• Chair’s Welcome and Introduction (LS)

• Minutes from the 27 September 2018 Annual General Meeting (LS)

• Review of 2018/19 (WH)…

• …including “What We’ve Delivered for Patients and Staff” (CP/HY&JB/MS)

• Financial Review including presentation of the 2018/19 Annual Report and Accounts (CP)

• Council of Governors Review of the Year 2018/19 (BD)

• Question and Answer Session (LS)

Agenda

Review of 2018/19

Will HancockChief Executive

We are continuing to grow as an organisation….and operate in an increasingly complex system(s)!

Our services An integrated approach

Past Future

> Enabling people to access right care, first time

> Saving lives and improving outcomes

> Supporting people in their own homes

Patient Transport

Emergency 999

NHS111 &IUC Service

SCAS

We have a clear strategy……….

….and that strategy is supported by goals and a set of values

• continued to perform well on the Ambulance ResponseProgramme (ARP) 999 emergency response timestandards

• with partners, embedded the Integrated Urgent Care (IUC)service in the Thames Valley…

• …and continued our co-production work for a new IUCservice in Hampshire

• delivered some good clinical outcomes for patients (e.g.stroke and STEMI care)

• established ourselves as the leading NHS provider ofPatient Transport Services, with contracts in ThamesValley, Hampshire, Surrey and Sussex

2018/19 was a challenging year for the NHS, but SCAS has:

• continued our work as a Global Digital Exemplar with anumber of key projects underway

• made good progress with the implementation of our ODStrategy – especially in relation to leadership developmentand health and well-being

• implemented a new Commercial Transformation Programme

• collaborated effectively with local systems and otherAmbulance Trusts

• established effective staff processes for ‘Freedom to SpeakUp’

• delivered strong financial outcomes

• maintained our status as a Segment 1 provider (bestpossible) under NHS Improvement regulatory approach

And also…..

• Global Digital Exemplar (CP)

• Urgent Care Pathways (HY/JB)

• Staff health and well-being (MS)

“What We’ve Delivered for Patients and Staff” – three examples

EPR Developments –enhancing electronic patient record functionality

Vehicle as hub –extended wi-fi for patient care and mapping updates

Resource Optimisation –using big data to improving demand forecasting and resource planning

Automation• 999 – control room automation• PTS – process improvement• Corporate – e-learning,

procurement .

Livelinks Video – using video between patients, control staff and road clinicians

Telephony transformation –latest telephone software to improve resilience, automation, and multi-channel access

EPR Acute Interface –passing data straight to hospital systems to enhance patient care

Integrated Urgent Care – Connecting organisations and clinicians to provide better seamless care

Example 1 - Global Digital Exemplar (GDE)

Example 2 - Urgent Care PathwaysProgramme Aims & Objectives

Support National & Local Strategies with NHS Constitution at its heart

Improve quality of Patient Care & Experience

Improve Patient Safety

Support Operational Clinical Staff

Support improvement in the reduction of our key rates for :-- See & Treat- See, Treat & Convey to Emergency Departments- See, Treat & Convey to Non-Emergency Departments

Efficiency Savings

1. Urgent Care Pathways - Access to key services across our footprint for our clinicians to refer our patients to directly

2. Digital Software Solution - Visibility of those services for our mobile clinicians

3. Clinical Governance - Safety & Consistency of all Urgent Care Pathways across SCAS

4. Terrafix MDT - Supporting the reporting, data & metrics to understand the patient journey to improve care

Urgent Care PathwaysProgramme Projects

Urgent Care PathwaysPathway Development Progress

Pathway doesn’t exist No access to Pathway for SCAS Clinical Staff

Potential Pathway existsNo current access to Pathway for SCAS Clinical StaffPathway access under discussion with Service Provider

Pathways exists but not in line with SCAS Urgent Care Pathway Plan requirements -e.g. not 24/7

Access available to SCAS Clinical Staff New Pathway in Pilot Phase

Pathway available in line with SCAS Urgent Care Pathway Plan requirementsPathway available to SCAS Clinical Staff but service rarely used despite accessibilityPathway access referral restricted to specific SCAS Clinical Cohort

Pathway available in line with SCAS Urgent Care Pathway Plan service requirementsAvailable to all SCAS Clinical Staff and used regularly

The programme team have

been using a RAG Rating tool to

understand the progress made

in the development of access to

Urgent Care Pathways

Urgent Care PathwaysAccess to Clinical Pathways

62

6

17

0

15

SCAS - All Pathways May 2019 RAG Rating Percentage

25

2324

4

24

SCAS - All PathwaysCurrent RAG Rating Percentage

Urgent Care PathwaysAccess to Clinical Pathways

Established & improved access to 25 Pathways

Reduction in Red RAG Rating by 51

Large number of pathways being discussed with our partners

37 pathways in pilot phase or need improvement with access, effectiveness & usage

84

8

23

0

21

33 31 32

5

32

0

10

20

30

40

50

60

70

80

90

1 2 3 4 5

No.

of P

athw

ays

RAG Rating

SCAS - All Pathways RAG Rating Comparison

Left - May 2019

Right - Current

Example 3 - Improving the wellbeing of our teams

• SCAS leaders better equipped to support their teams

• Rosters improved to provide better work-life balance and reduce fatigue

• Developed our staff support services

SCAS Leader

Module 1MaximisingIndividual Performance

Module 2Maximising

Team Performance

Module 3Leading

Service Development

Launched SCAS Leader ….

Numbers so far…• 102 people have started (6 cohorts) • 85 people have completed• Cohorts 1-6 line manage a combined total of ~1200 staff • Managers currently in post should complete by Dec 2020

SCAS Fatigue - Operational Field TrialSafr Ltd was commissioned to conduct a review as to the level of fatigue experienced by SCAS 999 operational personnel across 4 sites, over a total period of approximately 5 months.

This included pre-launch activities at each site. (Basingstoke, Didcot, Nursling, Wexham RCs) covering 90 staff.

Key Findings The levels of alertness and fatigue within SCAS were found to be broadly in line with the benchmarks for a 24/7 organisation and reasonably consistent across locations and job roles. However, long shifts –especially night shifts of 12 hours or more – were found to cause increased fatigue and therefore higher levels of risk.

What we changed Reduced the number of 12 hour shifts our 999 teams work Reducing the length of night shifts, particularly aiming to avoid night shifts of 12 hours or more and

reducing the number of night shifts in a given period

We have also …

• Improved our control centre environment• Encouraging healthy mind• Healthy eating • Smoking cessation• Weight management• Review of bag weights• Cycle to work scheme• Promoted health & wellbeing across our Trust

Health & Wellbeing Events

Launching our H&WB Portal

• https://www.sca.nhsbenefits.net/

https://www.sca.nhsbenefits.net/

Leading by example

Charles PorterFinance Director

Financial Review including presentation of the 2018/19 Annual Report and Accounts

Annual Report and Accounts can be accessed at: http://www.scas.nhs.uk/publications/

http://www.scas.nhs.uk/publications/

• Improving overall and underlying financial position

• Income has increased by £10.5m (5%) due to 999 contract income and Hampshire 111.

• Continuing operations surplus of £1,486k (£1,180k surplus prior year)

• Before STF/land disposal gains deficit was £1,636k reflecting improving underlying financial position

• £1.5m surplus achieved, with £3.2m STF (16/17 £3.2m)

Income and Expenditure

2018/19 12 months to

March £k

2017/18 12 months to

March £k

Income 225,989 215,487

(Deficit) before STF and gains on disposal of assets

(1,636) (4,412)

Surplus/(Deficit) from continuing operations

1,486 1,180

Margin 0.7% 0.5%

Discontinued operations - 131

Surplus 1,486 1,311

• £9.5m capex spend – on new 999 ambulances (£4.1m)

– £2.5m on Estates including Southern House refurbishment, and PTS resource centre (Loverock Road) and Fleet workshop (Milton Park) following Battle sale

– £2.4m IT spend including £1.2m Telephony upgrade and GDE

• 1.1x depreciation (£8.3m)

Capital Expenditure £m

0

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4

6

8

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14

07_0808_0909_1010_1111_1212_1313_1414_1515_1616_1717_1818_19

Estates

Southern House upgrade

Milton Park (fleet workshop) Loverock Road (PTS resource centre)

• Major review of Estates and updating strategy

• New sites following sale of Battle site for housing

AFTERB

EFOR

E

Cash position has increased by £4.9m to £22.6m, with the impact of the surplus (+£1.0m), part repayment of capital loan (-£1.7m), working capital (£2.8m) – debtors/provisions, disposals (+£2.6m),and capex less than depreciation (-£0.8m), PDC received (+£1.1m).

Cash £m

0

5

10

15

20

25

30

07_0808_0909_1010_1111_1212_1313_1414_1515_1616_1717_1818_19

Chart1

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10_11

11_12

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13_14

14_15

15_16

16_17

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18_19

Capex

3.827

3.516

3.468

4.977

9.573

8.3

8.329

27.1

19.9

20.2

17.6

22.6

Sheet1

07_0808_0909_1010_1111_1212_1313_1414_1515_1616_1717_1818_19

Capex3.8273.5163.4684.9779.5738.38.32927.119.920.217.622.6

• Successfully delivered £8.0m (3.5%) of cost improvements

• Savings to mitigate inflation, activity and cost pressures ensuring that quality can be maintained

• Carter review benchmarking Ambulance Trust efficiency showed SCAS in good light.

• Continuing drive to improve efficiency and value for money

Cost Improvement Plans

Council of Governors (CoG) –Review of 2018 / 19

Bob DugganBuckinghamshire Public Governor / Current Lead Governor

The Lead Governor for 2018/19 was Barry Lipscomb

• Contributing at the CoG and Board annual joint strategy workshop which focused on the development of the Trust’s strategic plans and priorities, in particular the new Long Term NHS Plan.

• Re-appointing two NEDs for a second term

• Providing input into the 2018/19 appraisals for both the Chair and NEDs

• Partaking in a Governor Development Programme, aimed at strengthening the effectiveness of the CoG and improving relationships between Governors, Non-Executive Directors and members

• Received the 2018/19 Annual Report and Accounts, and reports from the Auditors

Again, the CoG delivered the relevant statutory duties, including:

Held the Board to account for the performance of the Trust, via the NEDs:• through asking questions of the NEDs at formal CoG meetings, governor

attendance at Board meetings, and‘buddying’ arrangements with NEDs

Represented the interests of the members and public:• through attendance at a range of membership recruitment and engagement events,

and through day-to-day conversations with the general public

Improved individual and collective knowledge and potential:• through attendance at a range of membership recruitment and engagement

events, and through day-to-day conversations with the general public

More generally the CoG:

The CoG has identified the following priorities for 2019/20:

1. Ensuring that the interests of the Trust’s 17,000 members are suitably represented and that their views are brought to the attention of the Trust.

2. Contributing to the development of the Trust’s future strategic priorities and forward plans - with a strong focus on the newly published NHS Long Term Plan and local systems working together

3. Continuing the strong focus that the governors have in terms of holding the Board to account, via the NEDs, for the performance of the Trust

4. Continuing to review the effectiveness of the Council of Governors to ensure that the governors are appropriately supported to deliver their roles, that value is added where appropriate, and the functioning of the CoG is delivered in the most cost effective way and aligned with the values of the Trust.

Priorities for 2019/20

Closure of Annual General Meeting

Lena SamuelsTrust Chair

Slide Number 1Slide Number 2Review of 2018/19We are continuing to grow as an organisation….and operate in an increasingly complex system(s)!Slide Number 5….and that strategy is supported by goals and a set of valuesSlide Number 7Slide Number 8Slide Number 9Slide Number 10Slide Number 11Slide Number 12Slide Number 13Slide Number 14Slide Number 15Example 3 - Improving the wellbeing of our teamsLaunched SCAS Leader …. Slide Number 18SCAS Fatigue - Operational Field TrialWe have also …Health & Wellbeing EventsLaunching our H&WB PortalLeading by exampleFinancial Review including presentation of the 2018/19 Annual Report and AccountsSlide Number 25Slide Number 26Slide Number 27Slide Number 28Slide Number 29Council of Governors (CoG) – Review of 2018 / 19Slide Number 31Slide Number 32Slide Number 33Slide Number 34Closure of Annual General �MeetingSlide Number 36