numbers of patients surveyed, rather than just
percentages as without the numbers surveyed, these figures are difficult to read.
3. The report highlights the number of complaints received during 2009/2010. The Nottinghamshire County
and Nottingham City LINks were surprised that this number was so low (250) given the size of the area
that EMAS covers
4. Finally, we at LINk would like o acknowledge that significant improvements to EMAS services have been
made during the past year, and are pleased to see that strategies have been put in place for 2010 /
2011.
We hope that we have been able to make a valuable contribution to this Quality Account, and look forward to
working with EMAS in the future.
Changes made as a result of feedback:
We provided more information on the audit sample sizes to give clarity
We included numbers of participants in the patient survey
We included information on PALS activities and confirmed the number of complaints received.
Northamptonshire LINk
We thank you for sending us a copy of the draft Quality Accounts for 2009/2010. LINk has looked at these
and is attaching the following statement.
LINk is very aware that this is the first time the Trust has reported on a Quality Account and therefore
appreciate its content and acknowledge the timescale the Trust has had to work to.
LINk agrees that the statements of improvement and direction, as far as LINk is able to judge and measure,
are accurate and represent the Trust’s achievements and intention.
LINk will endeavour to work with the Trust throughout the coming year to ensure the public is well-informed
and that the patient experience is heard and acknowledged.
We look forward to seeing the patient strategy and working with the new post holder for patient experience.
LINk will report and monitor along the way.
Statements from Overview and Scrutiny Committees (OSC)
No statements were provided.
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Statement from our Lead Commissioner – NHS Derbyshire County (on behalf of associate
commissioners):
The East Midlands Ambulance Service NHS Trust (EMAS) Quality Account 2010 broadly reflects the
information received by NHS Derbyshire County (the PCT) through its contract monitoring arrangements.
The PCT has well-established mechanisms in place for checking service quality as part of its contract
monitoring. Over the past year the PCT has worked closely with EMAS to increase their focus on quality, in
particular patient safety, which was assessed, during the year, as an area requiring increased attention.
The PCT and the East Midlands Strategic Health Authority provided significant support to EMAS to improve
compliance with the Hygiene Code following the Care Quality Commission inspections in 2009 for this area
and also for Safeguarding Children and Vulnerable Adults. EMAS worked openly and collaboratively on this.
It is reassuring to note that they have recruited more staff with skills in this area and improvements are
evident through follow-up audits.
EMAS has agreed a number of quality measures with the PCT, some of which attract a quality incentive
payment. During 2010/2011 the focus will be on clinical quality measures such as treatment of people who
have had a heart attack or asthma attack along with showing improvements in their own outcomes on an
ongoing basis.
Other PCTs commented that it would have been helpful for the account to show performance in such areas
as heart attack care and treatment, arrival times (to the scene) and non conveyance rates (keeping people
at home) and for this to be presented by the different divisions e.g. Leicestershire and Northamptonshire EMAS is planning to develop this next year.
Developing a culture or environment where patient safety is paramount is vital and the PCT will monitor
performance in this area through a variety of methods, such as clinical incidents reported, complaints,
patient experience surveys, compliance with the law and inspections/visits.
The PCT will continue to work with EMAS to encourage and support continued improvements in the quality
of care.
EMAS was disappointed not to have achieved the two key response targets in 2009/2010. However, the
targets were met in the previous year and it may be helpful to the public for this information to be included
next year.
Quality Accounts are intended to help the general public understand how their local health services are
performing and with that in mind they should be written in plain English. The PCT has concerns that the
format and language of this Quality Account does not help local people to understand the level of
performance.
Changes made as a result of feedback:
We included information about performance standards for previous years
Our Communications Team made improvements to the readability and layout of the report to improve
the format and language.
Statement from East Midlands SHA Medical Director
This account is clear and laid out in an accessible way. It is good practice to state which groups have been
consulted; which it does do. The ambition to be the safest Ambulance Trust is to be commended.
In Part 1, the statements do not include a summary of which service lines have been reviewed.
In Part 2, it would be helpful to state how much improvement is the goal. This will be important when
assessing progress next year. Some of the measures seem to simply be setting up metrics? There could
be some ambition with respect to benchmarking.
In Part 3, the review of the year could include graphs and tables with comparative data, or trends. Much of it
relies on a narrative, so the balance of qualitative and quantitative could be altered. Pictures and colour and
possibly patient stories of their experience would bring it alive? It would be useful to get a sense of what
EMAS will look like in terms of quality in 12 months time.
This Quality Account could be easily improved by some fairly simple changes.
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Changes made as a result of feedback:
We included information on service lines
Where possible, we included benchmarking information
We included graphics and a selection of patient stories
In the final design phase, we included pictures and made use of colour to visually enhance the
document.
Patient stories
During 2009/2010 we received 442 letters of thanks from grateful patients, their relatives or carers.
The following extracts from a small selection of letters show how much people who use our services
appreciative the quality of care provided:
Having just survived a life-threatening medical experience I can only express my thanks to the East
Midlands Ambulance Service and your team of paramedics.
I am writing to pass on my appreciation for the excellent service I received from EMAS.
I recently had to call 999 to attend to my mother. I thought I must congratulate your swift response and total
professionalism. My call was dealt with efficiently and I was given excellent advice by your operator who also
held on the line to offer further advice.
My wife and I recently had cause to call on the service of your Paramedics. After calling 999 we were very
impressed by the speed of response and the care received from your staff.
I would like to pass on my thanks to the ambulance team who responded to my call for help. They did a
fantastic job and ensured my mum’s partner was given the best care.
I wanted to say thank you to the lady who was on the phone when I called 999. My little girl had fallen off
the sofa, stopped breathing, turned blue and then had a fit. I was totally hysterical but your operator was
lovely.
I should like to thank all the staff involved in the response to my 999 call when my husband collapsed.
Everyone was very efficient, kind and supportive. We are both most grateful for what they did.
This morning, I was taken unwell while driving and had to call out the ambulance service as I was worried I
was going to collapse. The person who took my call kept me calm on the phone whilst pinning down my
exact location and the paramedic crew arrived on scene very quickly. Both Paramedics were great,
professional and comforting and went beyond the call of duty to help me.
We welcome complaints because each case gives us the opportunity to investigate, respond to the
points raised and use the lessons learned to improve and change for the benefit of the public we serve.
We send details of all complaints to our network of Learning Review Groups. These teams identify key
themes and learning points and then share the outcomes with staff so everyone is aware of what
problems have been raised and what has been done to prevent recurrence. From April 2010, we send a
satisfaction survey to each complainant so we can assess if our handling of the complaint met their
needs and expectations.
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The following information provides examples of what we did in response to two complaints
received during the year:
Complaint
You were particularly concerned that your daughter suffered a broken leg and you believe
this was a result of the ambulance crew moving her from her bed onto the stretcher. There
was also a concern that pain relief was not given on scene and the option was not given
for a carer to accompany her to hospital when she travelled.
Action Taken
We undertook a thorough investigation which revealed the type of fracture sustained could
not have been caused by moving your daughter. We recognised the need for a review of
the patient’s specialised care needs and contact the GP and other healthcare agencies to
discuss this. We then developed a personalised care plan for the patient. This included a
requirement for attending crews to carefully consider the need to administer pain relief on
scene and a reminder that the carer should always be offered the option of accompanying
the patient to hospital.
Complaint
You were particularly concerned that an ambulance was sent under emergency 999
conditions but the call was then downgraded and the crew continued their journey under
normal road conditions. You were also concerned that when you made a follow-up 999
call, you were asked the same questions again.
Action Taken
We established the Triage Nurse had categorised the call correctly but had not made it
clear to the caller that the ambulance would not be travelling under emergency conditions.
We brought this to the attention of the Nurse to ensure callers are in future given this
information. We also advised the complaint why it is necessary for the same questions to
be asked again if a second call is made i.e. we need to establish whether the patient’s
medical condition has worsened since the first call.
Data Quality
EMAS did not submit records during 2009/2010 to the Secondary Users Service for inclusion in the
Hospital Episode Statistics which are included in the latest published data.
EMAS’ score in 2009/2010 for Information Quality and Records Management, assessed using the
Information Governance Toolkit, was 15 (out of a maximum score of 18).
EMAS was not subject to the Payment by Results clinical coding audit during 2009/2010 by the Audit
Commission.
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Our
Quality
Account
Part 3
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Review of quality performance
EMAS is required to achieve a range of performance outcomes specific to the nature of the
services we provide to the public as well as many other organisational responsibilities as laid
down by Department of Health.
The following information provides evidence that EMAS is performing very well in relation to certain
quality measures and that, compared with other ambulance trusts, we are making significant progress in
the areas where further improvement is necessary.
Performance against national targets (1 April 2009 to 31 March 2010)
Our key performance measure is how quickly we respond to 999 calls. We have a consistent track
record of achieving the standard for responding to 75% of category A, serious life-threatening calls within
8 minutes and 95% of category B, non life-threatening calls within 19 minutes. However, early last year
we experienced an increase in demand resulting in us responding to 5% more emergencies in
2009/2010 than in the previous year. In early 2010, we also experienced the worst weather conditions for
30 years. These two factors had an adverse effect on our results for 2009/2010.
The following graph provides details of our performance achievements over the last three years:
Category 'A' Performance
Category 'B' Performance
100.00%
90.00%
80.00%
70.00%
60.00%
50.00%
95.03%
94.17%
40.00%
79.45%
76.06%
94.51%
73.72%
30.00%
20.00%
10.00%
0.00%
2007/2008
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Preparing to respond to a state of emergency
We developed a Pandemic Influenza Plan which was audited by the EM SHA in 2009 and passed as
fully compliant. The EM SHA scored us at 98% which placed EMAS in the top two Ambulance Trusts in
the country for pandemic planning. In June 2009, our Emergency Preparedness Team arranged to
‘stress test’ the plan in an exercise involving operational personnel and the Trust’s senior managers. The
plan was viewed as robust with no changes made. We also set up a special Programme Board to
manage the possibility of a swine flu outbreak and subsequent pandemic. This approach allowed us to
provide assurance to the EMAS board that the organisation could declare its Statement of Readiness.
In April 2009, our Emergency Preparedness capability was improved by the introduction of the EMAS
Hazardous Area Response Team (HART). The Department of Health provided funding of £2.5m to
develop this initiative which allows us to deploy specially trained Paramedics to assess, rescue and treat
patients in hazardous areas, such as collapsed buildings and the scene of terrorist incidents. The
funding also allowed us to purchase 8 specialised HART vehicles and substantial amounts of new
equipment and uniform.
AMPDS Accreditation
In 2009, EMAS control staff achieved Automated Medical Priority Despatch System (AMPDS)
accreditation which recognised EMAS as an Emergency Medical Dispatch Centre of Excellence. In doing
so, we became the first organisation in the world to achieve Multi-Control Room Accreditation. The
award recognises our implementation of and compliance with AMPDS (the world’s most widely used
emergency dispatch system) and the excellent standard of care given to the public. The system, which
has been credited with helping save thousands of lives worldwide, gives control staff scripted life-saving
telephone instructions for situations such as resuscitation, airway obstruction, control of bleeding and
childbirth.
Electronic Patient Report Form (ePRF)
ECS (Emergency Care Solution) is the system the NHS has provided for ambulance services to replace
paper based Patient Report Forms with an electronic version - the ePRF. This is accessed by staff on
small, rugged laptop called a ToughBook. The first area to upgrade to the new system was Derbyshire
and we are now in the process of extending the use of ToughBooks throughout EMAS.
The ToughBooks also give front-line staff instant access to electronic information systems to help them
provide the best patient care. This includes clinical information on the diagnosis and treatment of specific
medical conditions, information on the administration of drugs and information on the diagnosis and
treatment of patients who are suffering from poisoning. The ToughBook allows EMAS staff to transmit
information about the patient’s condition to the hospital they are going to so they can prepare for the
patient’s arrival and subsequent emergency treatment. As the national NHS database develops,
ToughBooks will also give staff access to patients’ medications, allergies and past medical history and
eventually be able to arrange appointments and referrals to other parts of the NHS.
This approach will deliver clear safety and quality of care benefits to all patients.
Fleet
As the result of a £9m capital investment, 91 new ambulances are being introduced across EMAS with at
least one vehicle going to every EMAS station. These ambulances have been designed with the help of
a panel of staff from across EMAS whose views were sought to ensure operational needs were catered
for and that the ambulances were fit for purpose. This approach has led to all vehicles having a
standard equipment layout makes it easier for staff to replenish medical consumables to the correct level
and deliver the best possible patient care. The vehicles feature the latest medical equipment and have
CCTV installed to improve the security of staff.
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Equality and Diversity
We took a number of steps towards ensuring compliance with our equality, diversity and human rights
obligations and have published our Single Equity Scheme which is supported by the introduction of:
A Board level ‘Equalities Champion’
An Equalities and Human Rights Policy
An Equalities training matrix
A special session on Equalities at a Board away day
Equalities training for our Human Resource recruitment and selection team
Equalities training on our corporate induction courses
Briefings on Equality Impact Assessments to managers
The full-time post of Equalities Manager
Equality Impact Assessments as part of all reviews of policies and procedures.
We organised the NHS’ first-ever Religious Summit, attracting many local faith organisations to the event
in Leicester. We engage with gypsy and traveller groups, taking practical steps to improve health care
delivery. We work with special interest third sector organisations in devising new care protocols (e.g.
Motor Neurone Disease Association) and introducing new partnerships within communities (e.g. British
Heart Foundation).
Improving Patient Safety
Improving cleanliness and reducing health care acquired infections (HCAIs)
In response to the CQC inspection which found EMAS to be non-compliant against the Hygiene Code,
we put in place a number of actions. These included a comprehensive staff training programme, the
development of a number of policies and procedures, improved communications, an ambitious audit
programme and a programme of spot checks of vehicles and premises. Support was received from EM
SHA and our lead commissioner. This involved expert guidance and consultancy. An action plan was
subsequently developed which allowed EMAS to achieve compliance in December 2009.
Keeping adults and children well, improving their health and reducing health inequalities
We underwent a CQC Safeguarding inspection which found that further work was required in multiagency training and audit. After the visit, we made progress in a number of areas to strengthen our
safeguarding practice. For example, we improved communication with staff to raise awareness and
revised several policies and procedures to encourage reporting and feedback to/from front-line crews. A
mandatory programme for staff also started in January 2010 which covered infection prevention and
control, safeguarding and identification and management of risk.
Improving the patient experience
We believe that listening to our patients is a cornerstone of quality. Therefore, developing mechanisms
to improve patient experiences is of paramount importance to us.
We have taken a proactive approach to engage with our local communities about the services we
deliver. Our front-line crews respond willingly to invitations to visit schools and nurseries to help give
young people news about our services and how to avoid accidents. We also take part in joint exercises
with other emergency services to help educate young drivers. We capture the views of patients and the
public at every opportunity and also promote electronic media such as our website, discussion forums
and e-mail facilities as ways of giving EMAS feedback about its services.
In addition to PALS and compliments information, we also use national survey programme information
(overseen by the CQC) to inform our approach to patient care. Every six months, we also carry out
surveys of patients who we take to Accident and Emergency and those who have travelled on our nonemergency Patient Transport Service (PTS). During 2009/2010 we surveyed 108 patients on topics such
as privacy, dignity, pain management, infection prevention and control, courtesy and respect.
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We have established Strategic and Divisional Learning Review Groups to ensure service improvements
are identified and then put into practice.
We incorporate patient experience metrics into the Board Performance Report and since January 2010,
patient stories are presented at Board meetings.
As part of our ambition to secure NHS Foundation Trust status, we have successfully recruited over
12,000 members. As ell as keeping this diverse group of staff, stakeholders and members of the public
in touch with EMAS’ overall achievements, we intend to use members as a sounding board for any new
initiatives we are proposing to introduce. We anticipate that issues relating to quality will become a
central theme in our communications activity.
Staff engagement
We have developed a staff engagement strategy which sets out the minimum standards required to
ensure staff can engage with managers - from their direct line manager through to the Chief Executive.
This was formulated in association with staff representatives and seeks to ensure that effective two-way
communications are always maintained.
As well as continuing with Directors tours (in which Directors visit stations across our area to give staff
the opportunity of face-to-face discussions), we are further developing staff communications by providing
alternative ways for them to put forward their ideas electronically. On-line polls and discussion forums
(topics posted will be responded to by an appropriate Director) are two examples of the new facilities
now available. In 2010, we will also re-launch our staff suggestion scheme.
Clinical Effectiveness and Excellence
Stroke
We have worked with the National and Regional Stroke project teams to implement the National Stroke
Strategy. This work involved looking at the geographical area we serve to ensure that equitable services
are provided to all the public we serve and that we have the capacity to deliver the stroke equitably.
The FAST (Face, Arm, Speech, Time) initiative has become the national driver for early recognition of
potential strokes and to speed up patients’ delivery to the most appropriate place of care. EMAS was the
first ambulance trust to use the FAST test in its Control Room setting to assess if a patient was having a
stroke leading to the swiftest possible response.
Over the last year, we have carried out FAST positive access trials at hospitals across our area and
there have been some great success stories. Patients have been assessed quickly by ambulance staff,
delivered to a stroke unit within the three hour window and successfully thrombolysed - resulting in much
improved recovery rates.
Angioplasty / PPCI (Primary Percutaneous Coronary Investigation)
Along with Stroke care, the treatment of patients who have suffered a heart attack (either a Myocardial
Infarction – when the coronary artery is partly blocked or STEMI – where the coronary artery is
completely blocked) is also a priority for EMAS. As part of the regional project team, we have worked
with leads from the EM SHA and Cardiologists to introduce pathways for this patient group so they are
admitted direct to an Angioplasty suite for immediate intervention. This is a change in the way we have
traditionally practiced and its success is reliant on our staff using their expertise to quickly identify and
assess potential heart attack patients and deliver them to the most appropriate treatment centre as
speedily as possible.
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National Ambulance Clinical Performance Indicators (CPIs)
A performance indicator is an assessment tool used to monitor and evaluate the key governance,
management, clinical, and support functions that affect patient outcomes (Joint Commission on
Accreditation of Healthcare Organizations 1992).
Therefore, CPIs can be used to signal successes and deficiencies in quality of care, to monitor
continuing performance of organisations and to measure the result of process improvement.
CPIs seek to ensure that high quality care is:
safe (no needless harm)
effective (evidence-based)
patient centred (no feelings of helplessness and in accordance with patients reasonable expressed
wishes)
timely (no needless delay)
efficient (no waste and with realistic outcomes)
equitable (fair to all patients).
Historically, national ambulance indicators have focussed on emergency response times with limited use
of validated clinical outcomes to measure effective care. Whilst in some cases, getting emergency care
quickly is important, response time indicators do not in themselves assess the quality of care provided.
True clinical audit should enable Trusts to evaluate the care they deliver and drive improvement.
To this end, ambulance services in England have worked in partnership to develop CPIs based on best
evidence and which meet the principles set out above. The current CPIs cover:
Cardiac Arrest
STEMI (heart attack)
Asthma
Hypoglycaemia (low blood glucose)
Stroke care.
EMAS coordinates the National CPIs on behalf of all UK ambulance trusts and so far, four audit cycles
have been completed.
Innovation
End of life care
Over the last two years we have worked to develop a system for ensuring the end of life wishes of
patients are met in the community when calling for an ambulance. Since implementing this collaborative
piece of work, we have developed a pathway through which our healthcare partners can register end of
life care decisions taken by their patients. These are then flagged on our Control system so crews
responding to a patient are aware before they arrive of the patient’s end of life wishes.
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Our local improvement priorities
We are committed to improving the quality of the service provided to patients and the public and
have undertaken a significant amount of work to achieve the best possible outcomes.
We will continue to build on this foundation and, as part of this work, will engage with our staff,
stakeholders and the public to develop our priorities for the future.
Activities will include developing a Patient Experience strategy and a Patient Safety strategy. Our
‘Driving Quality and Delivering Change’ programme in association with the improvements we have
achieved in infection prevention and control has given us a platform from which to benchmark
performance and identify our priorities.
The following information identifies what we will do during the year to further improve, monitor and
assess our quality performance outcomes.
Quality Indicators 2010/2011
Operational delivery
As an organisation, we are focused on improving the service delivered to patients and achieving the the
best possible clinical outcome. To maintain this in 2010/2011 we will ensure our performance standards
are maintained and improved locally.
We will also introduce a single Computer Aided Despatch system (used in Control to manage responses
to 999 calls) to align the Lincolnshire Control with our Horizon Place Control (which is responsible for
Derbyshire, Nottinghamshire, Leicestershire & Rutland and Northamptonshire). This will provide greater
resilience between the two Control rooms and improve our reporting processes. In the future we will look
to implement the 3 digit number and NHS Pathways into our Control Rooms to provide our public with
alternative care pathways within health and social care.
Quality Dimension
Category A & B
performance standards
to be achieved by each
operational division and
with no deterioration on
the year end position
2009/2010
Category C calls - an
appropriate vehicle
arriving at location of
patient
Calls received from
other Healthcare
Professional e.g.
doctors
Quality Statement
We will endeavour to
meet this target and the
national target
Quality Measure
Category A calls 75% responded to within
8 minutes and 95% within
19 minutes
Category B calls 95% responded to within
19 minutes
Identified area of
development
Where monthly
performance is below the
required standard, we will
consider putting recovery
plans into action.
As a Trust will endeavour
to meet the target
75% arriving within 60
minutes of call connect
Where monthly
performance is below the
required standard, we will
consider putting recovery
plans into action.
We will endeavour to
meet the target
A suitable vehicle to
arrive on the scene within
15 minutes of time
agreed
Where monthly
performance is below the
required standard, we will
consider putting recovery
plans into action.
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Patient Safety
EMAS aspires to be the safest ambulance trust in the country by 2015. To achieve this, we have
developed a 5-year Patient Safety strategy and set-up a number of work streams to focus on delivering
specific aspects of the strategy.
A cornerstone to our plans is to understand more about how harm occurs to patients and how we can
reduce harm. The two key factors towards progress are that:
EMAS needs to develop a safety culture through which all staff feel able to report safety incidents
EMAS learns from these incidents and apologises to patients, their relatives or carers when
avoidable harm has been experienced.
Our Patient Safety strategy identifies the steps we need to take to move towards a safety culture. We will
measure our progress through the Action Plan which forms part of the Patient Safety strategy.
The measures we will use to improve patient safety are:
Quality Dimension
Quality Statement
Quality Measure
The number of patient
safety incidents reported
Improve the reporting of
patient safety incidents
A reporting culture is one
characteristic of a safety
culture
Timeliness of patient
safety incidents reported
(serious untoward
incidents within 24 hours
to Primary Care Trust and
safety incidents to
National Reporting and
Learning System [NRLS]
within 25 days).
Number of SBARs used
during clinical handover
Use of SBAR
(structured
communication tool) to
improve clinical
handover (A&E
turnaround)
Introduction of
Executive Team safety
walkarounds
Using SBAR will improve
the clinical handover
between our crews and
A&E staff
Safety walkrounds will
identify harm as
experienced by
front- line staff
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Reduction of clinical
handover time
Improvement in
communication process
as measured by crew
satisfaction
Number of safety
walkrounds carried out by
members of Executive
team
Number of actions
developed as a result of
walkrounds
Quality Account 2009/10
Identified area of
development
An awareness campaign,
including training is
required
A baseline survey of
culture at Board level has
been carried out
We will carry out a staff
survey to obtain a
benchmark and then
develop an action plan to
move the achievement of
a safety culture forward
Collaboration with NHS
Institute of Innovation and
Improvement
Development of SBAR
Additional training for staff
Development of protocols
for walkrounds in
association with Patient
Safety First Campaign
Team
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Clinical Effectiveness
National Clinical Performance Indicators have identified a number of clinical priorities that we will focus
on. We have identified asthma care as an area where we are below the national average.
Incidents involving falls has been identified in the CQUIN assessment as a call type which accounts for a
significant number of the 999 calls we deal with. In partnership with NHS colleagues, we will work to
reduce the number of patients taken to hospital and, as part of our work, we have already set-up a Falls
Strategy group. This initiative will lead to fewer A&E admissions and improved care of falls patients in the
community. By reducing this type of demand, we will also be able to provide better services for other 999
callers.
The measures we will use to improve clinical effectiveness are:
Quality Dimension
Oxygen saturations
recorded by crew (SpO2)
recorded
Quality Statement
Measuring oxygen
saturation improves the
clinical effectiveness of
care
Quality Measure
Percentage of patients
identified having had
oxygen saturations
measured on PRFs
Identified area of
development
Improved asthma care
Target: 85%
Peak Flow recorded
before treatment for
asthma
Falls
Measuring peak flow for
asthma before nebulised
medicines are
administered improves
the clinical effectiveness
of care
EMAS responds to a
many 999 calls relating to
falls. Of these, many
result in no injury, or a
minor injury not requiring
medical intervention.
These patients are not
taken to hospital but may
be at risk of more serious
injury from repeat
episodes. Referral to a
GP or specialist may help
reduce the risk of further
falls and subsequent
harm
Percentage of patients
identified having had peak
flow measured on PRFs
Improved asthma care
Target: 30%
Percentage of patients
who have fallen but do
not need taking to
hospital where the GP is
informed of the fall or
where the patient is
referred to a specialist fall
service (if available)
Reduce numbers of
patients taken to hospital.
Improve the care of
frequent fallers in primary
care setting
Development of advice /
calling cards for patients
Patient Experience
We are committed to understanding the patient (and carer) experience and have developed a 3-year
Patient Experience strategy. This identifies a range of measures we will take to capture the data we
need to monitor progress. One area we will focus on is to explore different ways of capturing patient
experience information and to decide how best to use this to further improve our delivery of services to
the public.
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Being treated with dignity and respect is the right of every human being and we have expressed a desire
to sign-up to the Dignity in Care challenge so we can take this important area of care forward. The
measures we will use to improve the patient experience are:
Quality Dimension
Quality Statement
Quality Measure
Identified area of
development
Number of complaints
Complaints/ Patient
satisfaction surveys
Patient experience can be
measured by the number
and nature of complaints
and satisfaction surveys
Survey of complainant
satisfaction following
resolution.
Number of A&E and PTS
surveys undertaken
Patient Stories
Real time patient
experience can be
obtained from patient
stories and are powerful
agents of change
Dignity in Care
Being treated with dignity
and respect is the right of
every human being
Patient Experience
strategy developed.
Action plan identifies
areas for development.
Number of patient stories
Number of improvements
to care/service as a result
EMAS Board will sign up
to become Dignity
Champions
Development of a Patient
Experience strategy
Sign up to Dignity in Care
Challenge
The data we will use to support our Quality Indicators are:
Metric
The number of patient safety
incidents reported by EMAS
Data for 2009/2010
24 serious incidents were reported
Comments
We understand the number of
incidents we report are lower than
the national average for ambulance
trusts
Timeliness of reporting of patient
safety incidents (serious
untoward incidents within 24
hours to PCT)
24 serious incidents were reported 9 of these were reported within the
24 hour time limit
The reporting of safety incidents
to NRLS
108 incidents out of 244 were
reported to the NPSA.
EMAS is one of the lowest reporting
trusts. This will be addressed as
part of our Patient Safety strategy
Clinical handover times
Average times reported to be 15
minutes
Clinical handover is in part
controlled by the acute trusts and
their capacity to accept a patient
from the crew
Quality of handover as
experienced by staff satisfaction
Not measured
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We will work in partnership with our
lead commissioners and EM SHA
to improve this area of reporting
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Percentage of patients identified
having had oxygen saturations
measured on PRFs
Cycle 2
Cycle 3
Cycle 4
79.13%
80.99%
82.00%
Part of the CQUIN schedule
Percentage of patients identified
having had peak flow measured
on PRFs
Cycle 2
Cycle 3
Cycle 4
17.37%
25.13%
20. 20%
Part of the CQUIN schedule
% of patients who have fallen but
do not require conveyance to
hospital where the GP is
informed of the fall or where the
patient is referred to a specialist
fall service (if available)
Number of complaints
This demonstrated that 29.3% of all
patients who call for an ambulance
are not conveyed to a treatment
centre.
Data on non-conveyance is
available for all patient conditions.
Falls accounted for the largest
number of total calls. Out of 100
patients, 47 did not need to be
taken to hospital
250 complaints were received and
1,250 PALS concerns
Part of the CQUIN schedule
Key Performance Indicator (KPI) to
be set as part of our Patient
Experience strategy
45 complainants were surveyed but
only 12 replied
Complainant satisfaction
following resolution
9 out of 12 were satisfied or very
satisfied
Number of improvements to
care/services as a result of
feedback from patient stories
2 patient stories were presented to
Board which resulted in
development of Patient Safety
Strategy
Part of our Patient Experience
strategy
Number of Category A patient
surveys carried out
None
Forms part of our Patient
Experience strategy
Number of Category B patient
surveys carried out
None
Forms part of our Patient
Experience strategy
Number of Category C patient
surveys carried out
National NHS Patient Survey
Programme (CQC)
Forms part of our Patient
Experience strategy
Number of Accident &
Emergency patient surveys
carried out
1 survey (57 respondents)
Forms part of our Patient
Experience strategy
Number of PTS patient surveys
undertaken
1 survey (53 respondents)
Forms part of our Patient
Experience strategy
Dignity in Care Challenge
Not yet signed up
To be achieved 2010/2011
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Increasing the number of people
surveyed and the response rate are
our aims for 2010/2011
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Contact EMAS
We welcome your comments about our Quality Account.
Email
Send your feedback to qualityaccount@emas.nhs.uk
Website
Visit us at www.emas.nhs.uk. Click on Get Involved and then Tell Us What You Think
Telephone
Call us on 0115 884 5000 ext 5145
Mail
East Midlands Ambulance Service NHS Trust, Trust Headquarters, 1 Horizon Place,
Mellors Way, Nottingham Business Park, Nottingham, NG8 6PY
To receive this information in large print, audio or in another
language, please call us on 0845 299 4112.
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communications@emas.nhs.uk