1. The Quality Agenda Jenny Winslade, Executive Director of Nursing & Governance

2. The Quality Triangle Safety – Will it do me any harm Effective – Will it do me any good Q Experience – Will I be treated with Dignity and Respect

3. Quality Outcomes Staff Experience Patient Experience Learning & Improvement Use of “I” statements Robust safety measures Improvement methodology

4. Developing the Quality Strategy Co-creation with staff and patients of the outcome measures and the ‘I’ statements 6-8 week engagement process on the principles and content Implementation needs to be built from the bottom up with support and oversight from the Executive Directors and the Board

5. Delivering the Quality Approach Quality Development Forum Quality Development Plan Quality Development Group Quality Committee Quality Account and Report

6. Reports of quality from the previous year and priorities for the forthcoming year. Covers all service lines. Consultation with CCGs, HOSCs and Healthwatch. Priorities focussed on 3 pillars – clinical effectiveness, patient experience and patient safety.

7. 2014-15 Quality Priorities Paediatric Big Six Aimed to promote evidence-based assessment of unwell children for the six most common conditions when accessing 999 services. Achievements: Big 6 Guideline published reduction in conveyance of cases that presented as lower-risk when compared against the guidelines all “Red Flag” cases recognised as such and appropriately treated and conveyed 88.37% of frontline clinicians have attended education events which contained Big 6 guidance.

8. 2014-15 Quality Priorities Frequent Callers Aimed to improvement the management of frequent callers who present to the ambulance service and other health and social care providers. Achievements: Contact made with Frequent User Leads across the healthcare community; A study of the most prolific Frequent Users across the Trust’s operating area and current care plans identified; Care plans developed for 999 Frequent Callers where required.

9. 2014-15 Quality Priorities Sign Up to Safety Aimed to develop and implement a clear, measurable safety improvement programme across the Trust, understand by a set of principles supporting the Sign Up to Safety pledges. Achievements: Developed a clear set of principles; Commented a programme of staff engagement; Improved the completion of actions developed through learning from serious and moderate harm incidents; Been actively involved in three Patient Safety Collaboratives.

10. 2014-15 Quality Priorities Sign Up to Safety Aimed to develop and implement a clear, measurable safety improvement programme across the Trust, understand by a set of principles supporting the Sign Up to Safety pledges. Achievements: Developed a clear set of principles; Commented a programme of staff engagement; Improved the completion of actions developed through learning from serious and moderate harm incidents; Been actively involved in three Patient Safety Collaboratives.

11. 2016-17 Quality Priorities Cardiac Arrest Improve adherence to Resuscitation Council guidelines and therefore the quality of resuscitation by Trust clinicians. Promote the benefits of partnership working with local acute trusts, in order to improve outcomes in cardiac arrest. Human Factors Undertake a review of human factors influencing errors made during the telephone triage process to identify solutions to improve patient safety.

12. 2016-17 Quality Priorities Accessible Information Improve level of contact by those with communication difficulties in advance of their treatment so that we able to provide them with a better and more accessible service; Increase engagement with groups supporting those with sensory loss to better understand their communication needs and help to develop bespoke communication tools; Increase access to the use of 999 text messaging services.

13. Monitoring Quality - CQC

14. What are the CQC finding?

15. 111 Inspection – March 2016 Positives: Call centre staff praised Safeguarding highlighted as a particular strength. Strong resilience provided through the integration of the two clinical hubs Areas for improvement: Staff levels, mix and experience. Overarching systems and processes. Quality assurance of individual practice Staff engagement. Dissemination of learning & feedback.

16. The Trust’s Next Inspection 6 - 10 June 2016 All service lines to be inspected Will consider issues and actions identified from 111 inspection Key questions and lines of enquiry A more intensive process than previously….

17. During the Inspection 4-5 days Inspection team of over 50 Station and vehicle inspections Third manning shifts Staff, patient and possibly Governor focus groups Manager interviews Possibility of unannounced follow up visits within 10 days of main inspection

18. Trust Preparation Quality Development Group Compliance assurance exercise and risks identified Quality Development Plan Met with SCAS to learn from their experience Experience of 111 inspection New Priority 1 Plan (including 111 inspection actions) CQC Communications Plan

19. QUESTIONS?