Summary

North East Ambulance Service (NEAS) NHS Foundation Trust:

  • employs over 2,700 people
  • serves a population of more than 2.71 million
  • covers the counties of Northumberland, Tyne and Wear, Durham and Teesside, an area of 3,200 square miles

In addition to providing emergency ambulance services and the 999 number call handling for the region, NEAS also runs non-emergency patient transport services and the 111 non-emergency number.

The service deals with over 400,000 emergency and urgent incidents per year, of which over 110,000 are immediately life threatening and require an 8 minute ambulance response time. Alongside this there are a number of other clinical quality indicators which are aimed at judging care on its quality, not just how quickly an ambulance arrives.

There are three national response time standards for Category A calls, those with a target for an ambulance to arrive within 8 minutes 75% of the time (these are split into Red 1, the most serious/time critical, and Red 2, serious but less time critical), and those with a target to get a patient carrying vehicle on scene within 19 minutes 95% of the time:

  • Category A Red 1 (standard 75%)
  • Category A Red 2 (standard 75%)
  • Category A 19 (standard 95%)

As the table below shows, along with most other ambulance services NEAS red activity response times were below target for 2015/16, following a dip in performance in 2014/15. This deterioration is also reflected nationally, with only three trusts likely to achieve end of year performance for Red 1 and only two for Red 2:

Category A incidents: percentage of responses within 8 minutes by ambulance trust, 2012/13 to 2015/16

   

June 2012 to March 2013

2013/14

2014/15

March 2015 to Feb 2016

 

Red 1

Red 2

 

Red 1

Red 2

 

Red 1

Red 2

 

Red 1

Red 2

                       

North East

76.6%

76.5%

 

76.9%

78.9%

 

70.0%

73.9%

 

69.6%

62.4%

North West

73.5%

76.6%

 

75.9%

77.4%

 

69.2%

69.5%

 

72.8%

61.8%

Yorkshire

71.7%

75.2%

 

77.4%

75.1%

 

69.9%

69.3%

 

72.1%

74.6%

East Midlands

70.0%

75.5%

 

71.3%

71.5%

 

71.6%

70.2%

 

67.5%

63.8%

West Midlands

78.9%

75.5%

 

80.0%

73.6%

 

77.5%

74.3%

 

68.6%

69.2%

East of England

74.2%

72.8%

 

73.6%

69.4%

 

71.0%

62.8%

 

75.6%

71.6%

London

77.7%

76.3%

 

77.4%

75.3%

 

67.2%

59.7%

 

72.1%

72.9%

South East Coast

75.1%

75.1%

 

76.8%

73.9%

 

75.3%

73.3%

 

72.6%

70.8%

South Central

78.2%

75.2%

 

79.2%

75.7%

 

75.0%

74.5%

 

74.2%

65.0%

South Western

74.3%

76.2%

 

73.1%

77.2%

 

75.2%

72.3%

 

78.8%

75.5%

Isle of Wight

78.7%

76.6%

 

80.2%

76.1%

 

80.9%

75.4%

 

71.1%

71.6%

                       

England

74.0%

75.6%

 

75.6%

74.8%

 

71.9%

69.1%

 

73.0%

68.3%

Source: NHS England Ambulance Quality Indicators data

             

The most recent NEAS board papers indicate that the high volume of emergency calls has impacted on the Trust’s ability to achieve performance, noting that red activity volumes were 21.3% greater in March 2016 than those in March 2015 (Item 10 – Performance Board Report – March 2016)

The NEAS Draft Operational Plan for 2016/17 provides an overview of the Trust’s performance recovery plan – this includes a trial Ambulance Response Programme (ARP) whereby the Trust, alongside four other ambulance trusts, has started to trial and evaluate an alternative approach to response performance standards:

Quality improvement planning

The NHS Constitution sets out the emergency care response standards. The Trust’s historical performance across all of these standards (Red 1, Red 2 and Red 19 and Category A and B before them), has been strong, however in the last 18 months, not only the Trust, but the whole ambulance sector has been struggling to achieve target levels of responses amidst the pressures being experienced in the wider urgent and emergency care systems. During 2015/16 we commenced with a performance recovery plan and this will continue to be delivered into 2016/17 to achieve improvements in Red 1 and Red 19 as a priority. This ensures speed of response to our most seriously ill patients.

Red 2 performance – responding to patients within 8 minutes 75% of the time – will continue to be under review throughout 2016/17 as we are planning to continue to contribute to ARP to evaluate the quality of the response rather than the speed. This is very much in accord with our aim to work towards delivery of an effective clinical delivery model, measured on clinical and quality outcomes. This element of our plan appropriately responds to the UEC review [The NHS England Urgent and Emergency Care Review led by Prof Bruce Keogh], the High Impact Actions released for ambulance services and the latest Ambulance Commissioning Strategy publication.

Our latest recovery forecasts are set to achieve an improved 2016/17 year end performance across all three targets and delivery of national standards by Quarter 4.

Recovery is dependent upon on system improvements (handovers, diverts) and funding support for the clinical hub, continuation of the Fire & Rescue Services co-responding scheme beyond June, and no adverse impact arising from service reconfigurations.

The Draft Operational Plan states that NEAS currently demonstrates high performance delivery in relation to each of its ambulance quality indicators.

Further reading:

Download NEAS Quality Report year ending 31st March 2015 PDF

NHS Ambulance Service Quality and Performance Reports


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