annual business plan 2014-2015 -...

AMBULANCE

SE RV I C E

Effective: 01 April 2014

Annual Business Plan 2014-2015

AMBULANCE

SE RV I C E

Contents

1.0 Executive Summary 3

2.0 NARU Profile 7

3.0 Strategic Direction 14

4.0 Review of Performance 2013-14 18

5.0 2014-15 Operational Objectives and KPI’s 23

6.0 Annual Planning Cycle 27

7.0 Performance Management 28

8.0 Financial Plan 29

9.0 Risk Management 30

10.0 Governance 31

11.0 Development Programme 33

12.0 Glossary Of Terms 35

13.0 Appendices 38

www.naru.org.uk

2

Contents

This document is the National Ambulance Resilience Unit’s(NARU) Annual Business Plan focusing on Financial Year 2014-15.

It describes for commissioners, stakeholders, staff and themanagement team at NARU how we will continue to deliverand improve on the services we provide.

It is derived from, and informed by, the 2013-16 NARU Strategyon a Page (Appendix 1). This is the second Annual BusinessPlan produced by NARU. A detailed work plan document isproduced separately. The work plan comprehensively itemisesand lists the on-going work of the unit.

Since June 2011, responsibility for the delivery of Nationalemergency preparedness policy in NHS ambulance services inEngland has been delegated to the National AmbulanceResilience Unit (NARU), hosted by West Midlands AmbulanceFoundation Trust (WMAS).

This is delivered via a contract managed by NHS England. Thecontract details the arrangements and expectations for NARU’scontribution in support of the UK’s Civil Resilience andcounter-terrorism (CONTEST) strategies and the Healthcommitments under the UK’s National Security Strategy andthe National Security Council.

NARU is an NHS organisation, operated mostly by subjectmatter experts on secondment from NHS Ambulance Services.

STRATEGIC DIRECTION

Through the process of reviewing our vision and values we tookparticular influences from the direction set by NHS England’sstated aim of playing, “a key role in the Government’s vision tomodernise the Health service with the key aim of securing thebest possible Health outcomes for patients by prioritising themin every decision it makes.”

We also recognise the requirements in the DH paper,“Arrangements for Health Emergency Preparedness,Resilience and Response from April 2013” (March 2012).In addition, other key drivers for NARU are:

Putting Patients First (NHS England Business Plan) 2014.The National Risk Assessment 2013.The Civil Contingencies Act (2004).The UK Counter Terrorism Strategy (CONTEST 2).The National Capabilities Programme and Survey.NHS England EP Guidance 2013.EPRR Core Standards 2013.The Centre for the Protection of the National Infrastructure.The NHS Commissioning Guidance.The Care Quality Commission.The National Occupational Standards.Taking Healthcare to the Patient 1 and 2.The Joint Emergency Services Interoperability Programme(JESIP).

The National Ambulance Resilience Unit (NARU) - Annual Business Plan 2014-2015

1.0

Executive

Summary

3

1.0 Executive Summary

Vision

NATIONAL AMBULANCERESILIENCE UNIT

Our VisionNARU will support theresilience objectives of NHSEngland, the Association ofAmbulance Chief Executives& Ambulance Commissioners.

NARU will also provide supportto the UK’s Civil Resilience andcounter-terrorism (CONTEST)strategies and the Healthcommitments under the UK’sNational Security Strategy andthe National Security Council.

AMBULANCE

SE RV I C E

1.0

Executive

Summary

All of these documents and organisations complement eachother in:

Emphasising the importance of Emergency Preparedness,Resilience and Response.Ensuring that the NHS in England is properly able to dealwith potential threats.Placing greater emphasis on patients and the quality ofcare provided in Mass Casualty type situations.Providing the framework for the NHS Ambulance Serviceto be part of the overall process for supporting the UK’sCivil Resilience and counter-terrorism (CONTEST)strategies and the Health commitments under theUK’s National Security Strategy and the NationalSecurity Council.Minimising inefficiency and bureaucracy so that NHSfunding supports patient care directly and delivers thebest value for every pound invested.

We used these themes to develop our three year strategy(Appendix 1), restate our vision, refresh our purpose andensure we are well placed to capitalise on the newopportunities of the changing NHS landscape.

REVIEW OF PERFORMANCE 2013-14

NARU has delivered the objectives as set down in the 2013-14Annual Business Plan and associated work plan. The workplan has been delivered on time and within budget against abackdrop of considerable change and uncertainty in light ofthe change in commissioning arrangements from DH to NHS

www.naru.org.uk

4

England. Annual Business Plan objectives met include:

The delivery of a stakeholder engagement report so asto ensure that NARU is responsive to the needs of itsstakeholders.Service improvement and increased efficiency and;Improved procurement, governance and staff engagementprocesses.

2014-15 PROGRAMMES OF WORK AND KEYPERFORMANCE INDICATORS

It is our intention to deliver the agreed number of workprogrammes for 2014-15. These will directly contribute to theachievement of our four strategic aims:

Achieve Quality & Excellence.Always Learn, Innovate and Develop.Ensure Delivery of the NARU Mission and Vision.Provide sound Governance, Value for Money andFinancial Control.

We have identified 12 business objectives for 2014-15 which willsupport this. Each of these objectives has an identified set of keyperformance indicators which will be used to inform the ContractBoard, commissioners and key stakeholders of progress.

ANNUAL PLANNING CYCLE

There is a planned programme of activities relating to thebusiness planning process for the Unit throughout 2014-15.

This includes:Agreement of the programmes of work.A planned series of communication and engagementevents to ensure all stakeholders understand thestrategic direction NARU has outlined and theircontribution to its achievement.Collaborative meetings with stakeholders to informand design the optimum commissioning structuresmoving forward.

PERFORMANCE MANAGEMENT

Delivery of the 2014-15 business plan will be performance-managed through the following measures:

Regular scrutiny of our work plan and our financialposition with NHS England.Monthly NARU Delivery Board scrutiny of the IntegratedWork Plan Performance Report, the Contract BoardAssurance Framework, financial position and CIPachievement.Regular stakeholder briefings and meetings.Regular updates to the Association of Ambulance ChiefExecutives (AACE).Central Management Team overview and assessment of delivery.Department and Team meetings.Emergency Preparedness, Resilience & Response Group.Delivery of objectives outlined in individual PersonalDevelopment Review meetings aligned to the strategicaims and Annual Business Plan.

FINANCIAL PLAN

The financial plan is as detailed in Section 8.0. The budget for2014-15 has been agreed at the same level as 2013-14, less4% cost improvement, and our spending will be within thoseagreed parameters.

Therefore efficiencies of around 6% will need to be realised.The governance and scrutiny arrangements that were put inplace in April 2012 will enable the unit to manage delivery ofthis CIP requirement. The unit plans to break even again at theend of 2014-15.


1.0

Executive

Summary

5

AMBULANCE

SE RV I C E

1.0

Executive

Summary

RISK

Risk management is a key component of enhancing theNARU objectives and is a central part of NARU strategicmanagement. The Delivery Board will ensure that decisionsmade by the unit are taken with consideration to the effectivemanagement of risks.

NARU will adhere to the Risk Management policies as laiddown by WMAS. Detailed operational risks will be regularlyreviewed through the Central Management Team mechanism.

GOVERNANCE

We have implemented a revised structure which will provide astronger governance and assurance framework for the unit.This includes the secondment of a Compliance Officer toreview NARU’s operational outputs and support thecommissioning of specialist interoperable ambulancecapabilities. We are also reviewing our internal configurationto support the changes in commissioning from DH to NHSEngland.

NARU DEVELOPMENT PROGRAMME

2014-15 is an important year for NARU as the relationship withNHS England matures. We have instigated a programme ofstrategic development and sustainable service delivery whichwill support NARU going forward.

www.naru.org.uk

6


2.0

NARU

Profile

7

Since 2004 a small number of ambulance staff have beenworking with the DH and other Government departmentsto provide ambulance perspective and specialist knowledgeof the ambulance response to major and unusual incidentsand providing guidance in relation to policy development.This team also acts as a conduit for information from thecentre to ambulance services locally, and vice versa, aswell as providing ambulance input to ministerial questionsas required.

This team developed into the NARU team of today, consisting ofa (still) small number of personnel seconded predominantlyfrom ambulance services around the country to provide subjectmatter expertise.

In recent years and recognising global incidents as well asthose closer to home, the development of the Hazardous AreaResponse Teams (HART) changed the core working of theDH ambulance team and led to the expansion of the team toprovide education modules, exercising and procurement ofspecialist equipment. This enabled front line ambulance staffto work in hazardous areas and is the Health element of thePREPARE and PROTECT strands of the Government’s counter-terrorism strategy (CONTEST).

A Service Level Agreement (SLA) for the management of NARUwas signed in July 2011 between the West Midlands AmbulanceService (WMAS) and the DH. This SLA was designed to ensure

that the management of NARU and the delivery of the Servicewould be professional, appropriately skilled, experienced andwould provide good governance. It was agreed that WMASwould determine the skill-set of resources required toundertake each of the work programmes, including (but notexclusively limited to) - programme management, clinicaladvice, operational management, procurement, financemanagement and training, education and exercising delivery.These skills would be delivered within the overall fundingenvelope agreed.

In 2013 the SLA between WMAS NHS Trust and DH becamea contract between WMAS NHS Foundation Trust and NHSEngland.

NARU’s main aim is to support the resilience objectives of NHSEngland, the Association of Ambulance Chief Executives andAmbulance Commissioners, putting patients and the safety ofstaff at the forefront of any planned response.

NARU also works with NHS Ambulance Trusts in England– and those in the devolved administrations – to helpstrengthen national resilience and improve patient outcomes ina variety of challenging pre-hospital environments. We providesupport to the UK’s Civil Resilience and counter-terrorismstrategies and the Health commitments under the UK’sNational Security Strategy and the National Security Council.

2.0 NARU Profile NARU’s main aim is to supportthe resilience objectives of NHSEngland, the Association ofAmbulance Chief Executives andAmbulance Commissioners,putting patients and the safetyof staff at the forefront of anyplanned response.

AMBULANCE

SE RV I C E

2.0

NARU

Profile

In particular, the work of NARU is focused on:

Review and maintenance of the national Hazardous AreaResponse Team (HART) capability, ensuring it is fit forpurpose and is capable of responding to new threats.Overseeing the implementation of, and representing theAmbulance Service in Initial Operational Response (IOR)and Specialist Operational Response (SOR) development,whilst also designing and delivering specific education andcommunications material for Ambulance and wider NHS.MTFA implementation and continuity programme.Representing the Ambulance sector at the JointEmergency Services Interoperability Programme (JESIP)governance Boards, providing an embedded subjectmatter expert and being at the heart of delivery within theJESIP work stream - including supporting developmentand delivery of JESIP training and exercising.Providing Ambulance capability in response to the civilresilience and counter-terrorism policy.Delivering the Health sector’s National Resilience ExerciseProgramme.Providing the Health crisis and consequence managementresponse to major emergencies.Ensuring the regulatory and professional compliancerequirements of high risk ambulance operations andquality assurance in commissioning these capabilitiesat local level.Emergency Services Mobile Communications Programme(ESMCP) – supporting the Health sector’s interests.

NARU supports all NHS Ambulance Trusts ensuring they

www.naru.org.uk

8

work together in a coordinated way to provide a safe andreliable response to major, complex and potentially protractedincidents as one overall unit. NARU supports the public,patients and ambulance staff of England.

NARU is increasingly being seen as an expert in the delivery ofmass casualty capability and is held in high regard in the UK,with its reputation growing on the international stage too.

This can be seen in the frequent requests for information via ourwebsite and the high profile footprint we have on social mediaalong with the many requests we receive from internationalpartners for support to various initiatives. Development in thisarea is part of the NARU Strategy (Appendix 1).

GEOGRAPHY

NARU has staff presence at WMAS in Birmingham, the PoliceNational CBRN Centre at Ryton near Coventry, the DefenceCBRN Centre at Winterbourne Gunner in Wiltshire and as partof JESIP at the Office for Security and Counter-Terrorism atthe Home Office. NARU is also able to use office space in NHSEngland’s EPRR department at the NHS EnglandHeadquarters in Leeds.

RANGE OF SERVICES

NARU provides services in a number of specific areas:Delivery of National Capability: NARU provides the National capability to mass casualty / complex major incidents, HART and those involving Chemical, Biological, Radiological,

Nuclear or Explosives (CBRNE) and in addition, a capabilitytohandle extreme threats and high risks, ensuring security ofambulance assets and the protection of critical infrastructureto support continuity of resilience.

Delivery of current policy & advice: Including advice, input,clinical response capability, service specifications, intra andinter-operability, guidance for Trusts, national training andexercising provided from the NARU training faculty,operational requirements and evaluation, assurance and auditand response to policy changes. NARU also obtains legaladvice on the maintenance of national interoperablecapabilities and helps support local compliance throughquality assurance and advice to local commissioners andservice providers.

Provide an immediate response to policy changes: Respondto any changes in policy or Government guidance in EPRR,liaise with Ambulance Chief Executives and appropriateDirectors in regard to any changes to policy and expectedambulance response, provide ambulance expert input andsupport to DH / NHS England and Trusts in respect of changesto and policy development for EPRR where there aresignificant workforce or training implications.

Horizon scanning: Horizon scan for potential operationalrequirements for EPRR capabilities, contribute to review andrevision of DH / NHS England policy and guidance in relation toEPRR. Provide ambulance contribution to public enquiries andreviews and ensure lessons are shared and implemented,advise and coordinate development of any new pre-hospital

clinical interventions in respect of major incidents involvingspecial operations or assets, support the delivery of theinteroperability programme.

Partnerships with the devolved administrations: NARUworks in partnership with the devolved administrations,developing effective policies to maintain UK wide resilience.

Provide specific input into various national programmes including:

The Civil Contingencies Capabilities Programme: The Cabinet Office’s Capabilities Programme is the coreframework through which the Government is seeking to buildresilience across all parts of the United Kingdom. Within this,the Department of Health (DH) is responsible for ensuring thatplans exist to maintain continued Health Services in Englandin the event of a catastrophic incident. It is also responsible forthe mass casualties work stream. The Home Office leads thework stream in respect of response and recovery capabilitiesfor incidents involving chemical, biological, radiological ornuclear materials, particularly those causedby terrorism.

NHS Preparedness: The aim of NHS Preparedness is toensure the NHS, as a critical national function, can prepare,mobilise and respond to a wide range of disruptive challengesthat have the actual or potential consequence of disrupting thedelivery of patient care in England. The strategic intent, toensure NHS - funded healthcare providers are individuallyrobust to mitigate, respond and recover from disruption, which in turn will provide the NHS as a whole with collective


2.0

NARU

Profile

9

AMBULANCE

SE RV I C E

2.0

NARU

Profile

resilience. This intent links Health emergency preparedness,crisis and consequence management and system resiliencewith the goals of ‘Liberating the NHS’- of improving patientoutcomes through ensuring NHS providers continue to delivercare during a crisis – or in summary deliver care to the patientwhen they need it most.

The National Risk Assessment of Civil Emergencies: Each year the Cabinet Office undertakes a classifiedassessment of the civil emergency risks facing the UK.Several of the high priority risks require the preparedness ofan emergency Health response, for example, flooding,terrorist attacks and pandemic influenza, in order to ensurean effective response, prevent unnecessary loss of life andimprove patient outcomes.

The aim of NARU, in contributing to the national programmesabove is to ensure effective and efficient coordination in theimplementation of Government policies for NHS AmbulanceServices’ emergency preparedness, resilience and response. In addition the key purpose is to enhance pre-hospital clinicalresponse capabilities thus improving patient outcomes fromdisruptive challenges or threats to public health.

Research and Evaluation: NARU provides evidence-based,enhanced capabilities to current and emerging threats andrisks, to deliver a fit for purpose, pre-hospital response with a focus on patient care and improving clinical outcomes.

National coordination: Harmonisation of core deliverablesis essential if resilience is to be implemented consistently

by ambulance trusts nationally in order to provide a safeand reliable national emergency response capability.

On Call: NARU also provides a cadre of appropriately trainedand experienced tactical and strategic commanders to providesupport to the NHS Operations Crisis Centre and the NationalAmbulance Coordination Centre as required.

NARU WORK ACTIVITIES

NARU activities encompass cross-Government policydevelopment and specifically the business objectives of DHand NHS England. This is in respect of the implementationof systems and capabilities associated with pre-hospital careof patients in the event of major or catastrophic incidents,whether caused deliberately by terrorist or other maliciousactivity, or by accident or natural disaster. To implementpolicy for such capabilities requires the development of anumber of deliverables within Trusts to establish the requiredcapability and integrate appropriate responses withinambulance operations.

In addition, much of the day-today work of the NARU involvesprovision of formal and ad hoc ambulance representation andadvice within the DH and NHS England, cross-Governmentprogrammes and working groups. In the event of a major orcatastrophic incident, NARU personnel will support DH leads,EPRRP and NHS England as directed. They will also supportambulance services nationally, either by sending officers tosupport the affected Trust, or in the on-going operating of theNational Ambulance Coordination Centre (NACC).

www.naru.org.uk

10

NARU KEY CAPABILITY AREAS

The NARU key capability areas are as follows:

Emergency Preparedness and Resilience for responseto mass casualty and complex major incidents.Specialist operations including HART.CBRNE – encompassing Hazardous Materials (HAZMAT)and Nuclear Emergencies including IOR & SOR.Response to Extreme Threats and High Risks – asidentified by JTAC/ Civil Contingencies SecretariatNational Risk Assessment.Security of ambulance assets and protection of criticalinfrastructure to support continuity of resilience.

For each of the work areas, NARU undertakes to coordinate onbehalf of NHS Ambulance Services, certain deliverables inrespect of:

Policy Requirements: Contribute subject matter expertiseto policy development – translating policy requirementsinto operational translation and delivery.

Clinical Response Capabilities: Advise on the developmentof appropriate and feasible pre-hospital clinical responsecapabilities – with the aim of improving patient outcomes.

Service Specifications: Detail what is expected of NHSAmbulance Trusts in terms of deliverables andcommissioning requirements to fulfil the commitmentto policy delivery and maintain legal compliance.

Joint Emergency Services Interoperability Programme:Provide strategic, tactical and operational advice to JESIPthrough representation on the Strategic & ProgrammeBoards and by providing an embedded subject matterexpert within the JESIP team and supporting developmentand delivery of JESIP training, exercising and legacy.

Intra-operability with the NHS:Work closely with theHealth economy and other specialist response agenciesin the development of Joint Operating Procedures (JOPS),Tactics & Doctrine, Multiagency Training/Exercising andstandardisation of equipment common to all parties(e.g. radio communications). To build robust workingrelationships and understanding of all responsecapabilities and ensure effective response andcommunications in the event of major disruptive incidents.

Guidance for Ambulance Trusts: Clarify the scope andresourcing arrangements of how deliverables are to bemet, including generic operating procedures and riskassessments to be built on by trusts and avoid duplicationof effort or variation in delivery, allowing for agreed localvariation when necessary, provided national capability andmutual aid are not adversely affected.

National EPRR Education Training & Exercising: Developor source effective and innovative modules that supportdelivery, such that training of ambulance personnel atall levels, in respect of resilience and emergencypreparedness, consistently meets and strives to exceed aminimum national standard, the requirements from Trusts


2.0

NARU

Profile

11

AMBULANCE

SE RV I C E

2.0

NARU

Profile

and is recognised by partner agencies. Organise andensure ambulance participation in national andinternational exercises designed to test or provideassurance of procedures and capabilities. All NARUeducational products are aligned to National OccupationalStandards, AACE command guidance and JESIP doctrine.

Operational Requirements: Identify key resources neededto support delivery, in respect of personal protectiveequipment, clinical and non-clinical equipment and otherspecialist assets – establishing methods of effectiveevaluation and risk assessment to support centralprocurement processes or frameworks that ensurevalue for money, as well as building on appropriatetechnological advancements.

Evaluation, Assurance & Audit Processes: Develop andundertake independent, objective, evidence-basedevaluation and assurance processes through which thenecessary evidence will be collected and monitored toassess compliance with service specifications, evaluatevalue and impact of service provision, determine levelsof resilience and preparedness, as well as provide thenecessary assurances as required by NHS England.This also includes supporting local commissioningarrangements through the provision of expert advice onsafety critical systems and mandatory minimum levels tomaintain legal and professional compliance in highlyspecialised capabilities.

Operational activities in respect of the above are detailedwithin the NARU Objectives for 2014-15. In addition there arekey on-going objectives:

Respond to any changes in policy or Government guidancein respect of emergency preparedness and resilience,including major incident planning and response to highpriority risks as identified through the NationalCapabilities Programme and the National Risk Assessment.

Liaise with and advise Ambulance Chief Executives andDirectors regarding any changes to policy and expectedambulance response.

Horizon-scan for potential operational requirements forEPRR capabilities, including developments in equipment,technology, research and clinical interventions.

To contribute to the review and revision of DH/NHSEngland policy and guidance specific to emergencypreparedness and response.

Provide ambulance contribution to public inquiries andreviews e.g. 7/7 inquest outcomes, and ensure lessonsare shared and implemented.

Advise and coordinate development of any newpre-hospital clinical interventions in respect of majorincidents involving special operations or assets.

Respond to outcomes and decisions regarding the JointEmergency Services Interoperability Programme.

www.naru.org.uk

12

Provide advice and guidance to DH / NHS England /Commissioners and Trusts in respect of changes to andpolicy development for EPRR where there are significanttraining implications or compliance issues for safetycritical systems.

Ensuring that all the above is communicated to the rightorganisations and individuals is the responsibility of ourcommunications programme. Managing all communicationsand stakeholder engagement initiatives to help NARU achieveits strategic goals, foster public and political confidence inNARU and the work areas it delivers on is key.

This includes management of the NARU website and onlinenewsletter establishing and communicating key messages inorder to promote positive and accurate interpretations of ouraims and activities in the media and among stakeholders. Italso includes maintaining firm procedures, standards andpolicies around media management, publishing, events, films,corporate identity, internal communications, and other areasof communications and ensures they are implementedconsistently and appropriately.

More information on the services that NARU provides canbe found at www.naru.org.uk.


2.0

NARU

Profile

13

AMBULANCE

SE RV I C E

3.0

Strategic

Direction

www.naru.org.uk

14

Our strategy is to deliver our vision for the future throughcontinuous improvement. We will always keep patients andthe safety of staff at the centre of everything we do.

In particular, the work of NARU is to focus on:

Special Operations including the national Hazardous Area Response Team capability.

Civil resilience and counter-terrorism policy.

The Health sector’s National Resilience ExerciseProgramme and the Health crisis and consequencemanagement response to major emergencies.

NARU STRATEGIC AIMS

This year NARU has slightly amended one of its StrategicAims to better reflect the unique role NARU provides onbehalf of stakeholders.

These are:

Achieve Quality and Excellence.

Always Learn, Innovate and Develop.

Ensure Delivery of the NARU Mission and Vision.(Previously ‘Ensure Effective Stakeholder Relationships’)

Provide Sound Governance, Value for Money andFinancial Control.

We intend to deliver these aims through focussedachievement on the underpinning objectives. The specificobjectives for 2014-15 are in Section 5.0.

3.0 Strategic Direction

Vision


Our VisionNARU will support the resilience objectivesof NHS England, the Association of AmbulanceChief Executives and AmbulanceCommissioners. In addition NARU will alsoprovide support to the UK’s Civil Resilienceand counter-terrorism (CONTEST) strategiesand the Health commitments under the UK’sNational Security Strategy and the NationalSecurity Council.


Our Mission

Preparingfor theFuture,ProtectingLives Today

NARU VALUES

Our values are an essential part of our strategy as it is throughthese that we set out the culture of NARU through describingthe behaviours we expect all our staff to demonstrate.

We have worked hard to make sure that the values we holdare complementary to West Midlands Ambulance Service NHSFoundation Trust’s values but are simple, transparent andresonate across the Unit.

Excellence in delivery.Patient focussed.Investing in staff health and wellbeing.Providing high quality support to NHS Trusts.Value for money.Providing credibility.Integrity.Transparency.Innovation.Proportionality.Sharing learning to inform developments.An international leader in ambulance resilience.

Our priorities for 2014-15 are to continue to embed theseacross all aspects of NARU. We intend to reinforce our valueswith all staff within NARU and ensure a copy of our Mission,Vision and Values are included in the standard PerformanceDevelopment Review (PDR) paperwork.

Figure 3.1 is the ‘Strategic Planning Framework’ for NARU. It shows the links between the Mission, Vision, Values and the strategic aims and how individual staff objectives agreedthrough their PDR process contribute to the achievement ofthe vision for NARU.

The strategic objectives of NARU are linked through theAnnual Business Plan to the departmental and individualobjectives. This provides an organisational blueprint whichtranslates the strategic objectives into operational deliveryover the next year.


3.0

Strategic

Direction

15

AMBULANCE

SE RV I C E

3.0

Strategic

Direction

Figure 3.1 National Ambulance Resilience Unit Strategic Planning Framework

www.naru.org.uk

16

Strategic Vision

Feed back loops help define and refine the Strategic Vision, Mission and Values

Operational Objectives

Departmental Objectives

Individual Objectives agreed at PDR

Mission & Values Strategic Goals Strategic Aims

VisionNARU will support the resilienceobjectives of NHS England, theAssociation of Ambulance ChiefExecutives and Ambulance

Commissioners. In addition NARU willalso provide support to the UK’s CivilResilience and counter-terrorism

(CONTEST) strategies and the Healthcommitments under the UK’s

National Security Strategy and theNational Security Council.

To provide a first class service throughconstantly seeking to innovate and be

recognised for our quality and to provideresponsive, flexible, consistent services

appropriate to the needs of the patient andin line with commissioner intentions.

Achieve Quality &Excellence

To develop, lead, deliver and coordinateambulance resilience and to create an

environment in which NARU develops to itsmaximum potential, where excellenceflourishes, and which inspires others.

Always LearningInnovating andDeveloping

Mission

Preparing for the Future,Protecting Lives Today

ValuesExcellence in delivery, Patient focussed,Investing in staff health and wellbeing,High quality support to NHS trusts,

Value for money, Providing Credibility,Integrity, Transparency, Innovation,Proportionality, Sharing Learning toinform developments. An international

leader in ambulance resilience.

To create an environment, in whichNARU is able to fully deliver the mission

and vision statements, is a trustedpartner for stakeholders, is responsiveto their needs and requirements, whilstmaintaining excellence in all we do.

Ensure Deliveryof the NARU

Mission and Vision

To provide efficient and effectivemanagement personnel and processes

Provide SoundGovernance, Valuefor Money and

Financial Control

Figure 3.2 shows the annual and five year activities linked tothe Long Term Strategic Plan and the Annual Business Plan.These activities are underpinned by management monitoringand review which will influence the development of thestrategic plans for NARU. This link is important in ensuringthat all activities at individual patient, staff and executive level,inform progress and strategy development in the future.

Further information on this work is contained in Section 6.0 – Annual Planning Cycle.


3.0

Strategic

Direction

17

Figure 3.2 NARU Strategic Model / Business Planning Activities by Strategic and Annual Plan

Performance Appraisal

Performance Measurement

Delivery

Defined Objectives

Strategic Priorities

Vision & Purpose

Annual Business Plan

5 Year Plan

Resilience B

oard

Annual Reports

Managers

Managem

ent Board

Staff

AMBULANCE

SE RV I C E

4.0

Review of Performance

2013-14

www.naru.org.uk

18

The 2013-14 NARU Annual Business Plan set out thestrategy, objectives and delivery mechanism and was thefirst Annual Business Plan developed by NARU.

NARU has delivered the agreed work plan and set of objectives.The work plan has been delivered on time and within budgetagainst a backdrop of considerable change and uncertainty inlight of the change in commissioning arrangements from DHto NHS England.

Also the 2013-14 NARU objectives have also been delivered.These were set against four strategic developments goals:

1. Achieve Quality & Excellence2. Always Learning, Innovating and Developing3. Ensure Effective Stakeholder Relationships4. Provide Sound Governance, Value for Money and

Financial Control

During 2013, NARU commissioned a stakeholder engagementreview. This review established a genuine and positive need forNARU. In brief, stakeholders were in agreement and supportedthe fact that NARU:

Coordinates resilience nationally.Helps to promote the importance of resilience nationally(and internationally).Acts as a specialist point of contact, and provides advice,best practice and guidance.Acts as a strategic link between Government departmentsand the individual ambulance services.Provides access to high quality, high impact training onmatters associated with resilience.

Although there is still more work to be done with stakeholders,these results demonstrate the positive steps that have beentaken to improve the NARU service.

4.0 Review of Performance 2013-14

1. Strategic Goal - Achieve Quality & Excellence

1.1 Full delivery of the 2013-14 agreed Work Plan

1.2 Continued achievement of agreed on-going objectives in the NARU Strategy

1.3 Work towards aligning NARU contract to CSR timescales

2. Strategic Goal - Always Learning, Innovating and Developing

2.1 Active progression of the development objectives in the NARU strategy

2.2 Improve the engagement with and the well being and safety of the NARU workforce

2.3 Deliver Service Improvement and increased efficiency

3. Strategic Goal - Ensure Effective Stakeholder Relationships

3.1 Build and maintain positive relationships with Stakeholders

3.2 Ensure a successful transition to NHS England

4. Strategic Goal - Provide Sound Governance, Value for Money and Financial Control

4.1 Ensure financial break even

4.2 Ensure good governance is embedded within NARU

4.3 Ensure WMAS procurement processes are embedded within NARU

4.4 Design the NARU commissioning arrangements with NHS England

Delivery Risk

Amber

Green

Red

Delivery Risk

Red

Green

Amber

Delivery Risk

Green

Red

Delivery Risk

Amber

Green

Green

Amber

Year End Outcome

Green

Green

Green

Year End Outcome

Green

Green

Green

Year End Outcome

Green

Green

Year End Outcome

Green

Green

Green

Green

The National Ambulance Resilience Unit (NARU) - Annual Business Plan 2014-2015 4.0


2013-14

19

AMBULANCE

SE RV I C E

4.0


2013-14

www.naru.org.uk

20

Table 4.1: 2013-14 Business Plan Objectives Year End Position

Objectives and targets Constraints identified Targets and methods of assessingachievement

Comments

1.1 Full delivery of the 2013-14 AgreedWork Plan

1.2 Continued achievement of agreedon-going objectives in the NARUStrategy

1.3Work towards aligning NARU contractto CSR timescales

Changes in Governmentpolicy, funding withdrawn

Changes in Governmentpolicy, funding withdrawn

Stakeholder objections,procurement law

2013-14 Work Plan delivery approval atResilience BoardMilestones achieved on or before scheduleStakeholder feedback positively reflectsdelivery

Departmental reports Minutes of meetingsExample of service changes as aconsequence of stakeholder feedbackExample of proactively seeking feedbackfrom all service users

Development of an outline planEngagement with NHS EnglandMinutes/Notes of meetings

Objective and Targets achieved



1: Strategic Goal - Achieve Quality & ExcellenceStrategic Aim – To provide a first class service through constantly seeking to innovate and be recognised for our quality, and to provide a responsive, flexible and consistent service appropriate to the needs of the patient and in line with commissioner intentions.



2013-14

21


Comments

2.1 Active progression of the developmentobjectives in the NARU strategy

2.2 Improve the engagement with, and thewell being and safety of the NARUworkforce

2.3 Deliver Service Improvement andincreased efficiency

Delivery Board Report

Audit of staff PDR records to confirmevidenceReduction in staff sickness

Budget reportsWork PlanDelivery Reports

Objective and Target achieved



2: Strategic Goal - Always Learning, Innovating and DevelopingStrategic Aim – To develop, lead, deliver and co-ordinate ambulance resilience, and to create an environment in which NARU develops to its maximum potential,where excellence flourishes, and which inspires others.

3.1 Build and maintain positive relationshipswith Stakeholders

3.2 Ensure a successful transition toNHS England

Stakeholder engagement processMinutes/Notes of meetingsPositive stakeholder feedbackRenewal of contract

Signed Contract with NHS England Meeting notes/minutesFeedback from meetings/events



3: Strategic Goal - Ensure Delivery of the NARU Mission and VisionStrategic Aim – To create an environment in which NARU is a trusted partner for stakeholders, responsive to their needs and requirements, whilst maintainingexcellence in delivery and support.

AMBULANCE

SE RV I C E

4.0


2013-14

www.naru.org.uk

22


Comments


4.2 Ensure good governance is embeddedwithin NARU

4.3 Ensure NHS procurement processesare embedded within NARU

4.4 Design the NARU commissioningarrangements with NHS England

Budget statementsDelivery of work planDelivery of any agreed budget evidencedthrough Finance departmentMonthly financial reporting to SLA Board

Procedure documentationAudit of procedures

Delivery Board ReportsEvidence of staff training/information

Minutes of meetingsEvidence of framework agreementConfirmed contractual arrangements for2014 onwards





4: Strategic Goal - Provide Sound Governance, Value for Money and Financial ControlStrategic Aim – To provide efficient and effective management personnel and processes


5.0

2014-15 Operational

Objectives & Key Performance

Indicators (KPI)

23

2014-15 will again be a key year in the continuingdevelopment of NARU. The aim is to help strengthennational resilience and improve patient outcomes in avariety of challenging pre-hospital environments, whilstimproving clinical effectiveness, cost effectiveness andstakeholder perception.

Table 5.1 shows all of the objectives NARU will be deliveringagainst during 2014-15.

The Red, Amber, Green (RAG) rating relates to theassessed risk of achievement given the standard orresource requirements.

RED

Requires significant NARU financial, staffing, clinical,or management resource and organisational focus in orderto secure delivery.

High level of risk and/or high to medium level of thirdparty dependency.

Represents an extremely challenging programme.

AMBER

Requires some NARU financial, staffing, and clinical ormanagement resource and organisational focus in orderto secure delivery.

Medium level of risk and/or high to medium level of thirdparty dependency.

Represents a significantly challenging programme.

GREEN

Requires NARU financial, staffing, clinical or managerialresource to ensure successful delivery.

Low level of risk and/or medium to low level of third partydependency.

Represents a challenging programme.

We have included a number of operational objectives for2014-15 which we know will stretch NARU and provide us witha challenge to deliver. NARU is confident that althoughchallenging, these are achievable and will directly contributeto us moving forwards.

5.0 2014-15 Operational Objectives and Key Performance Indicators (KPI)

AMBULANCE

SE RV I C E

5.0

2014-15 Operational


Indicators (KPI)

www.naru.org.uk

24

1. Strategic Goal - Achieve Quality & Excellence

1.1 Continued achievement of agreed on-going objectives in the NARU Strategy

1.2 Work towards increasing length of NARU contract to minimum 3 years

2. Strategic Goal - Always Learning, Innovating and Developing

2.1 Active progression of the development objectives in the NARU strategy

2.2 Improve the engagement with and the well being and safety of the NARU workforce

2.3 Deliver Service Improvement and increased efficiency including 4% CRES

3. Strategic Goal - Ensure Delivery of the NARU Mission and Vision

3.1 Full delivery of the 2014-15 agreed Work Plan

3.2 Build and maintain positive relationships with Stakeholders

3.3 Review EPRG and sub groups and implement recommendations

4. Strategic Goal - Provide Sound Governance, Value for Money and Financial Control


4.2 Ensure good governance is embedded within NARU

4.3 Support the NHS England NARU Review

4.4 Design the NARU commissioning arrangements with NHS England

Green

Red

Red

Green

Red

Amber

Green

Green

Amber

Green

Green

Amber

Table 5.1 Summary of KPI’s for 2014-15 by Strategic Goals


5.0

2014-15 Operational


Indicators (KPI)

25

Strategic Goal 1 - Achieve Quality & Excellence

Key Performance Indicators 2014-15

1.1

1.2

Identifier

Strategic Aim: To provide a first class service through constantly seeking to innovate and be recognised for our qualityand to provide a responsive, flexible and consistent service appropriate to the needs of the patient that is in line withcommissioner intentions.

Continued achievement ofagreed on-going objectives inthe NARU Strategy

Work towards increasinglength of NARU contract tominimum 3 years

Objective

Additional priority items added towork plan in year diverting resources

Non engagement by stakeholders


Identified Constraints

Departmental reports Minutes of meetingsExample of service changes as aconsequence of stakeholder feedbackExample of proactively seeking feedbackfrom all service users

Development of an outline planEngagement with NHS EnglandMinutes/Notes of meetings

Evidence

Strategic Goal 2 - Always Learning, Innovating and Developing

2.1

2.2

2.3

Identifier

Strategic Aim: To develop, lead, deliver and co-ordinate ambulance resilience and to create an environment in which NARUdevelops to its maximum potential, where excellence flourishes, and which inspires others.

Active progression of thedevelopment objectives in theNARU strategy

Improve the engagementwith, and the wellbeing andsafety of the NARU workforce

Deliver Service Improvementand increased efficiencyincluding 4% CRES

Objective





Delivery Board report

Audit of staff PDR records to confirm evidenceMonthly reporting of PDR compliance throughthe Integrated Performance ReportReduction in staff sickness

Budget reportsWork PlanDelivery Reports

Evidence

AMBULANCE

SE RV I C E

www.naru.org.uk

26

5.0

2014-15 Operational


Indicators (KPI)

Strategic Goal 3 - Ensure Delivery of the NARU Mission and Vision

3.1

3.2

3.3

Identifier

Strategic Aim: To create an environment, in which NARU is able to fully deliver the mission and vision statements, is atrusted partner for stakeholders, is responsive to their needs and requirements, whilst maintaining excellence in all we do.

Full delivery of the 2014-15Agreed Work Plan

Build and maintain positiverelationships withStakeholders

Review EPRG and sub groupsand implementrecommendations

Objective






2014-15 Work Plan delivery approval atResilience BoardMilestones achieved on or before scheduleStakeholder feedback positively reflects delivery

Minutes/Notes of meetingsPositive stakeholder feedbackRenewal of SLA

Review reportEPRG TORMeeting notes/minutes

Evidence

Strategic Goal 4 - Provide Sound Governance, Value for Money and Financial Control

4.1

4.2

4.3

4.4

Identifier

Strategic Aim: To provide efficient and effective management personnel and processes.

Ensure financial break even

Ensure good governance isembedded within NARU

Support the NHS EnglandNARU Review

Design the NARUcommissioning arrangementswith NHS England

Objective

Increased costs, CIP Plan doesn’twork



Delivery of work planDelivery of any agreed CIP evidenced throughFinance deptMonthly financial reporting to SLA BoardBi Monthly reporting to NHS England viaTeleconference

Procedure documentationAudit of procedures

Provide reports, minutes & evidence as required

Minutes of meetingsEvidence of framework agreementConfirmed contractual arrangements for 2014onwards

Evidence


6.0

Annual Planning

Cycle

27

The Annual Business Plan published in April each year is theculmination of a series of events, consultations, performanceand priority review. It is a significant milestone in the businessplanning cycle.

This section sets out the programme of work associated withmonitoring and maintenance of the 2014-15 business plan andthe development of the three year Strategic Intent plan 2012-15.

It is through this process that NARU will agree objectives withstakeholders; produce implementation plans, mitigateagainst risk and review the monitoring and assurance cycle.

A timetable for strategic planning is included in Table 6.1 toprovide an indicative sequence of events required tostrategically review and plan for NARU.

6.0 Annual Planning Cycle

Table 6.1 High Level Annual Strategic Planning Cycle April 2014 - March 2015 – NARU

AprilCommunicateand implement2014-15 annualbusiness plan

Build theachievement ofstrategic aimsinto annualPersonalDevelopmentPlans/Reviews(PDP/R)

Year end reviewof achievementof 2013-14 workplan andobjectives

Confirm workprogrammes tosupport 2014-15objectives

MayStrategy review

Managementevent

Commence CIPreview for 2014

Draft 2015-18Strategic IntentPlan produced

Start to develop15-18Commissioningplan

Review ofGovernance

JuneAssess workprogrammes tosupport 2014-15objectives

Revieworganisationalstrategy

Assess deliveryof 14- 15 AnnualBusiness Plan

JulyConfirmation ofstrategic goals

Commence 15-18commissioningand contractnegotiations

AugustReviewgovernance

Review risks

SeptemberStart to develop15-16 work plan

Assess deliveryof 14-15 AnnualBusiness Plan

Identity andmitigate againstany at riskprojects

Agree 15-18Commissioningplan with NHSEngland

OctoberFinance review

Start to develop15-16 AnnualBusiness Plan

NovemberAchieve WMASapproval for 15-18Commissioningplan

DecemberAgree 15-16contract

Agree draft15-16 AnnualBusiness Planwithstakeholders

Assess deliveryof 14-15 AnnualBusiness Plan

Identity andmitigate againstany at riskprojects

JanuaryDelivery Boardapproval of the2015-18Strategic IntentPlan

FebruaryAssess deliveryof 14-15 AnnualBusiness Plan

Final mitigationof at riskprojects

Agree the 15-16work plan withStakeholders

MarchIdentify andquantifyorganisationalrisk against thenew annual plan

Formal Approvalof 2015-16annual Businessplan

AMBULANCE

SE RV I C E

7.0

Performance

Management

www.naru.org.uk

28

The performance management of the business plan hasbeen considered within the context of the contract betweenNHS England and WMAS. Delivery of the 2014-15 businessplan will be performance managed through the followingmeasures:

Twice yearly reports to stakeholders including narrativeof work plan and financial position.

Monthly NARU Delivery Board scrutiny of the IntegratedWork plan Performance Report, financial position and CIPachievement.

Regular stakeholder briefings, meetings andteleconferences.

Quarterly meetings with Ambulance commissioning leads.

Central Management Team overview and assessmentof delivery.

Emergency Preparedness, Resilience and Response Group.

Department and Team meetings.

Delivery of objectives outlined in individual PersonalDevelopment Review meetings aligned to the strategicaims and annual business plan.

Operational delivery plans for each KPI will be delivered ineach relevant area and performance managed through theCentral Management Team with assurance through theDelivery Board

Organisational and departmental progress against each of theKPIs will be reviewed and evaluated by the NARU DeliveryBoard. The NARU Delivery Board will:

Provide ownership of the operational plans.Provide guidance and leadership.Monitor variance against plans.Agree remedial actions.

The WMAS Deputy Director of Finance will provide assuranceand financial scrutiny of the programme and will reportprogress regularly to the Delivery Board. Regular meetingswill be held between the WMAS finance department andNARU leads to ensure progress.

The system of internal control has been designed tomanage risk in order to provide reasonable assurance ofits effectiveness to all stakeholders.

7.0 Performance Management


Financial

Plan

29

The 2014-15 financial plan has been constructed througha process of engagement with key internal and externalstakeholders. It is integrated with and fully supports thedelivery of the 2014-15 business plan objectives.

The budget for 2014-15 has been agreed at the same level as2013-14 less 4% cost improvement and spending will be withinthose agreed parameters. Therefore efficiencies of around 6%will need to be realised.

Following this funding cut, NARU has conducted an impactassessment on its core service provision. Through efficienciesin the establishment and use of resources, NARU is confidentthat it will be able to maintain its core outputs and deliver abreak even position at year end.

Nevertheless, increased financial control and cost reductionswill need to be carefully managed throughout the 2014-15fiscal period. The governance and scrutiny arrangements put inplace in April 2012 will enable the unit to manage delivery ofthis CIP requirement. The unit still plans to break even again atthe end of 2014-15.

Management of funding streams via the contract, and centralrevenue allocations to Trusts (where applicable) will bemanaged in line with WMAS standing financial instructionsand procedures.

Key points to note in respect of the plan are as follows:

The plan requires delivery of a Cost ImprovementProgramme (CIP) of 4%. In addition no inflation uplifthas been provided, therefore a CIP of around 6% needsto be realised.

Robust financial control will be required throughout2014-15. This must focus on NARU future position as wellas in-year delivery.

8.0 Financial Plan

AMBULANCE

SE RV I C E

9.0

Risk

Management

www.naru.org.uk

30

Risk management is a key component of enhancing theNARU objectives and is a central part of NARU strategicmanagement. It is the process whereby we methodicallyaddress the risks attached to our activities with the goal ofachieving sustained benefits to patient care and to the NARUstrategic agenda, within each activity and across the portfolioof all NARU activities. The focus of risk management at NARUis the identification and treatment of risk.

It is integrated into the culture of NARU with an effectiveprogramme led by the most senior NARU management. Thistranslates into tactical and operational objectives, assigningresponsibility throughout NARU with each manager andemployee responsible for the management of risk as part oftheir job description.

NARU will take all reasonable steps to ensure that suitableand sufficient risk assessments are carried out. Suchassessments will record the range of hazards associated withthe activities, an evaluation of the corresponding risks and anynecessary control measures in both existing and proposedactivities of the Unit. It is worth noting that many of theoperational capabilities supported by NARU require theapplication of safety critical systems. They have the potentialto be high risk and NARU staff, particularly through ourexisting governance and compliance work programmes,provide a significant contribution to the effective managementof risk for major incidents.

All actions contain inherent risks. Risk management is centralto the effective running of any organisation. At its simplest,risk management is good management practice. It should notbe seen as an end in itself, but as part of an overallmanagement approach. The Delivery Board will ensure thatdecisions made by the unit are taken with consideration to theeffective management of risks.

NARU will adhere to the risk management policies as laiddown by WMAS.

9.0 Risk Management

Figure 9.1 Risk Management Process

Establish Context

Monitor

and

Review

Identify Risks

Analyse Risks

Evaluate andRank Risks

Treat Risks

Assess

Risks

Communication and Consultation


10.0

Governance

31

The Delivery Board is responsible for the governance of NARU.The Delivery Board will prepare twice yearly reports for NHSEngland and the WMAS FT Board. The Central ManagementTeam (CMT) is responsible for the day to day management ofNARU. The CMT reports to the Delivery Board. A review ofgovernance arrangements will be held in quarter one of 14-15.

Figure 10.1 (on page 32) shows the NARU Governancestructure. As can be seen NARU have put robust and rigorousgovernance structures in place to ensure that the unit ismanaged appropriately.

The structure is essential to the effectiveness of the jointworking relationship between the NARU team and the keyindividuals with responsibility and expertise for emergencypreparedness and resilience within the ambulance trusts.

As well as the on-going key objectives listed in section 2.0, andspecific deliverables within this document, there are corporateactivities undertaken within NARU in order to support deliveryof all of the work areas identified.

As part of our 2014-15 business planning, NARU will reviewthe effectiveness of the CMT and Delivery Board interfacesto ensure optimal levels of governance and assurance. Thisreview will be completed in the first quarter.

The Delivery Board is accountable to the WMAS Chief Executiveand NHS England for the delivery of all requirements within thecontract and associated business plan.

The WMAS Chief Executive is the national ambulance ChiefExecutive lead with responsibility for national EPRR issues.He is also Chair of the Association of Ambulance ChiefExecutives (AACE) and National Ambulance Director and actsas the link between NARU and AACE, ensuring AACE prioritiesfor EPRR are recognised and acted upon appropriately byNARU in addition to those of other stakeholders.

NARU operates within the governance structure establishedwithin WMAS and adheres to WMAS financial standinginstructions, policies and procedures.

Where appropriate, NARU undertakes central procurement ofkey specialist assets and equipment on behalf of AmbulanceTrusts. This ensures consistency across trusts throughnationally developed and agreed specifications. Nationalcontract frameworks are also developed by NARU with theWMAS procurement team, to enable trusts to obtain value formoney for maintenance and servicing contracts and essentialresilience.

10.0 Governance

AMBULANCE

SE RV I C E

10.0

Governance

www.naru.org.uk

32

Figure 10.1 – NARU Governance Structure

Key

Accountable to

Reports to

Advises/Informs

National AmbulanceCommissioning Group

(NACG)

Quality Assurance &Audit Function

National TrainingCentre

Association ofAmbulance ChiefExecutives (AACE)

AACE DirectorsSub-Groups(NDOG etc)

UK Health Dept ResiliencePolicy Board

Four CountriesAmbulance Resilience

Group

Various Advisory Sub-groups -National HART

Coordinating/Operations/Clinical/Training/Vehicle

& Equipment

Specific Task & Finish groupsestablished under work

streams

NHS England

Contract

Host Ambulance Service NHS Trust (WMAS)

Emergency PreparednessResilience and Response

Group (EPRRG)

Work streamsMitigation, Preparedness, Response &

Recovery, Business Continuity

National Ambulance Resilience Unit (NARU)

Delivery Board

NARU Central Management Team


11.0

Development

Programme

33

NARU comprises a small team of subject matter expertswith considerable experience from working in or with NHSambulance services and other relevant agencies. As a teamNARU is well placed to act objectively and independently inmany areas such as acting as a conduit between Departmentof Health / NHS England and Ambulance Trusts, providing:

Full time support to NHS England, Trusts, commissioningbodies and DH.

A single point for provision of advice on turning policy into operations, and input from operations to influence the development of new policy.

Patient focused development of cross government policyinitiatives including scientific research and development.

An operational sensibility to academic policy thinking,putting requirements into operational context.

Ambulance input/access to the Incident CoordinationCentre (National) and NHS England.

In addition NARU is able to centrally coordinate developmentand implementation of ambulance Emergency Preparedness& Resilience and Response (EPRR) policies and proceduresproviding:

A structure that encourages consensus and ownershipacross Trusts, avoiding duplication or conflict of effortand resources.

Clear service specifications for EPRR requirementswithin Trusts.

A central point of contact for multiagency partners ata strategic level.

The ability to operate across Government sectors.

A central function and facilitation for Trusts regardingstakeholder engagement.

Ensure responses and initiative developments areproportional and provide value for money.

Encourage evidence-based best practice and consistencyin approach across Trusts.

Benchmarking EP capabilities and policy against otherjurisdictions and international partners.

Undertaking scientifically-based processes for evaluationof the effectiveness of policy implementation and delivery.

11.0 Development Programme

AMBULANCE

SE RV I C E

11.0

Development

Programme

www.naru.org.uk

34

Facilitate maintenance of national standards byproviding flexible and adaptable, centrally providedtraining programmes.

Provide national procurement frameworks for all Truststo utilise.

Evaluation and horizon scanning of specialist assets– equipment & vehicles.

An independent and objective assurance and auditfunction to assess Trust capabilities and compliance withpolicy delivery. This includes, advising on the mandatoryminimum standards required for legal compliance inregard to operational safety critical systems.

NARU will communicate and actively seek to develop itsservices in line with the above. NARU also intends to continueto progress its development objectives throughout 2014-15as laid out in the three year strategic intent plan.


Glossary

of Terms

35

EXPLANATION / TRANSLATION

Specific terrorism threat type.

Legislation setting out the requirements for organisations which may need to respond toa significant major incident within their operational area.

Accountable Officer of an NHS Body.

Programme designed to increase efficiency for less cost.

Aims to reduce the risk to the United Kingdom and its interests overseas from terrorism,so that people can go about their lives freely and with confidence.

New professional body which aims to increase professionalism in policing (replaced NPIAin Dec 12).

The Centre for the Protection of National Infrastructure. Body that protects national securityby providing protective security advice. Protective security is 'putting in place, or building intodesign, security measures or protocols such that threats may be deterred, detected, or theconsequences of an attack minimised'.

Non-governmental agency responsible for monitoring and performance measuringNHS organisations.

Government Department that provides strategic leadership for public Health, the NHS andsocial care in England.

Emergency Preparedness, Resilience & Response.

NHS organisations which operate under a different governance and financial frameworkto previous NHS Trusts.

TERM

CBRNe - Chemical, Biological,Radiological, Nuclear andexplosive

CCA - Civil Contingencies Act(2004)

CEO - Chief Executive Officer

CIP - Cost ImprovementProgramme

CONTEST - UK CounterTerrorism Strategy

CoP - College of Policing

CPNI - Centre for theProtection of NationalInfrastructure

CQC - Care Quality Commission

DH - Department of Health

EPRR

Foundation Trusts

12.0 Glossary of Terms

AMBULANCE

SE RV I C E

12.0

Glossary

of Terms

www.naru.org.uk

36


Measures which ensure the appropriate management of an organisation.

A highly trained group of staff who are trained to deliver ambulance services under specific,especially challenging circumstances.

Report presented monthly to Delivery Board highlighting performance against keyindicators.

Body set up in 2012 which aims to ensure Emergency Services work together coherentlyas a matter of routine.

These help an organisation define and measure progress toward organisational goals andobjectives.

Medical Emergency Response Incident Teams.

Centre designed to support trusts in the event of significant service disruption toambulance operations.

National Ambulance Resilience Unit.

Body that aims to help raise performance in business, industry and the public by layingdown standards.

National Health Service.

NHS England is responsible for providing an oversight and assurance on the day-to-dayoperational delivery of the NHS against a backdrop of reform.

Replaced by CoP Dec 12.

Work stream of CONTEST where an attack cannot be stopped, to mitigate its impact.

Work stream of CONTEST to strengthen our protection against terrorist attack.

Service Level Agreement.

TERM

Governance

Hazardous Area ResponseTeam (HART)

Integrated Performance Report(IPR)

Joint Emergency ServicesInteroperability Programme(JESIP)

KPI(Key Performance Indicator)

MERIT

NACC - National AmbulanceCoordination Centre

NARU

National OccupationalStandards

NHS

NHS England

NPIA - National PolicingImprovement Agency

PREPARE

PROTECT

SLA


Glossary

of Terms

37


All those who may use the service, be affected by or who should be involved in its operation.

Specialist team of paramedics who have been trained to carry out emergency treatment indifficult conditions, for example, where a patient is trapped underground.

West Midlands Ambulance Service (FT).

TERM

Stakeholders

USAR - Urban Search andRescue

WMAS

AMBULANCE

SE RV I C E

13.0

Appendices

www.naru.org.uk

38

Our Mission

Our Vision

Our Values

Our On-going Objectives

(day to daybusiness -monitored everyyear againstagreed KPI's)

Preparing for the future, protecting lives today

NARU will support the resilience objectives of NHS England, the Association of Ambulance Chief Executives andAmbulance Commissioners. In addition we will also provide support to the UK’s Civil Resilience and counter-terrorism (CONTEST) strategies and the Health commitments under the UK’s National Security Strategy and theNational Security Council.

Excellence in delivery, patient focussed, investing in staff health and wellbeing, high quality support to NHS trusts,value for money, credibility, integrity, transparency, innovation, proportionality, sharing learning to informdevelopments and as an international leader in ambulance resilience.

1. Coordinate delivery of a national capability in: response to mass casualty / complex major incidents, HazardousArea Response Teams (HART), Chemical, Biological, Radiological, Nuclear or Explosives (CBRNE). In addition,response to extreme threats and high risks, security of ambulance assets and protection of critical infrastructure tosupport continuity of resilience.

2. Delivery of current policy including advice, input, clinical response capability, service specifications, intra andinter-operability, guidance for Trusts, national training and exercising, operational requirements and evaluation,assurance and audit.

3. Respond to any changes in policy or government guidance in EPRR, liaise with Ambulance Chief Executives andDirectors in regard to any changes to policy and expected ambulance response, provide ambulance expert input andsupport to DH / NHS England and Trusts in respect of changes to and policy development for EPRR where there aresignificant workforce or training implications.

4. Horizon scan for potential operational requirements for EPRR capabilities, contribute to review and revision of DH/ NHS England policy and guidance in relation to EPRR. Provide ambulance contribution to public enquiries andreviews and ensure lessons are shared and implemented, advise and coordinate development of any new pre-hospital clinical interventions in respect of major incidents involving special operations or assets, support thedelivery of the interoperability programme.

5. Continue to work in partnership with the devolved administrations, developing effective policies to maintain UKresilience.

13.0 AppendicesAppendix 1: National Ambulance Resilience Unit Strategy on a Page 2013-16


13.0

Appendices

39

OurDevelopmentObjectives

(tackling thekey areas wherewe intend todeliver majorchange over thenext 3 years)

1. To deliver service improvement and increase efficiency by: continually appraising and assessing current deliveryand looking at new and other delivery methods and by working in partnership with stakeholders in order to ensurethe most appropriate systems are in place that meet the requirements of those stakeholders and provide the bestpossible value for money.

2. To develop capabilities that enhances ambulance service EPRR utilising innovative models and methodology.

3. To develop new income streams utilising the expertise within NARU to expand the national and into theinternational market in the provision of advice, guidance and expertise in HART, CBRNE and resilience.

4. To transform the delivery of national ambulance EPRR by developing Key Performance Indicators (KPI) to ensureeffective and efficient coordination in the implementation of government policies for NHS ambulance services, byenhancing pre-hospital clinical response capabilities thus improving patient outcomes from disruptive challenges orthreats to public Health. This will be achieved equitably.

5. To build on the Joint Emergency Services Interoperability Programme, work in partnership with the Office forSecurity and Counter Terrorism (OSCT) and the Fire and Rescue Services National Resilience and Assurance Team(NRAT) to develop integrated strategic operational resilience arising from Home Office, DCLG and DH policydirection.

AMBULANCE

SE RV I C E

The National Ambulance Resilience Unit (NARU)Annual Business Plan 2014-2015

For further information please contact:

National Ambulance Resilience Unit (NARU)

Website: www.naru.org.uk

© National Ambulance Resilience Unit (NARU). Produced by NARU Communications and Stakeholder Engagement, April 2014.

annual business plan 2014-2015 -...

Documents