1. your hospitals, your health, our priority PTS – The Vital Link with Acute Trusts 2 April 2014 Andrew Foster Chief Executive

2. your hospitals, your health, our priority What do you know about Wigan?

3. your hospitals, your health, our priority

4. Wigan Infirmary 1910

5. your hospitals, your health, our priority State of the art ambulance 1910

6. your hospitals, your health, our priority Snapshot of WWL £250m turnover, 3 Hospitals, 4,400 staff 90,000 A&E attendances 84,000 admissions (30,000 via A&E) 82,900 discharges Dec 2008 became a Foundation Trust 2009-10 red rated for governance on A&E 2012-13 best performing A&E dept in NW 2013-14 fifth best A&E in NW

7. your hospitals, your health, our priority Pressure 5.5% cost saving every year (= 31% in 5 yrs) Underlying rising demand 3/4% per annum 60% of cost is staff; can’t reduce staffing ratios Monitor scrutinises performance, quality, governance and leadership CQC scrutinised quality, governance and leadership Mid-Staffs, Francis, Keogh etc Government sets key targets 18 weeks and A&E

8. your hospitals, your health, our priority When it’s bad…. Average A&E attendances 250; peak 320 The public view is of the front door 95% A&E target No beds Plastic chairs It’s the back door stupid! And that’s where PTS is crucial A bit of history

9. your hospitals, your health, our priority 1. The NWAS Days Commissioned centrally – Blackpool PCT/CCG Little local commissioner involvement Poor service overall – only one vehicle Eligibility and out of area issues Delays in keeping up with discharges Manual systems with bed manager co-ordinators Private Ambulances required (£220k)

10. your hospitals, your health, our priority Don’t panic

11. your hospitals, your health, our priority 2. The “New Dawn” – 1 April 2013 Arriva successful in GM PTS On-line booking system “The Cleric”; good local engagement; change in culture, wards book direct New contract – Monday to Friday 9am-5pm No evening or weekend other than A&E Eligibility criteria enforced KPI’s for booking, 80% in 1 hour,90% in 1½ hours

12. your hospitals, your health, our priority 3. Declining Patient Experience Unaware of actual activity numbers Out of area problems Unable to cope with demand; extensive waiting in Discharge Lounge/Wards; patients re-bedded! Contract is 5 day service – Not fit for purpose Restrictions on patient type e.g. Palliative, Mental Health, Out of Area etc

13. your hospitals, your health, our priority Is this new partnership better?

14. your hospitals, your health, our priority 4. What have we done? Extensive staff training around on-line booking A designated vehicle, Mon to Fri, 1pm to 5pm Senior meetings with Arriva and commissioners Better communications and escalation agreement Working together to accurately assess demand Extended ad-hoc Private Ambulance to a formal contract up to 31/3/14.

15. your hospitals, your health, our priority 5. Where do we go next? Finalise Level of Service required. Agree revised contract with Commissioners. Ensure Arriva can resource Improve discharge planning and booking If the above can’t be achieved: – Explore alternative PTS providers – In-house provision? – Improve patient experience and value for money

16. your hospitals, your health, our priority