Rivers Building Tallaght October 23 rd October 28 th October 29 th Kilkenny and Cork October 27 th Limerick and Galway November 2 nd Mullingar November 19 th Donegal November 27 th Kells December 4 th National Ambulance Service Strategic Plan Vision 2020 Staff Focus Group Meetings Facilitators: Damien McCallion Martin Dunne Vincent Cronly

Introduction – Damien Presentation Vision 2020 Strategic Plan – Vincent Discussion Session – Martin Session Close – Martin 2

3 Enables clarity for staff, patients and general public on direction of ambulance services Framework for the next 5 Years - Process running over 12 months – workshops, international literature review - External input sought from >10 key partners including National Patient Forum - Consolidate all reviews and feedback into one single coherent plan Vision 2020 Steering Group Acute Hospitals, Primary Care, Quality Improvement, Health & Wellbeing and other key HSE Divisions

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Context for our Strategic Plan Our Goals and Objectives Draft Implementation Plan 5

Internal HSE Review Completed mid 2014 Commissioned as a result of concerns from HIQA to provide assurance Review team comprised of senior HSE mgmt outside of NAS HIQA Review Completed Dec 2014 Key findings focused on improving operational performance, effective leadership and mgmt, alternative models of care, DFB relationship and better ownership. Capacity Review Completion October 2015 Focused on improving NAS operational performance Key will be technology, dynamic deployment, additional resources and community response. HR and OD Development Strategy Commenced April 2015 Target Q Focused on developing a clear people and organisation strategy Review of Services in Dublin Target Q Jointly commissioned between HSE & DCC TOR to identify optimal approach for Dublin Carndonagh Investigation Completed Oct 2014 Initiated as a result of a tragic death in LGH Ambulance turnaround framework developed as a consequence Implementation Group in place Fleet & Equipment Strategy Commenced May 2015 Target Q Focused on ensuring an appropriate and cohesive fleet plan, systems and structure to 2020 Quality and Patient Safety Plan Commenced Q QIP developed to improve quality and safety of services

Key Challenges 7 Improve quality and patient safety systems, such as clinical audit Improve performance through dynamic deployment, single dispatch centre, and focus on patient outcomes Improve service in Dublin with Dublin Fire Brigade Develop and implement new models of care Ensure organisation is modern and fit for purpose Address manpower challenges to increase staffing in key areas Integrate ICT Systems Modernise fleet, infrastructure & control systems Improve our approach to patient engagement

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Emerging and International Trends in Pre-Hospital Emergency Care Increasing demand at 3-5% per annum. Developing alternative Models of Care: – Hear and treat call in Emergency Operation Centre – “low acuity” – Alternative destinations for patients other than ED – minor treatment centres – Treat and discharge patients where hospitalisation not required – Care Bundles for specific groups of patients Integrating within the broader health care system; Emergency and Urgent Care with hospitals and primary care Infrastructure investment and development – technology driven performance improvements in response times Leadership & workforce development (inc. paramedic shortfalls) Moving from single target focus on time based targets to broader set of measures focusing on outcomes Use of dynamic deployment to improve response times Use of Community First Responder Schemes in rural areas 9

10 Sets out the HSE goals to improve the health service which are incorporated within the National Services Planning process

11 Our Strategic Goals

What we will do Play an active role in improving population health needs Engage with Health and Wellbeing community promotion programmes Participate in the delivery of community based educational/ training programmes Develop and implement a public information campaign – appropriate use of 112/999 and use of alternative care pathways Ensure a prevention focused approach to staff health and wellbeing Implement the Health Ireland Framework within the NAS Review NAS policies, procedures and practices to maintain staff safety and welfare Improve occupational health support to NAS Our Goals, Objectives and Projects 12 Goal 1 Promote Health & Wellbeing as part of everything we do so that our patients and staff will be healthier Goal 1 Promote Health & Wellbeing as part of everything we do so that our patients and staff will be healthier

What we will do Improve quality of care and patient safety Implement an electronic patient care record (ePCR) Introduce additional clinical performance measures Develop and implement clinical support capacity Develop alternative models of care Implementation of Hear and Treat in NEOC Establish and agree basis for handling routine activity Implement paramedic treat and discharge protocols Seamless, responsive and safe service in Dublin region Implement recommendations of the review group Improve operational performance Implement real-time performance and quality dashboard Improve ambulance turnaround performance Implement additional capacity Optimise the location of ambulance resources Expand national linked Community First Responder schemes Expand retrieval services Goal 2 Provide fair, equitable and timely access to quality, safe emergency services that people need Goal 2 Provide fair, equitable and timely access to quality, safe emergency services that people need 13 Our Goals, Objectives and Projects

What we will do Improve our engagement with patients and service users Develop and implement a Patient and Service User Engagement Strategy Implement a NAS patient forum Become more transparent and open with our patients, the public and staff Continue implementation of the HSE Open Disclosure National Policy – near & adverse advents Continue implementation of the National Standards for Safer Better Healthcare Implement the National Incident Management System and Complaints & Compliments Management System Carry out an annual staff survey & implement an annual action plan on feedback Strengthen leadership capacity to manage change – facilitative management style Goal 3 Foster a culture that is honest, compassionate, transparent and accountable Goal 3 Foster a culture that is honest, compassionate, transparent and accountable 14 Our Goals, Objectives and Projects

What we will do Engage with and involve our staff in the provision of service Implementation of the ‘Public Health Services People Strategy’ Develop an annual communications plan that includes focus on staff Provide clinical services ‘web’ and access to NAS staff Strengthen NAS leadership, workforce and governance structures Implementation of NAS Human Resources and Organisational Development Strategy Embed formal staff and managers performance management system Implement recommendations of the Management Structure Review Implement a management training and development programme Provide a high quality, competent workforce to meet our model of patient care Implement a comprehensive workforce plan Increase staff numbers to meet international norms Implementation of a comprehensive education and competency assurance plan 3rd level educational programme for paramedics Regular review of staff development needs Goal 4 Engage, develop and value our workforce to deliver the best possible emergency care and services to the people who depend on them Goal 4 Engage, develop and value our workforce to deliver the best possible emergency care and services to the people who depend on them 15 Our Goals, Objectives and Projects

What we will do Ensure that NAS fleet and equipment is appropriate for use Implement recommendations of the NAS fleet and equipment strategy Ensure that NAS has effective infrastructure Review NAS deployment points Carry out a fit-for-purpose review of current and future NAS estate requirements Commence estate upgrade and new build programme Improve our service efficiencies and effectiveness through the use of technology enabled solutions Develop NAS eHealth strategy Continue the development of the NAS CAD system Continue the introduction of mobile data terminals and navigation tool Implement a single national rostering/time (CORE) system Implement NAS payroll system Goal 5 Manage resources in a way that delivers best health outcomes, improves people’s experience of using our services and demonstrates value for money Goal 5 Manage resources in a way that delivers best health outcomes, improves people’s experience of using our services and demonstrates value for money 16 Our Goals, Objectives and Projects

17 Implementation Plan Implementation is subject to: Completion of Reviews, Strategies and Plans Service Planning and Funding Dependent across the lifetime of the strategic plan

18 Sample Implementation Plan

Survey 19

20 Consultation Feedback To Date Survey Suggested Areas of Improvement Improve Staff Health and Wellbeing Develop Rosters Introduce Deployment Points Introduce Alternative Care Pathways Introduce Patient / Public Relations/Education Improve Management / Staff Engagement Improve Clinical Supervision / Audit Improve Staff Training & Development Improved Fleet and Equipment Introduce Management 24Hr Cover Increase Staffing Levels Improve relationship between Control and Operations Station Upgrade Improve operations with Dublin Service (DFB)

Next Steps 21 Review Questionnaire Feedback and Feedback from External Stakeholders Review of Services in Dublin Fleet & Equipment Review HR and OD Development Plan Capacity Review

Open Forum Discussion 22