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PTS – The Vital Link with Acute Trusts 2 April 2014

PTS – The Vital Link with Acute Trusts 2 April 2014. Andrew Foster Chief Executive. What do you know about Wigan?. Wigan Infirmary 1910. State of the art ambulance 1910. Snapshot of WWL. £250m turnover, 3 Hospitals, 4,400 staff 90,000 A&E attendances 84,000 admissions (30,000 via A&E)

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PTS – The Vital Link with Acute Trusts 2 April 2014

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  1. PTS – The Vital Link with Acute Trusts2 April 2014 Andrew Foster Chief Executive

  2. What do you know about Wigan?

  3. Wigan Infirmary 1910

  4. State of the art ambulance 1910

  5. 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

  6. 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

  7. 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

  8. 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)

  9. Don’t panic

  10. 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

  11. 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

  12. Is this new partnership better?

  13. 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.

  14. 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

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