Glossary of Terms

Our people

When we refer to ‘our people’, we mean our team of North West Ambulance Service (NWAS) staff and volunteers. Without our people, there is no NWAS, and a big part of this strategy is about how we support them to be at their best. We have a director of people who oversees a People Strategy, which takes a lead from the national NHS People Plan and People Promise.

Health inequalities

Health inequalities are preventable, unfair and unjust differences in health between groups, populations or individuals. Health inequalities are usually caused by wider social and economic factors such as differences in housing, employment and education.

Population health

Population health means looking at the health of a ‘population’ (a group of people from an area). It involves improving physical and mental health outcomes, promoting wellbeing and reducing health inequalities, and includes wider issues that impact on health, like housing, employment, education.

Person-centred

Person-centred care is tailored to a person’s needs – every patient is different and needs to be cared for as an individual with specific symptoms, characteristics, needs, personal circumstances and values, as is set out in the NHS Constitution.

Unwarranted variation

Variation means differences in healthcare services received by individuals or groups of people. Some variation is acceptable (or ‘warranted’) because care should be patient-centred, to meet the needs or an individual or specific group of people. Unwarranted variation is defined as variation in the way care is provided that cannot be explained by differences in patient illness or preferences and offers no improvement in outcomes.

Integrated care system / board / partnership

Integrated care systems (ICSs) bring together providers and commissioners of NHS services across a geographical area with local authorities and other local partners, so they can work together to plan health and care services to meet the needs of their population (people living in their area). Each ICS has an integrated care partnership (ICP) and integrated care board (ICB). The ICB is responsible for overseeing the dayto-day running of the NHS locally – it manages a single pot of funding and has a plan to meet the health needs of its population. The ICP is a partnership of NHS, local authority, voluntary, community, faith and social enterprise (VCFSE) and academic institutions working together on the joint health and care agenda to coordinate services and to plan in a way that will deliver improvements in population health and reduces inequalities.

Introduction

From the chair and chief executive

The last two years (2020-2022) will forever be remembered for when the NHS faced the biggest challenge in its history. The huge impact of Covid-19 cannot be underestimated – the often devastating impact on individuals and families, the differences it has made to our society, and the learning that can be taken by the NHS organisations at the forefront of the pandemic.
Our healthcare needs have changed and North West Ambulance Service (NWAS) must look to how we can adapt and improve in this new world.
With this in mind, we are pleased to introduce our new strategy and mention a few highlights from this document.
First and foremost, a message to our workforce and volunteers. The courage, care, compassion and commitment you have shown in recent times has been overwhelming. We both like to get out to meet as many of you as we can, and each time we come away feeling proud and inspired. To all of you, whether on the patient-facing frontline, or behind the scenes keeping everything running smoothly, a big thank you.
Our organisational strategy provides a picture of where we are now and where we want to be in the future. It sets out our aims and the objectives we need to meet to achieve our vision. It also defines our core purpose and outlines the values that underpin everything that we do.

To all of you, whether on the patient-facing frontline, or behind the scenes keeping everything running smoothly, a big thank you.

There have been recent changes across the wider healthcare system, of which we are a major part, with the formal introduction of integrated care systems (ICSs). This will encourage stronger partnerships between public sector organisations and the NHS which ultimately, will improve the lives and health of the people we serve. We want to continue to develop meaningful and sustained relationships with our partners and take on a key role as part of the wider healthcare system, making a positive contribution to preventative and emergency healthcare.

Despite Covid-19, we have introduced several innovations and improvements and we have ambitious plans to do more to improve. We need to look at how effectively we deliver our services, ensuring we have the right resources in the right place, at the right time, to perform to the high standards our patients expect. Our response times matter, but the quality of care we provide is just as important. We must influence our ICSs to support the right investment in the trust and we must make sure our staff have all the right tools, training and expertise to deliver that high-quality care.

We also want to listen more and demonstrate we act on feedback from staff, patients and partners. Staff have told us we need to continue to improve the everyday working lives of everyone at NWAS, so we must also focus on getting the basics right for staff and looking after each other.

Sadly, we continue to hear about incidents of violence and aggression towards our colleagues. It is worrying to know many feel it is almost ‘part of the job’ and don’t report these when they happen. We don’t want anyone to feel this way. It is not part of the job and reports of such incidents will be taken seriously and acted upon.

The staff survey told us the past few years have taken their toll on health and wellbeing and so, through this strategy, we commit to creating a working environment where physical and mental health and wellbeing is a priority.

To create employment opportunities that make a difference and fully represent our communities, we need to do more to attract, retain and develop staff from a range of diverse backgrounds. We will develop innovative ways to champion equality and diversity across the trust, supported by our various networks.

In the North West, we have some of the most deprived communities in the country and with that comes enormous health challenges. Social circumstances can result in people having hugely different experiences of healthcare and we have a part to play in reducing these inequalities. Within this strategy we talk about population health; this might sound different to how we have previously talked about our role in the healthcare system but now is the time to step up to these challenges.

We are very proud of the trust’s commitment to the environment and have won several awards for our initiatives to lessen our impact, however there is always more that each of us can do in our journey to become net zero by 2040. A cleaner environment is beneficial to our health and goes hand in hand with our aim to improve the health of our communities.

This strategy has been developed by listening to our people and creating a shared vision for the future of NWAS which works for and with our staff, volunteers, patients and partners. We hope you find it interesting and as always, we are very keen to hear suggestions about where service improvements can be made.

Thank you.

We are NWAS

We are a team of more than 6,700 people working in 300 different roles. Some of us work directly with patients of the 999, NHS 111 and patient transport services. Others work behind the scenes, providing expertise and vital services to make sure all parts of the organisation are well-run and have the right support. We have more than 1,000 volunteers, including some who respond to emergencies in their communities and others who help people get to and from important hospital and clinic appointments.

We aim to achieve the best possible physical and mental health outcomes for each person who needs us. We will provide high-quality emergency care to save lives and make a difference to people with life-threatening illnesses or injuries. For those with less serious conditions, we will tailor our response to each person’s needs. This may include urgent clinical assessment, advice over the phone, referring them elsewhere or alternative transport for scheduled appointments.

MEDICAL: Clinical Safety and Treatment Research and Development Public Health and Prevention Freedom to Speak Up Medicines Governance and Optimisation

CORPORATE AFFAIRS: Legal Services Corporate Governance Datix and Risk Management

QUALITY, INNOVATION AND IMPROVEMENT: Mental Health High Intensity users Safeguarding Infection Prevention and Control (IPC) Improvement Clinical Audit Regulatory Compliance Health and Safety ICT Information Governance Business Intelligence Development and Innovation

STRATEGY, PARTNERSHIPS AND TRANSFORMATION: Communications Patient Engagement Strategy, Planning and Transformation Programme Management Office Partnerships and Integration

PEOPLE: Learning and Education Organisational Development Human Resources Wellbeing Inclusion

FINANCE: Finance Procurement Estates, Fleet and Facilities Management Support Services Sustainability

SERVICE DELIVERY: NHS 111 Patient Transport Service Voluntary Car Service Paramedic Emergency Service Community First Responders Contact Centres Clinical Hub Resilience Gazetteer

Our Values

Our values are the behaviours that underpin all that we do. They describe how we should approach our work. They can be found in our systems and processes, from appraisal paperwork to planning tools for large-scale projects for change. Putting our values into practice supports us to provide compassionate care and improve outcomes and experiences for our people, patients and communities.

Working together

We work together to understand and value every role in achieving our shared purpose. We live and breathe inclusivity; everyone matters.

Being at our best

We challenge ourselves to be the best we can be. We are curious and push boundaries to improve everything we do.

Making a difference

We make a difference through doing the right thing by our staff, patients, partners and communities. We act with compassion and kindness.

What’s going on around us

Our national context

The NHS is always looking to improve the service provided to the public by publishing recommendations and guidance for NHS trusts. There have been several national reviews in recent years which emphasise the critical role ambulance services play within the wider health and care system.

In response, we have been changing the way we care for patients. We have reduced the number of patients taken to emergency departments and focused on treating people as close to home as possible if they do not need to go to hospital, while reducing unwarranted variation.

Our priorities will continue to be guided by national legislation and recommendations. We know national priorities for 2022-2023 include closer working between health and social care at a local level, reducing delays and long waits, improving access to primary care (GP and community services) and mental health services, managing health and inequalities within populations, and staff health and wellbeing.

We must recognise the central role we play as an ambulance service and work in partnership with the wider health and care system to overcome our shared challenges and deliver the best care possible for our communities.

Our healthcare needs have changed and NWAS must look to how we can adapt and improve in this new world.

Our Partners

From 2022, we will see stronger emphasis on integrated care which is focused on local places, populations and systems. Integrated care is when health and care organisations work together to meet the needs of local people.

Integrated care systems (ICSs) became legal bodies in July 2022. ICSs are made up of commissioners of NHS services, health and care providers and other partner organisations who work together to deliver services in their area. ICSs share four goals: working together and supporting integration, reducing bureaucracy, improving public confidence and accountability, and supporting public health, social care, quality and safety.

We are the only regional NHS organisation in the North West that operates across five ICSs: Cheshire and Merseyside, Greater Manchester, Lancashire and South Cumbria, North East and North Cumbria, and Derbyshire (which includes Glossop). While there are challenges with working across many ICS areas, we have gained experience as a key partner within the urgent and emergency care (UEC) system. We deliver UEC services across a large area and have valuable data and insight which helps to identify opportunities for improvement, share learning and best practice, and predict future demand.

The future of integration needs health and care providers to work together and with patients to design services around people’s needs, with a focus on preventing serious health problems and reducing health inequalities. We have an opportunity to work together within our ICSs to support this work and help people when they need us most.

We work with a range of partners at a local, regional and national level

SYSTEM: Integrated care systems (ICSs) Integrated care partnerships (ICPs) Integrated care bodies (ICBs)

REGIONAL: Regional commissioners North West NHS England and Improvement NHS Digital

NATIONAL: NHS bodies Health Education England (HEE) Regulators

PLACE: Universities Health and care providers Charities and the voluntary sector Patients, service users and community groups

SPECIALIST: Ambulance sector Association of Ambulance Chief Executives (AACE) Northern Ambulance Alliance (NAA) Emergency Services Network/Blue Light Collaborative Local resilience forums

Our Demographic

Population: over 7.5M

Average age: 42 years

Area approx: 5,400 square miles

The factors that might impact on health and social care needs are different in each area we cover. For example:

Cumbria and Lancashire

North Cumbria (part of North East and North Cumbria ICS)

Lancashire and South Cumbria ICS

Cheshire and Mersey

Cheshire and Mersey ICS

Greater Manchester

Greater Manchester ICS

Glossop (Part of Derbyshire ICS)

*Indices of multiple deprivation (IMD) is a measure that helps identify the most and least deprived areas in England, considering a range of factors relating to people’s living conditions. A high IMD means that an areas is more deprived than an area with a lower IMD. The national average IMD score is 21.79. References; NHS England ICS profiles Office for National Statistics (ONS).

Our population

We are there for a population of more than seven million people across approximately 5,400 square miles in the communities of Cumbria, Lancashire, Greater Manchester, Merseyside, Cheshire, and Glossop in Derbyshire. The diversity in our region makes the North West a unique place to live, but also presents some challenges. In the North West, 32% of people live in the highest levels of deprivation and have significantly worse health outcomes, healthcare experiences and life expectancy than the general population.

People living in our communities are sicker than before the Covid-19 pandemic. They have been hesitant to access health services and others have waited a long time for some conditions to be diagnosed and treated. There are more people living with poorly managed long-term conditions and, as people get older, we can expect there will be more people in our communities living with illnesses.

We know from our data that the overall health of our region’s population has a huge effect on demand for our services. If we can address the health inequalities within the North West and help tackle the causes of illness by looking at the wider factors that affect our health, we can help people to stay healthy and reduce the need for them to have care from the NHS.

Our learning

2020-2022 has been one of the most challenging periods we have ever faced. Everyone has been affected by the pandemic and we have seen an increase in the number of people needing our help.

Our people have experienced sickness, loss, unprecedented demand for their services and difficult working conditions. Our communities have experienced lockdowns, delays in care and delays to scheduled treatment. Our patient satisfaction data tells us that, although we continue to see high levels of satisfaction in relation to the care, compassion and respect our staff provide to patients, we are still seeing fluctuations in overall satisfaction across our 999, 111 and patient transport services.

We are determined to keep the good things that have emerged from these challenges – we have worked closely with partner organisations and the public, we’ve welcomed flexible ways of working and used new techniques to support our response. Improved communication, decision-making and partnership working has allowed us to make changes more quickly.

We will continue to face challenges over the next few years, but learning from experience and welcoming new opportunities will allow us to continuously improve our services.

Our People

Our people are exceptional. They have proudly been there for our communities despite the unpredictable and challenging conditions they’ve faced. They are resilient and have quickly adapted to new ways of working to provide help when people need us most. We’ve worked together and supported each other as friends and colleagues, but the pandemic has had a significant effect on health, wellbeing, morale and motivation. This is reflected in a lower response rate to our NHS staff survey and lower scores than we would like in some areas, for example, retention and progression, job satisfaction, health, wellbeing and burnout, and bullying and harassment.

The feedback shows that our people want to see action targeted at improving their everyday working lives and want our strategy to focus on getting the basics right. We want NWAS to be a brilliant place to work for everyone, so it is important we listen to our teams and work with them to find solutions to problems. We will engage and lead in an inclusive and supportive way, making sure we give everyone the same opportunities, and invest in the health, wellbeing and happiness of each person to allow them to be at their best.

Our road to integration

In 2019, we developed our Urgent and Emergency Care (UEC) Strategy which focused on closer working between NHS 111, 999 and patient transport services. Our aim was to make sure patients received high-quality care in line with their needs, regardless of how or where they contacted us.

We’ve focused on putting in place shared technical infrastructure and clinical expertise to improve resilience and allow us to manage activity and respond to demand more effectively. For example, in early 2022, we changed the triage system used by 999 to the same system used in NHS 111. This means all call handling staff will be trained and familiar with the same system in case there is a need for colleagues to work across services. Patients will get the same care from NWAS, regardless of which telephone number they use to reach us.

We’ve started to develop more integrated systems, processes and pathways, both internally and with our partners. Our goal is to have joined-up pathways of care, so patients have a better experience and receive the right care, in the right place, first time. Integration will continue to be a priority for us but we have made a strong start from which we can strengthen how our 999, 111 and patient transport services work more closely together to help people when they need us most.

Sustainability

Climate change has a direct effect on people’s health. Extreme climate events such as droughts, floods and storms increase the number of people needing our help.Greenhouse gases are a major contributor to climate change and affect the quality of the air we breathe and the health of the people who live and work in our region. We are in a climate emergency.
The NHS contributes to 40% of the public-sector’s carbon emissions but has ambitions to reverse its effect on the environment. We are committed to the NHS England/ Improvement ‘Greener NHS’ plan to deliver a new, zero-carbon NHS by 2040.

Our Vision…

is to deliver the right care, at the right time, in the right place.

Right care

We will provide outstanding care that is safe, effective and focused on the needs of the patient.

Right time

We will achieve all operational performance standards for our paramedic emergency service, NHS 111 and patient transport service.

Right place

We will provide care in the most appropriate setting for each patient’s needs, taking fewer people to emergency departments by providing safe care closer to home or referring people to other health and care pathways.

Every time

We will provide services which are consistent, reliable and sustainable.

Our vision is ambitious. To achieve it we need to balance getting the basics right while continuously striving for excellence.

Get the basics right

When we talk about the basics, we mean the foundations on which high-quality services are built and maintained. We must consistently get these right to make sure our people have everything they need, every day, to help patients when they need us most.

Strive for excellence

Striving for excellence means we must look for opportunities to continuously learn and improve what we do and how we do it. We must take opportunities to change areas of our service to respond to the needs of our people, patients and partner organisations to improve health outcomes in our communities.

What does this mean for…

Our patients?

“By receiving the right care, at the right time, in the right place, I get access to individual care by professionals who listen and respect my views.”

Our people?

“To deliver the right care, at the right time, in the right place, I will have the tools and development to allow me to listen to and understand patients and respond to their needs in the most appropriate way, providing the best possible care.”

Our organisation and the partners we work with?

“Working together to deliver the right care, at the right time, in the right place, will mean that the healthcare system flows better and will improve the quality of patient care, outcomes and experience.”

Our commitment to equality, diversity and inclusion

To create an inclusive culture, we must develop an environment where diversity is truly valued. If we are to deliver our vision we must recognise that discrimination exists in society, in our workplaces and in healthcare, and take proactive steps to address inequalities. Our commitment to equality and inclusion will feed into everything we do and is a responsibility shared by everyone at NWAS.

The care we provide must be accessible to everyone and we will treat each person fairly based on their individual needs. We will take action to reduce inequalities in access, experience and health outcomes, especially for groups of patients considered vulnerable or at higher risk.

Our leaders will be visible role models for inclusion. We will understand what it means to be anti-racist, consider the impact of decisions on diverse groups, take a zero-tolerance approach to discrimination, and proactively address inequalities whether at work or in the services we offer to the public. We will challenge behaviour that does not align to our values. Our people will be encouraged to bring their whole selves to work and to deliver inclusive and patient-centred care.

Diversity is something to be celebrated and we are proud that our 18 networks and forums have provided safe environments where people are encouraged to be themselves, challenge the way things are done and work together with leaders to improve NWAS for everyone.

We must make the most of opportunities to work together with our patients, the public and our partners across health and social care to design services that positively impact our communities and improve the overall health of our population.

Our commitment to equality, diversity and inclusion extends beyond the lifespan of this strategy, but over the next three years through delivery of our aims, we will focus on the following priorities:

• Making sure everyone who works for NWAS has fair job and career progression opportunities which will improve diversity and representation at all levels of the organisation
• Educating and developing our leaders and people to improve understanding of racism, discrimination and cultural competence to deliver a step change in the experience of our people and patients
• Using patient data and experience to drive improvements in access and health inequalities, for people from diverse communities.

As a member of staff it is important to me that it is an inclusive place for everyone to work, feel valued, respected and be able to carry out their role safely and confidentially to patients

Our aims

Our aims are the areas we need to focus on to achieve our vision to deliver the right care, at the right time, in the right place; every time by 2025.

Provide high-quality, inclusive care

We recognise there are health differences between groups in the communities we serve. We will listen to understand and make sure our services are accessible to everyone. We will work to prevent harm while using learning and research to continuously improve patient care and experience.

• Self care
• Effective care
• Person-centred care

Be a brilliant place to work for all

We will create an environment where our people feel happy and safe, have access to equal opportunities and are supported to be at their best.

• Looking after our people
• Investing in our people
• Leading our people compassionately

Work together to shape a better future

We will work together to improve the services we provide. We will work with our partners and the public to find solutions which improve access, outcomes and experience for everyone. We will work together to become more sustainable and have a positive effect on our communities and environment.

• One NWAS
• One North West
• One Future

Every member of staff, patient, One North West One future carer and community will feel valued and respected when coming into contact with us as a service.

Provide high-quality, inclusive care

We will put the patient at the centre of everything we do and listen to them so that we understand their needs. We will work to prevent harm while using learning and research to continuously improve our service.

We must create a safety culture where everyone understands the importance of safety and what it means in their role. Our attitude towards safety comes from the top. Our leaders will become role models for designing, putting in place and maintaining safe working practices and procedures. We must build trust and confidence by having open and honest conversations and making sure our people are never afraid to report incidents or tell us where we could improve.

Safe Care

We will focus on safety to prevent harm and improve quality of care.

• We will use learning to continuously improve the safety of our systems, processes and practices.
• We will have a zero-tolerance approach to harm and will learn from incidents, complaints and claims to make improvements.
• We will continue to improve our safety culture by focusing on our ‘pillars of quality’ which protect patients from harm.
• We will focus on reducing harm caused by delays in assessment, response or handover.
• We will use data and innovative solutions to improve how we can keep patients safe and monitor their health.
• We will make sure we have the right number of people with the right skills, knowledge, equipment and working conditions.
• We will make sure everyone understands how their role contributes to safety.
• We will improve our approach to risk management to protect our staff and patients.

Effective Care

We will use evidence to improve our services and achieve the best possible outcome for our patients.

• We will make sure our staff have access to up-to-date guidelines and tools to help them make decisions.
• We will use information gathered through our digital systems and audits to make sure we are clinically effective and meet our care standards and quality indicator measures.
• We will reduce differences in patient outcomes and experience based on the care we provide.
• We will use the specialist knowledge of all the different roles in our workforce to improve outcomes for vulnerable and high-risk patients.
• We will do more research to improve our clinical practice. We will help our staff to reflect and learn from incidents to improve care for patients.

Person-centred Care

We will work with our patients and the wider public to reduce health inequalities and make sure our services are accessible and offer an excellent experience for everyone.

• We will listen to our patients and respect their different needs to provide compassionate, inclusive care.
• We will work closely with our patients and the wider public, listening to their experiences and feedback to make improvements.
• We will build effective relationships with our communities to understand their needs and make sure our services are accessible for everybody.
• We will engage with people in an accessible and inclusive way.
• We will make sure we share feedback from patients and the public at all levels, so we can continuously improve how we work with, and provide care for, our patients.
• We will develop a plan to reduce inequalities in access, experience and health outcomes, especially for groups of patients considered vulnerable or at higher risk.
• We will make better use of data.

What will success look like?

Getting the basics right

• Reduce incidents of harm through a focus on safety and robust risk management.
• Use learning and insight from clinical audits to improve performance against ‘ambulance quality indicators’, which measure overall quality of care and patient outcomes.
• Achieve performance standards across 999, NHS 111 and the patient transport service within agreed financial budgets.
• Improve friends and family test results and patient survey satisfaction scores.

Continuously striving for excellence

• Rated outstanding by the Care Quality Commission (CQC).
• Improved digital systems to gather information which can be broken down by indices of deprivation – a measure that helps identify the most and least deprived areas in England.
• Continuous improvement and learning across our services.

It is important to me that patients like my mother, who are elderly and don’t use technology, maintain autonomy.

Be a brilliant place to work

Our people are our greatest asset. We must make their mental and physical wellbeing our top priority and make sure they have access to equal opportunities and are given the skills and knowledge to be at their best.

Our networks and forums celebrate what makes us unique as well as providing safe environments for people to discuss their lived experiences in relation to employment and health inequalities. We don’t always get it right but we continue to strive to create an environment where people are encouraged to be themselves, challenge the status quo and work together with leaders to improve NWAS for each other, our patients and our service users.

Looking after our people

• Wellbeing will be our priority.
• We will improve staff safety, including: physical safety – health and safety, violence and aggression, personal protective equipment (PPE) and non-clinical incidents; and psychological safety – culture, freedom to speak up (F2SU) and bullying.
• We will not tolerate any form of discrimination, bullying or violence.
• We will be open and inclusive.
• We will take time to listen, understand and respond.
• We will solve everyday problems by providing the right tools, skills and environment needed to provide the best possible care.
• We will not expect staff to sacrifice time for family, friends or interests for work.
• We will support flexible working.
• We will learn from each other, support each other and celebrate success.
• We will work together to find solutions to challenges.

Investing in our people

We will develop potential and encourage talent.

• We will provide high-quality, effective training and education.
• We will support continuing professional development.
• We will make sure there is effective clinical supervision.
• We will identify and develop talent.
• We will provide fair career progression which improves diversity.
• We will support people to use digital technology to make their jobs easier.
• We will make positive progress towards a representative workforce at all levels.
• We will celebrate diversity.
• We will support colleagues from different services, backgrounds and job roles to work together and learn from each other.
• We will improve everyone’s confidence and competence to deliver effective, quality care to patients who have diverse beliefs, attitudes, values and behaviours.

Leading our people compassionately

We will lead and engage in a compassionate, fair and inclusive way to support everyone to be their best at work.

• We will support our leaders to be compassionate and inclusive.
• We will develop our people to make sure the services and care we provide is equally accessible and tailored to individual needs.
• We will engage with our staff networks and forums to drive change and represent our communities.
• We will provide training and development to help teams understand their strengths and weaknesses, allowing them to thrive.
• We will have in place a fair and learning culture in everything we do to encourage people to acknowledge their mistakes and learn from them.
• We will focus on preventing problems from becoming issues and make sure people are well-led in an environment where they can be at their best.
• We will create a culture of courtesy and kindness between our staff and our patients which reflects our values.

What will success look like?

Getting the basics right

• An increase in people applying to work with us and staying with us.
• A reduction in incidents of violence and aggression towards our staff.
• A reduction in manual-handling incidents.
• Better career and personal development opportunities.
• Early progress towards improving staff survey results in spotlight areas including ‘compassionate and inclusive’, ‘safe and healthy’ and ‘staff engagement’.

Continuously striving for excellence

• Improved feedback about working for us.
• An increasingly diverse workforce at all levels that reflects and can represent our communities.
• Reduced use of formal management processes.

Working in an environment with a ’just and learning culture’ means I am able to recognise the mistakes I make and feel supported to learn from them.

Work together to shape a better future

We will work together to improve the services we provide. We will work with our partners and the public to design solutions which improve access, outcomes and experience for everyone. We will become more sustainable and have a positive effect on our communities and the environment.

What do we mean by integration?

• Our people will work more flexibly together. We will understand each other’s roles and do our best to respond to demand, preventing unnecessary delays in care.
• Systems and processes will be more joined up, allowing us to communicate and share information more easily with each other to improve decision-making and patient experience.
• Our infrastructure will be designed so that we can work more closely together and, where possible, share facilities, systems and resources.

Patients and service users needing urgent or emergency advice, care or transportation

Clinical assessment

• Support over the telephone
• Dedicated clinician responds to support on scene
• Direct appointment with other care service
• Self-care or advice
• Specialist eg. mental health/pharmacist

Paramedic Emergency Service Dispatch

• Take to emergency department or other facility
• Treat on scene
• Refer to other health service

One NWAS

We will become more integrated, working together across services to support each other and our patients.

• We will continue to encourage our staff and teams from different professional and geographical areas to work together.
• We will integrate our staff, systems, processes and infrastructure where appropriate, to become a more flexible and responsive service.
• We will provide opportunities for our staff to develop.
• We will work as a team and share knowledge, expertise and resources across our services to improve communication, learning and decision-making and reduce differences in patient outcomes.
• We will use our resources more effectively and work together as 999, 111 and patient transport services to assess, treat and transport patients in line with their needs.
• We will develop a better understanding of each other’s roles and the valuable contribution we all bring to achieving our purpose and vision.
• We will review our systems and processes to make sure they do not negatively impact specific groups or individuals.

One North West

We will work with our partners in the health and care system to find solutions which improve access, outcomes and experience for everyone.

• We will develop and maintain good relationships with key stakeholders by following four partnership principles.
  • 1. Direction – together we will agree priorities for partnership working, based on shared challenges and opportunities, and make clear what we can offer to the system.
  • 2. Intelligence – we will use our data and insight to identify inequalities, influence improvements and measure success.
  • 3. Accountability – we will make sure our leaders have the skills and knowledge to confidently engage and work with our partners and follow through commitments.
  • 4. Consistency – we will provide consistent communication and representation at meetings and events to make sure we are engaged at the right levels.
• We will work with our partners to look at the issues which currently affect the flow of patients, outcomes and experience, such as delays and the number of patients being taken to hospital.
• We will work together to find opportunities to achieve our longer-term goals, such as better health for those who live in our communities and a more sustainable environment.

One Future

We will work together on behalf of our communities to become a more sustainable organisation, improving health now and for future generations.

Environmental sustainability – we will become net zero by 2040.

We will educate and support our staff to make environmentally sustainable changes. We will provide clear environmental leadership at all levels of the organisation. We will invest in greener buildings, vehicles and energy supplies that are net zero compatible – achieving a balance between carbon emissions put into the atmosphere and those taken out.

Social responsibility – we will have a positive effect on our communities.

We will widen access to jobs, development and progression, providing career opportunities for the people in our communities. Where possible, we will develop and maintain local supply chains which support local businesses. We will continue to work with our public and patient representatives to design services that deliver effective, quality care to patients who have diverse beliefs, attitudes, values and behaviours.

Population health – we will work with our partners to improve the overall health of the public.

We will support initiatives which prioritise the needs of people in the community who are vulnerable, at high risk of illness or need to access healthcare services regularly. Population health – we will work with our partners to improve the overall health of the public. We will support initiatives which prioritise the needs of people in the community who are vulnerable, at high risk of illness or need to access healthcare services regularly.

What will success look like?

Getting the basics right

• Population health – we will work with our partners to improve the overall health of the public.
• We will support initiatives which prioritise the needs of people in the community who are vulnerable, at high risk of illness or need to access healthcare services regularly.

Continuously striving for excellence

• Integrated services that are more flexible and resilient.
• Good relationships with our partners.
• Systems that work between partner organisations.
• Shared data and information across the healthcare system.
• A reduction in carbon emissions for each year of this strategy.

We are very proud of the trust’s commitment to the environment and have won several awards for our initiatives.

Delivering our strategy

• Our three-year trust strategy outlines where we are now, where we want to be and the areas we want to focus on to achieve our vision. We all share responsibility for the aims and objectives and must work together to achieve success.
• But our strategy is just the start. There are supporting strategies and plans which must all align so we can achieve our vision to deliver the right care, at the right time, in the right place; every time. Our supporting strategies provide more detail on how we will achieve our aims and objectives, including areas of focus and key measures of success.
• Our three-year plan outlines how we will turn our strategy into action. It will help us to prioritise what we are going to do and when we will do it, making sure we have the right capacity, expertise and resource to achieve our vision.
• Each year, we will develop an annual plan which shows what the projects, milestones and measures will be for the coming year. This plan will help shape our directorate, team and individual objectives to make sure we’re all working together.
• As well as developing strategies and plans, we must also work together to improve the things we can’t see such as how we communicate with each other and our organisational culture.

What does this mean for you?

Turning our strategy into action will mean the following for our patients, our people, our organisation and our partners.

Our patients

• I will have timely access to urgent, emergency and patient transport services, and the people who care for me will listen to and respect my needs.
• I will receive care which is safe, effective and centres around my individual needs. I will receive care in an appropriate setting, as close to home as possible.
• I will only have to tell my story once, as health and care services will be working together to provide a joined-up, effective experience.
• I will have the opportunity to have my say about NWAS services to help make improvements.

Our people

• I will have access to everything I need to help people when they need me.
• My colleagues and I will all have access to excellent training, education and development opportunities.
• I will know my health and wellbeing is important to the organisation and I will feel happy, healthy and supported at work.
• I will experience fewer frustrations as I will have access to more joined-up systems, information and pathways.
• I will feel that I can suggest and make improvements which improve patient care, solve everyday problems, or allow the organisation to strive for excellence.

Our organisations and people we partner with

• We will work together as NWAS services and with other healthcare partners to solve shared problems and welcome new opportunities.
• We will have good relationships with partner organisations which will allow us to work closely together.
• Our partners will see and interact with NWAS leaders who have confidence and ability and act with integrity.
• We will be a more resilient service because our people, systems, processes and infrastructure will be more joined up and flexible.
• We will understand each other’s roles and work across boundaries to provide the best care for our public. We will share information, resources and expertise as part of an integrated system.

Acknowledgements

The pandemic has taught us that when we break down boundaries and silos and work together, amazing things can happen.

A special thank you to:

• All members of our equality, diversity and inclusion networks and all those who participated in the reference groups, for sharing their personal views and experiences to inform the content of this strategy.
• All members of our Patient and Public Panel (PPP) for their continued contributions and a particular thank you to those who took the time to offer ideas and feedback through meetings, workshops and surveys to make sure this strategy was right for our patients.
• All members of NWAS staff who contributed to the ‘Ideas Room’ forum or participated in engagement events. The comments and ideas put forward influenced all aspects of the strategy – the need to balance getting the basics right whilst looking to improve and develop emerged from staff and became a core focus within the strategy.
• All the departments, teams and trade union representatives across NWAS who welcomed the Strategy Development Team with open arms and supported the development of this important and exciting strategy.

We are NWAS.

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