Presentation to South Eastern LCG 

Brian McNeill 

Director Operations 

13 May 2010

NIAS MISSION & VISION

• To deliver effective and efficient care to people in need and improve the health and well‐being of the community through the delivery of high quality ambulance services.

• An Ambulance Service contributing to a safer community and better quality of life in NI through first  class “out  of hospital”emergency, nonemergency and disaster services.

NIAS At A Glance• Resources Available

• 47 Locations & 2 Control Centres

• 1000+ Staff 

• 307 ambulance vehicles

• 56 A&E Peak of day 

• 24 RRV

• 368,000 patient contacts 

• 1:5 of population

• 124,000 emergency calls (09/10)

• 6.7% increase from 08/09

• 36,000 urgent  Calls  (08/09)

• 207,000  non urgent ( 08/09)

REVENUE to cover running costs £59.112m

CAPITAL to cover cost of equipment £2.971m

How much money did NIAS receive in 2009/10?

How was it spent? 2009/10 Expenditure £59.1m

How was it spent? 09/10 CAPITAL £2.971m

£2,470k

£322k

£138k

£41k

20082008‐‐11 11 A Major ChallengeA Major Challenge

for NIASfor NIAS

EFFICIENCY EFFICIENCY SAVINGSSAVINGS

COMPREHENCOMPREHENSIVE SIVE

SPENDING SPENDING REVIEWREVIEW

Performance ImprovementPfA targets

• 2009/2010–From April 2008 Regional‐ 70% of cat A calls within 8 62.5 LCG 

by March 2009 Regional 72.5%  and 65% LCG

2010 ‐2011From April 2010 – Regional 72.5% and 65% LCG

By March 2011 – Regional 75% and 67.5% LCG 

Performance Improvement Call categories 

• Category  A:‐ immediately life threatening receive an emergency response with 8  mins by (PfA target).

• Category B :‐ Serious but  not  life threatening 

18 /21 min response for 95% of calls.

• Category  C :‐ not  immediately  serious or life threatening.  Currently  up to 1 hour.

Cumulative Cat A8 2009/10

Cumulative Year to Date Category A Performance - % of calls with response less than 8 minutes

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarNI

Target 70 70 70 70 70 70 70 70 70 70 70 72.5LCG

Traget 62.5 62.5 62.5 62.5 62.5 62.5 62.5 62.5 62.5 62.5 62.5 65Northern

Ireland 74.0 74.8 74.7 74.4 73.8 73.7 73.4 73.2 72.2 71.8 71.6 71.5Belfast

LCG 89.5 88.7 88.7 88.6 88.2 87.9 87.5 87.2 86.7 86.3 85.9 85.6South

Eastern LCG 73.4 72.3 72.3 71.8 71.6 71.7 71.4 71.5 70.3 69.2 69.0 68.7

Northern LCG 66.1 66.8 66.6 66.1 65.1 64.5 64.3 64.1 62.7 62.4 62.3 62.7

Southern LCG 66.2 67.2 67.3 67.5 67.0 67.5 67.0 66.6 65.9 65.6 65.5 65.3

Western LCG 67.6 71.8 71.4 70.6 70.5 70.8 70.8 70.6 69.5 69.4 69.0 68.7

Monthly  Cat A 2009/2010Monthly Category A Performance - % of calls with response less than 8 minutes

Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb MarNI Target

70 70 70 70 70 70 70 70 70 70 70 72.5LCG Target

62.5 62.5 62.5 62.5 62.5 62.5 62.5 62.5 62.5 62.5 62.5 65

Northern Ireland 74.0 75.5 74.5 73.4 71.3 73.3 71.6 72.0 65.6 67.9 68.8 70.5

Belfast LCG 89.5 88.0 88.5 88.3 86.8 86.3 85.1 85.3 83.2 82.4 81.3 83.1

South Eastern LCG 73.4 71.2 72.4 70.5 70.5 72.4 69.8 72.2 62.2 59.5 66.8 65.9

Northern LCG 66.1 67.5 66.1 64.7 61.1 61.9 62.7 63.1 52.9 59.6 60.9 66.8

Southern LCG 66.2 68.2 67.5 68.1 64.6 70.1 64.5 63.8 60.9 63.2 64.5 63.0

Western LCG 67.6 76.3 70.5 68.4 69.9 72.8 70.7 69.4 61.0 68.5 65.1 65.6

South Eastern  LCG PERFORMANCE YEAR 2009‐10

AREA CAT A8 CAT B18 CAT C18 URGENT (Not more than 

15 mins late)

% % % %

Ards 56.5 83.0 77.4 55.7

Down 61.5 87.1 82.5 55.9

Lisburn 74.2 93.8 89.4 65.4

North Down 78.6 95.3 91.0 56.8

Overall LCG 68.7 90.1 86.1 59.3

Increase in CAT 8 Response

20082008‐‐11 11 A Major ChallengeA Major Challenge

for NIASfor NIAS

EFFICIENCY EFFICIENCY SAVINGSSAVINGS

COMPREHENCOMPREHENSIVE SIVE

SPENDING SPENDING REVIEWREVIEW

Achieving Financial Balance

Potential Investment Profile £000s 2008/9 2009/10 2010/11

Efficiency Savings 1,236,000 2,681,000 4,516,000

Revenue Investment Funds(for Service Development) 2,500,000 4,000,000 5,600,000

Capital Investment Funds(Fleet, Estate, Equipment) 5,000,000 5,000,000 4,500,000

CSR  Investment Year  1 and 2

• Additional RRV 

• Rollout  of Thrombolysis

• Clinical Team Leader Infrastructure

• Category  C – Doctors in Control 

20082008‐‐11 11 A Major ChallengeA Major Challenge

for NIASfor NIAS

EFFICIENCY EFFICIENCY SAVINGSSAVINGS

COMPREHENCOMPREHENSIVE SIVE

SPENDING SPENDING REVIEWREVIEW

Service Modernisation 

• RESPONSE TIMES IMPROVED• EXPENDITURE MANAGED• THROMBOLYSIS EXTENDED• TECHNOLOGY DEVELOPED• TACTICAL DEPLOYMENT INCREASED• PARAMEDIC TRAINING DEVELOPED• PHARMACY CENTRALISATION• CAPITAL INVESTMENT (Fleet and equipment)

NIAS ‐ 2010‐2011 CHALLENGES

Review of PCS objective 

• To improve the efficiency and effectiveness of Patient Care Services (PCS) in the care, management and transportation of Patients within the HSC.

NIAS PATIENT CARE SERVICE ACTIVITY 2008‐2009

• 129,094 Admissions, discharges, transfers and outpatient transports.

• Plus 

• 79,412 Voluntary Car Service (VCS) 

• Planned hours approx : 2,600 hrs per week.

Proposed outputs   

• An Ambulance  Patient Care Service based on meeting “clinical need as a first priority” and identifying options where appropriate for addressing mobility issues.

• Improving contributing to PfA targets and patient flow.

• Protecting the Emergency Ambulance response capability by providing patient  carrying capacity 

• Promoting  a whole systems approach which represents best value 

Challenges 2010 ‐ 2011

• Work with key  stake holders to:– maintain clinical quality & safe work practices through performance mgt

– Consolidate Service Delivery Model in NIAS

– Manage Demand & offer alternatives

– Monitor and change service mix – Supply V demand

– Flag consequences of actions of others

– Manage staff/public relations

– Increase productivity of ambulance transportation

Conclusion 

• Transform from a service focusing primarily on resuscitation, trauma and acute care towards becoming the mobile resource for the HSCB‐

• Hear and treat

• See and treat

• Improve the speed and quality  of service provided to patients with emergency care needs.