WMAS Board Meeting Minutes – Wednesday 25th March 2026

Present

• Prof. I Cumming – Non-Executive Director (Chairman) and voting member
• Mr AC Marsh – Chief Executive Officer and voting member
• Prof A Hopkins – Non-Executive Director (Deputy Chair)
• Ms S Banks – Non-Executive Director and voting member
• Ms C Beechey – Director of People and voting member
• Mr A Brown – Service Transformation and Patient Safety Director
• Mrs C Eyre – Director of Nursing and voting member
• Mr M Fessal – Non-Executive Director and voting member
• Mr N Hudson – Chief Operating Officer
• Mrs J. Jasper – Non-Executive Director and voting member
• Mr M Khan – Non-Executive Director and voting member
• Mr V Khashu – Strategy and Engagement Director
• Mr M MacGregor – Communications Director
• Mr S Nat – Non-Executive Director and voting member
• Ms K Rutter – Director of Finance and voting member
• Dr R. Steyn – Medical Director and voting member
• Mr P Higgins – Governance Director and Trust Secretary
• Mrs R. Farrington StaffSide Representative
• Mr I Syme – Member of Public
• Ms C Tilley – Journalist
• Mr D Tooley – Journalist

Minutes

03/26/01 – Welcome, Apologies and Chairman’s Matters

Apologies for absence were received from. Ms D Scott and Ms K Freeman.

The Chairman reported that Diane Scott (Organisational Assurance Director) would be leaving the Trust on 31 March 2026. He wanted to place on record the thanks of the Board for her contributions, and asked for the thanks of the Board, and best wishes for the future be passed onto Diane.  

03/26/02 – Declarations of Interest

None Declared.

The Chairman reminded directors of their duty to ensure their declarations in the register of interests is maintained and up to date as it is published on the Trust’s website.

03/26/03 – Questions received from the public prior to the meeting

The Chairman indicated that a written question had been received from a member of the public (which is set out below). The Chairman thanked the member of the public for submitting the question and asked Vivek Khashu to respond to the question on behalf of the Board. To maintain transparency and to ensure it forms part of the records of this meeting the formal written response will be attached as an appendix to these minutes.

To avoid duplication a copy of the question with the response is appended to these minutes as Paper 02a.

03/26/04 – Board Minutes

The Board was requested to approve the minutes of the meeting of the Board of Directors held on 28 January 2026 as an accurate record

03/26/05 – Action Log and any matters not on the agenda for this meeting

A Matter Arising: Impact of Handover Delays – Minute numbers:

• 01/26/07 Board Assurance Framework (BAF)
• 01/26/09a Report of the Director of Finance – Finance & Capital Funding update
• 01/26/10a Combined Clinical Directors Quality Reports
• 01/26/13b Report of the Chair of the People Committee
• 01/26 13c Report of the Chair of the Finance & Performance Committee
• 01/26/13d Report of the Chair of the Quality Governance Committee

Given that the impact of handover delays on the quality of patient care and safety is a consistent and recurring theme throughout the Minutes of the last meeting as detailed above for ease of future reference; and, given the recent Channel 4 news item on the subject. The Board acknowledged the content of the recent Channel 4 news item and the impact on patient safety within the context of the discussion at the previous Board meeting and as set out in the Minutes of the last meeting.

b. The Board Log

The Board Action Log was submitted; the Action Log contains the schedule of matters upon which the Board have asked for further action or information to be submitted. Matters on this log can only be deleted through resolution of the Board. (For the avoidance of doubt unless specified below all matters contained on the Board log will remain on the log until the Board resolves that the matter can be discharged).

Minute 01/26/03         Staff Survey Leads – Update

1. The CEO would follow up with the Non-Emergency Services Delivery Director to ask the control room staff to introduce their name when they answer the telephone in pts control etc. 
2. The CEO would follow up on the installation date for the new furniture in EOC at Tollgate and MP.

The Board was advised by the CEO that he had actioned these matters a) was complete and work was underway in relation to b) and that will be completed soon.

On this basis the Board agreed to discharge the matter from the Action Log.

Minute 01/26/08b       Manchester Arena Inquiry (MAI) Recommendations & Needs Analysis Register

The Board were to receive an update at this meeting on the national funding at the March Board meeting.

The CEO updated the Board in relation to this matter. He stated that the Trust had met with national representatives of NHSE and also DHSC since the last Board meeting. The content of the funding bid that the Trust made nearly four years ago and the fact that there had been no progress in that time was deeply frustrating and given the purpose of the funding was to provide the Trust with the means of responding if a similar incident occurred again was completely unacceptable. The CEO reported that the bid had now been reviewed based on the current position to reflect the Lord Toby Harris review in London. As a result of the outcome of that review the submission bid from to an additional three HART Teams, giving a total of four teams. This now increases the Trust’s revenue bid to £32 million per annum and increases the capital element (which will initially be a one off) to £23 million.

There is a further meeting which NHSE have called for all Ambulance service CEOs in England to attend in two weeks’ time to give an update on how they going to progress this issue, and the CEO undertook to update the Board following that meeting and report to the next ordinary Board meeting in May 2026.

The Chairman reflected on the fact that the recommendations arising from the public inquiry into tragic incident were received nearly four years previously. It is now nearly three years that this matter has been on the Board’s Action Log given the risks to the public since the submission of the Bid for funding to deliver against the recommendations. It was essential that the Board saw some progress by the NHSE or Department. The Chairman asked the Board to keep this matter on the Action Log for a further update to the next board meeting.

03/26/06 – Board Assurance Framework

The Board Assurance Framework was submitted.

The Director of Nursing presented the BAF, and for purposes of assurance stated that there is a review of the Trust’s strategic risks undertaken by the Head of Risk and the relevant risk owner. The reviews are continuous and report changes are made quarterly.  The outcome is then further reviewed by EMB and then the relevant Board Committee that has the relevant strategic objective within its Terms of Reference. The BAF was also reviewed by the Audit Committee in terms of corporate governance of the Trust.

Work relating to the BAF this month has been a continued focus on cyber terrorism, and in relation to Strategic Objective 2, “A Great Place to Work for all People”, the NHSE Sexual Misconduct Framework has been implemented. The purpose of the framework is to protect staff from inappropriate or harmful sexual behavior at work, support victims, and provide clear reporting and investigation procedures.

Sukhjeeven Nat advised the Board that the Finance and Performance Committee of the Board had reviewed those elements of the BAF that come within its Terms of Reference and that in terms of Strategic Objective 4: “Innovation and Transformation” that a Cyber Security & AI Task & Finish Group had been established by the Digital Transformation Working Group which reports into the EMB to look at not only cyber risks but also the risks, as well as opportunities provided by AI.  Mohammed Fessal the NED lead on Digital and Data Transformation, indicated that he had been invited to the meeting of the Group and that he felt that there was a great deal of learning that came out of the meeting that will benefit the Trust and contribute to mitigating the risks in relation to AI and cyber security. Karen Rutter stated that the Trust has a draft AI Policy that focuses on keeping the organization and staff safe. However, given the speed of advancement, the strategy soon becomes out of date. The Chairman referred to the benefits and also the risks in the use of AI and gave examples such as students using AI in a positive way and negatively in terms of failing to cross reference and check the sources. The Chairman referred to the use of AI by other Ambulance Trusts e.g. LAS are developing the use of AI to populate patient records. The 2025 investigation by the Health Services Safety Investigations Body (HSSIB) which highlighted significant concerns regarding the interpretation of 12-lead ECGs by ambulance crews he queried whether the Paramedics had been too reliant on AI or whether it had not been used correctly. It was his experience that in other organisations he was familiar the use of AI had assisted people in generating complaints. He concluded by stating that he felt that given the risks as well as the opportunities for the Trust and its staff a Board Briefing, to enable sufficient time, to have a more focused discussion at the Board Briefing given that technology is moving so quickly.

Karen Rutter stated that given the Chairman’s comments the Board needed to determine the direction of travel and ambition about what we are going to do and part of that is education so that workforce understand what they can and can’t do with the use of AI. In addition. in this area as it was important to note that some FOI requests for example are clearly generated from AI as in some cases the original request is left at the bottom of the request.  Mohammed Fessal agreed and indicated that the discussion should not only focus on an AI strategy given the points made at this meeting and it was important to have an open and transparent conversation at the Board Briefing on the use of AI and set the direction of travel and link it to Cyber Security. Julie Jasper as Chair of the Audit Committee, indicated that this had been the subject of a recent discussion at the Audit Committee with the Trust’s internal Auditors that risks and opportunities of AI should be a regular item on the Board agenda and therefore supported the use of the Board Briefing for a more focused discussion and Board education and try and stay ahead of the curve.

The Chairman asked Karen Rutter and Mohammed Fessal to lead on the Board Briefing session with input from across the organization utilizing the June and September Board Briefing sessions.

03/26/07 – Chief Executive Officer Reports

a – CEO Report

A report of the CEO was submitted.

Progress against the following strategic workstreams are elsewhere on the agenda for this meeting:

• Operational oversight in particular the implications of Handover Delays and the risks to Patient Care.
• Representations to secure funding to implement the Manchester Arena Inquiry Recommendations. The CEO reiterated the earlier discussion and that he was pressing for proper funding to enable the Trust to be able to adequately respond to a similar serious incident.
• Collaborative Working between West Midlands Ambulance Service University NHS FT (WMAS) and East Midlands Ambulance Service NHS Trust (EMAS). The CEO reported that an executive-to-executive meeting between EMAS and WMAS has been scheduled and this will move forward with a Joint Programme Board made of a core group from each Trust which will develop a programme of work. The purpose being to enable the two organisations to work more closely together in the interests of patient care in both areas.
• Development of workstreams arising out of the 10 Year Plan.

The CEO concluded his report by stating that it was agreed with the national Team and the commissioners to achieve performance of 28 minutes for this whole financial year and the funding was allocated on achieving the performance. The national target still being 30 minutes for the current year.  Due to the extraordinary efforts of the operational staff over the last 12 months the CEO was pleased to announce that the Trust will end the year about 24 ½ minutes which he stated was good news for the Trust’s patients and the community we serve. This will help to support the national commitment to achieve 30 Minutes as part of the March Spring the Trust are doing everything it can to further improve its contribution to the 30 minutes national commitment.

The Chairman stated that this was truly a remarkable achievement given the level of hospital delays across this region. The Chairman on behalf of the Board thanked the Chief Operation Officer and his operational colleagues for this achievement.  The CEO reemphasised that the achievement was despite handover delays continuing despite the promises to address this issue. Last year the Trust achieved 29 Minutes Category 2 performance and this year achieving 24 ½ stated that was 4 minutes better than the Trust was funded to achieve and 6 Minutes better than the national target. This was a huge achievement and concurred with the Chairman in thanking all Operational Staff in achieving this outcome. The national performance target for next year reduces from 30 Minutes this year to 25 Minutes next year. This Trust will work to achieve the outturn of 24 Minutes but will have an ambition to achieve better performance if the funding is forthcoming.

Mushtaq Khan congratulated the CEO and COO on this achievement especially when operating within such a challenging environment in terms of continuing handover delays. It reflects the hard work of operational staff to achieve this result. It also reflects the Board’s decision to remain focused on delivery of performance despite the challenges of handover. At Finance & Performance Committee, meetings remain focussed on how the Trust can make inroads in improving performance as it has a huge impact on potential patient outcomes. Given that the Trust remains ambitious to improve and achieve the 18 Minute target.

Mohammed Fessal supported the previous comments in relation to the achievement and asked specifically how it will be communicated to our workforce. As they have worked so hard to achieve this outcome and that the message doesn’t get lost with other messaging especially in the context of the challenges staff have faced in terms of handover delays and the national landscape of other ambulance trusts achievements.

The Chairman asked the Board to recognise the achievement of staff in the Emergency Operations Centre in terms of Call assessors and despatch. The CEO in supporting the Chairmans comments indicated that this Trust answers 999 calls quicker than any other Trust and averaged call answering of just two seconds. The Chairman indicated that it should be seen as a patient experience in terms of the time it takes of making the call and then being seen by a clinician.

Members of the Board stated that it is a whole Organisational effort as one team working together both corporate and operational and it is a collective approach in the interests of the patient.

Julie Jasper referred to the all staff briefing that she attended and indicated how informative it had been on issues including addressing the handover delays, and in addition Julie referred to the work of the clinical validation team in terms of their contribution to achieving this outcome.

b) 

1. Executive Scorecard – December 2025

2. Executive Scorecard ICS Sub Report – December 2025

The Executive Scorecards were submitted.

The CEO indicated that the content receives more detailed review by the Finance & Performance Committee.

Resolved

That the Executive Scorecards submitted be received and noted.

c. WMAS Organisational Strategy Update

A report of the Strategy and Engagement Director was submitted.

The Strategy and Engagement Director updated the Board of Directors (BoD) on the development of the Trust’s organizational strategy, which now includes both internal and external engagement and feedback.

Professor Alex Hopkins asked whether the document referred to the work with Universities, where the Trust’s staff provided supervision and mentorship for the University students. It supports the Trust’s commitment and support for paramedic education. It was observed that the document referred to aspirations as the only University Ambulance Trust. In addition, the positive impact on systems of innovation, although it is mentioned it needs to be strengthened to show our support for integration in both the preamble (historic) and in the strategy as part of our ongoing evolution and contribution to the innovation of paramedic practice within the system. It was stated that the Trust had led and is possibly leading the world in the development of paramedic practice role, especially in relation to the integrated system support. The Chairman reminded the Board that at the strategy development day there had been a discussion about clinical progression routes for our paramedics. The Universities in the region providing paramedic science as a degree are looking at amending the courses to make them “prescriber ready” in terms of academic attainment. Is this something we will want to move to, or are we going to stick with the current model. Given that this is a five year strategy it is an area that needs to be considered. Vivek Khashu indicated that the Trust needed to consider in the strategy what the future model will look like within the context of the system.

Caron Eyre asked about whether we should include something on neighbourhood health as a strategic shift towards community-based care, aiming to deliver services closer to home, emphasizing prevention, and integrate NHS, social care, and local services as part of alternative pathways.

Julie Jasper asked if Vivek would meet with her to discuss thoughts on the content, the Chairman suggested that members of the Board let Vivek have any comments or views so that the final document reflects the view of this Board in terms of strategic direction with a view to the final draft coming to the Board meeting in May 2026.

The CEO reported that in terms of the Provider Capability Assessment the Trust has been rated as Green Amber NHSE has undertaken to let us know what the Trust needs to do to get to Green.

IN relation to the Quarterly Segmentation Report, the Trust has been rated as segment 3, which was odd as the Trust was only £200k off plan in month 9, which represents 0.1% of the Trust’s turnover. Yet the Trust was still on plan to breakeven at year end. The CEO indicated that he was confident that the Trust would revert back to segment one by quarter 4 as it will be predicated on the year end position of breaking even.

Professor Hopkins asked whether there were any specifics provided as to why the Trust was rated as it was? The CEO indicated that there was reference to FTSU arrangements and system working but nothing specific upon which the Trust can take action. In particular as our FTSU had been the subject of external review with all actions undertaken and closed off. Professor Hopkins indicated that it was difficult for the Trust to develop an action plan to address any concerns if there were no specifics from the NHSE Regional Office. The CEO indicated that as soon as the NHSE provides the detail then an action plan will be developed but unless the Trust knows what the issue is then it cannot take action. The CEO indicated that these two matters had been discussed with the NHSE Regional Team at the recent Provider Review Meeting, at which one of the Trust’s NEDs was present, and the NHSE representatives have indicated that they respond and advise the Trust, and nothing has yet been received. Unless the Trust is advised of the issues it cannot take action. The next meeting is in a few weeks’ time.

Professor Hopkins thanked the CEO for the clarity and stated that it was impossible for the Board to request an action plan unless it is provided with the specifics upon which to act. Julie Jasper concurred and stated that it was essential that the Board note with concern that the specifics underpinning the views of the NHSE have not been made known to the Trust to enable it to take appropriate action.

The Chairman indicated that unless the Trust is provided with specifics action cannot be taken so the CEO was asked to pursue the NHSE for the specifics.

03/26/08 – Report of the Director of Finance

08a – 2025/26 Month 11 Finance Report

A report of the Director of Finance was submitted. 

The year to date is slightly off plan as it has been all year due to the recording of the mediated contract income levels due to overtime spend in January and February. The forecast was still break even at the year end.

The Board was advised that there was an emerging risk relating to escalating fuel costs as a result of the middle east conflict. The Trust has gone to daily pricing as opposed to weekly. In addition Capital is on plan to deliver also so overall the Trust will deliver against plan.

Sukhjeevan Nat indicated that the year end forecast was reduced to £35.1m due to a change in the capital plan from leasing to buying. It was his understanding that leasing and the buying has the same impact on the Balance Sheet. The Cash position is solely due to handover delays. Karen Rutter stated that all assets are recorded on the balance sheet due to IFRS 16 and the cash impact is when the payments are made for either a purchase or lease item. The reduction in planned income is the income for handover delays.

The Chairman thanked the Director of Finance and her staff on the out-turn results as it is due to grip and control of the finances.

08b – 2026/27 Opening Budgets for approval (Revenue and Capital)

A report of the Director of Finance was submitted.

Karen Rutter stated that the submission was for approval so that the Trust commences the year with an approved budget. It sets out the Medium Term plan information submitted to the NHSE in February for which the Board Assurance Statement was provided. There was a further NHSE submission in the last week to reflect any changes and Cheshire PTS income and expenditure was included. There is no change to the bottom line and there are no other amendments to the submitted plan.

The 2026/27 assumptions are based on 400k lost hours although the contract is likely to affect the base line based on everything above the base line hours as agreed in the mediation that is chargeable. The Trust are seeking clarity on how this will play out during the year in terms of phasing the income in the event of handover improvement so that there is nil income. The risk is reducing cost at pace if handover delays decrease, but the plan is built on 400k hours. The presentation sets out how the budget is distributed.

The Capital plan is set out in the presentation and includes strategic capital to be confirmed in relation to the Hub replacement, and the approval is sought and more granular detail will come forward as the year progresses.

Julie Jasper complimented the Trust on securing Cheshire PTS vehicles. The Chairman sought clarity given that the Northwest Region have provided the capital, is there any chance that the Midland Region will provide capital for the PTS vehicles in the Midland region. Karen Rutter stated that the relevant ICBs in the West Midlands are still being progressed.

08c – Finance Strategy

A report of the Director of Finance was submitted.

The Board was advised that the plan has been supported by the EMB and was also supported by the Finance & Performance Committee. Any changes emanating from implementation of the 10-year plan will be brought to the Board.

Sukhjeevan Nat indicated that it had been discussed in detail at the Finance & Performance Committee. In particular the document addressed transformation and future proofing. In addition there was a discussion on whether to apportion any weighting to the objectives so that there was more focus on those objectives that were more critical to the Trust. Generally a good discussion.

The Chairman stated that it will be a live document that can never be final given the fluidity of the wider national strategic and financial position within which the Trust operates.

08d – Delegation of Authority for Approval of 25/26 Annual Report and Accounts

A report of the Director of Finance was submitted.

Karen Rutter stated that a date is now in the diaries for NEDs to review the accounts prior to submission and there is also a date for the Audit Committee to receive the audited Annual Report and Accounts and the Audit opinion.

08e – Delegation of Authority for Contract Signature

A report of the Director of Finance was submitted.

03/26/09 – Reports of the Director of People

9a – Board Skills Matrix 2025/26

A report of the Director of People was submitted.

The Director of People requested members of the Board to review the contents prior to its inclusion in the Annual Report. In addition, the Board was requested to approve the content of the Skills Matrix, subject to any comments received for publication in the Annual Report.

09b – 2025 Staff Survey Results

A report of the Director of People was submitted.

Carla Beechey presented the staff survey results stating that the survey results had been reviewed by EMB and the People Committee prior to submission to the Board. The response rate for WMAS is 42% compared to 68% in the 2024 survey, a factor in this reduction could be that there was no incentive offered to complete the survey.

The Trust wide Action Plan was also appended, EMB approved the Action Plan at its meeting on 17th March 2026.

The Action Plan was broken into the following themes:

Civility, Compassion, Communication- Being open and transparent with staff about what is being handled, at what level and what are the limitations. Involving staff in what would be helpful to support them in managing those challenging situations.

Managers and Teams – Give Managers scope to make decisions and interact more with staff. Team based rostering was suggested. Team building and socialisation for peer support.

Staff morale and safety – Keep working on key areas such as physical violence, Sexual misconduct and bullying & harassment. Recognising and valuing staff and their work. Making appraisals more meaningful. Looking at opportunities for career development and progression.

The actions were then broken down into following sub headings:

• Promoting a culture of compassion and inclusivity
• Increasing Staff Involvement & Communication
• Civility and Respect
• Meaningful Recognition
• Inclusion and social interactions
• Improve communication between staff and management
• Promoting a culture of compassionate leadership
• Management and Leadership Development
• Development Opportunities
• Worklife Balance

Underpinning the Trust wide Action Plan there localities were required to hold Listening into Action (LiA) consultations with their staff to continue working on the Local Action Plans (LAP), which have been rolled out over three years. The LAPs focus on local improvements that staff want to see in their areas.

Carla Beechey reported that the CEO was meeting with the Staff Survey Leads to see if there was any further support that could be provided.

There was also a staff survey free text report which contains anonymized comments from staff, EMB decided that the free text report and dashboard will be shared at Director level only to preserve anonymity.

A dashboard would be developed to enable staff survey leads to work with their relevant managers to drill down into specific responses rather than work with a number of spreadsheets.

The Diversity and Inclusion Steering and Advisory Group (DISAG) has recommended more engagement with and from the Staff Networks to address some the findings from the report.  The reason for the Workforce Disability Equality Standard (WDES) data being specifically included as this was a specific demographic staff survey group that was reviewed and there will be some targeted work in this area. The Trust will work with the other Networks such as the One Network and Women Network to target specific areas arising from the staff survey.

Vivek Khashu indicated that the results do not reflect or correlate with the effort and work being put into promoting FTSU amongst staff and the Guardian will look at the findings and as such the staff survey results made for difficult reading.  The numbers of growing referrals would indicate growing confidence in using the speak up process, however, the FTSU team alongside board leaders would need to reflect and consider what additional actions could be taken to improve. The CEO indicated that the meeting with FTSU Ambassadors may offer the opportunity to seek their views as a direct interface with staff.

Carla Beechey emphasized that the themes set out in the Action Plan were being picked up elsewhere on the Board Agenda, such as the work on implementing the NHSE Sexual Misconduct Framework as part of Strategic Objective 2, “A Great Place to Work for all People”. The Staff survey results should not be seen in isolation and the work feeds into wider workstreams.

The Chairman thanked the Director of People for presenting the Staff Survey report and next actions and indicated that the implementation of the Action Plan will now be monitored through People Committee and report any significant issues or matters to the Board. He indicated that the response rate was disappointing and whether there should be some form of incentive reintroduced to encourage staff to complete the survey.

Mohammed Fessal concurred with the Chairman. However, he observed that even with a higher response rate in previous years the themes coming out have been similar. He stated that whilst there was clearly a correlation with handover delays and the impact on staff morale there were themes that are the same such as managerial relationships, workload and development. It is important to work through the action plan concentrating on these specific areas and most importantly communicating the actions taken.

Carla Beechey stated that the People Committee receives a triangulation report that looks at employee relations data, complaints and grievances. It does not correlate with the staff survey results and is not consistent with what workforce representatives are saying. Carla questioned whether a higher response rate would make any difference to the results coming out of the survey as it doesn’t reflect the feedback being received from other staff forums. The CEO reminded the Board that the Trust’s attrition rate is the lowest in comparison with other NHS organisations in the region and lowest in terms of average in the country.

The Chairman stated that the triangulation was helpful to have that triangulation so that things don’t get lost that are not picked up in the staff survey and also may moderate the extreme views of individuals given the different functions undertaken by staff in the Trust.

In conclusion the Chairman indicated that feedback will be via the People Committee, but also asked the Director of People to also regularly update the Board in her regular report to the Board.

03/26/10 – Combined Clinical Directors Quality Reports

The Combined Clinical Directors report was submitted.

Dr Steyn, the Trust’s Medical Director, highlighted the following salient matters contained in the report:

• In January 2026 there 50,071 hours were lost. That is the equivalent to 151 ambulances ‘lost’ for their full 12 hour shift every single day of the month.

• During January 3,565 empty ambulances were deployed to the hospital to cohort patients in an ambulance outside of the emergency department rather than responding to 999 emergencies.

• NHSE Region did not support implementation of National winter 45 minute handover action cards, which therefore have not been implemented. The Chairman sought clarity on whether other regions are using them why this region isn’t using them. Many other regions didn’t need to use them as handover delays were not as bad, but the Midland Region decided not to use them. So it was a local decision not a mandate from the national team.

• Dr Steyn highlighted that on a more positive note, there has been Regional NHSE led 45 minute implementation ‘Triumvirate’ meetings with WMAS & Acute Executives, where the focus has been implementation of the 45 minute maximum handover with engagement from a number of WMAS Executives. January was the second worst month on record for hospital handover delays.

• Signs of improvement are beginning to show with handover delays beginning to reduce but it was still too early to tell whether this was a sustainable improvement. The average timings are coming closer to 45 minutes. This is a very poor measure of a maximum and when considering the 90^th centile that is three to four hours, so that is what is needed to reduce. Dr Steyn stated that in the 95th centile it lies at 7-8 hours. The Chairman asked whether the averages are used as an indicator? Vivek Khashu indicated the reports are sent out showing this information and data. Suzanne Banks stated that it is paramount that it is the impact on patients not numbers, especially given that the patient may be waiting lengthy periods of time in the back of ambulances. The Trust should remember the impact on staff morale as they watch the patient suffering and awaiting care of handover delays and this is sometimes forgotten, Dr Steyn agreed and stated that there is a definite impact on patients in particular the impact on frail patients and patients remaining on the back of ambulances are not as visible. The impact on staff is also paramount as they just don’t know when they will finish as they have a duty of care to the patient on the back of the ambulance. Dr Steyn indicated that there is an issue that we miss the impact of handover delays by focussing on the data and numbers. A patient on the back of an Ambulance may not have been assessed by the acute medical staff.

• Dr Steyn felt that the issue was keeping the Executive of the Acutes focussed on patient flow. There are improvements but Dr Steyn questioned how sustainable these improvements in delays were, given that Acutes have relied on Corridor Care. There has been a meeting with Dr Timothy Briggs (Getting it Right First Time) that is going to look at emergency and urgent care. This will focus also on the risk of corridor care in Acutes which will also look at patient care on the back of ambulances.

• Moving on to other matters Dr Steyn indicated that MERIT funding was still unresolved.

• The report also referred to the restructure of the Transformation and Patient Safety Directorate which is being progressed primarily due to the reduction in Mental Health income, Cost Improvement requirements and need to ensure effective structures. The reduction in funding for the HISU (High Intensity Service User) provision will no longer exist in Black Country following reduction in income from Commissioners.

• The Trust is making preparatory plans for the upcoming changes to JRCALC guidance (specifically in relation to Termination of Resuscitation) and the Trust has taken action to meet this launch on 15 April 2026, and a training programme has been developed with a two hour extraction time for training.

Aidan Brown indicated that there is a comparator between hospital handover delays and incident reporting.  In addition, this Trust remains the worst effected by handover delays in the country.

The Chairman indicated that many Acutes repeat the observations this Trust has undertaken including ECGs. Dr Steyn indicated that until the EPR shows the tests the Acute will proceed to carry out the necessary tests.

03/26/11 – Report of the Chief Operating Officer

A report of the Chief Operating Officer was submitted highlighting various matters contained within the report. Activity during February was 4% higher than the previous February in 2025. Resources were fine, and hand over delays meant 28,000 lost hours. The Trust did go to Surge 4 which meant the Trust contributed to the system as less patients were making their own way to Emergency Departments at Acutes, although it meant greater activity for this Trust due to resource availability.

In terms of Cat 2 mean performance, the Trust averaged 20 minutes which was very positive.

Planning is in place for Easter/Spring seasonal holidays.

The Chairman congratulated the operational leadership on the JR CALC training implementation which was a challenge given the short timescales.

Vivek reported to the Board on behalf of a member of the public that the Trust Information Pack showed the sites and the lost hours and whether that could be included in the report. The CEO reported that the detailed performance data is reported to the Finance & Performance Committee where it receives forensic review and detailed scrutiny.

03/26/12 – Report of Strategy and Engagement Director

A report of the Strategy & Engagement Director was submitted.

To present the refreshed strategies for:

• Fleet
• Estates and Sustainability
• Clinical and Quality
• Finance (approved as part of the Finance papers see Minutes 03/26/08c above)

Each strategy has been reviewed by the respective assurance committee and EMB.

Dr Steyn indicated that the Clinical & Quality Strategy document has been subject to detailed review. Dr Steyn indicated that several smaller strategies have been incorporated into this strategy, so it is comprehensive. He felt that with the impact of the operational challenges of handover delays the Trust was still focused on high quality and safe clinical care. The strategy brings together the clinical, quality and improvement work plans and recently approved Patient Experience Strategy. The last page in the document sets out the strategy on one page.

Karen Rutter referred to the Estates and Fleet strategies, indicated that they are future proofed and highlight the ambition of the Trust as well as delivering day-to-day improvements. The content of both documents is predicated and dependent on capital funding availability and utilizing the various national pots of funding available to the Trust.

Sukhjeevan Nat asked about sustainability in relation to the fleet strategy and asked for an update the number of electric powered vehicles being used operationally by the Trust. The Chief Operating Officer reported that there were this year eight vehicles delivered to the organization with four being delivered to Erdington and four to Sandwell: with 18 vehicles in total being used by the Trust in the current year.  There is a training plan in place to ensure that these vehicles are being utilised operationally. Karen Rutter indicated that approximately 16 electric vehicles were ordered for next year. NHSE have asked whether the Trust could order more electric vehicles next year. However, the Trust want to analyze the effectiveness of the vehicles in the operational setting such as liaising with Acutes in terms of charging points before ordering further vehicles.

The Chairman stated that the majority of vehicles were Fiat and asked about future proposals such as MAN TGE vehicles used by other Ambulance services. The CEO stated that the Trust is looking at the reliability, economic viability and cost effectiveness of vehicle replacements. The Trust was also retaining the viability of fleet replacement of vehicles over five years old and the transition from diesel to hybrid or electric. The CEO indicated that the Trust are currently reviewing the fleet replacements and was including MAN TGE in that evaluation. The Trust is taking a considered review and over the next 3 months the Trust will determine its fleet requirements 2027/28 with a report coming to the Board to place the order for the vehicles to retain build slots.

03/26/13 – Board Committee Meeting Minutes and Chairs Reports

13a – Audit Committee

The Chairs Report of the Audit Committee meeting held on 10 March 2026 was submitted along with the minutes of the meeting held on 22 January 2026.

Julie Jasper highlighted the following salient matters:

• The Claims & Coroners Report  submitted to the Committee didn’t provide the assurance the committee required, and as a result matters moved on at a pace and Julie indicated that following a discussion with Suzanne Banks as Chair of QGC, Karen Rutter and Caron Eyre there will be a report to Audit Committee on changes made to the quality governance surrounding the Claims & Coroners Report and the learning for the Trust. The matter was resolved subject to the report to the Audit Committee.

• In terms of External Audit, the audit is progressing in a timely manner and the timescales for the review of the Accounts and Annual Report have been drawn up with sign off by the Committee on 22 June 2026.

• The Internal Audit have produced two positive reports on Make Ready and Risk Management which will assist with the Head of Internal Audit opinion in the Annual Governance Statement. The Internal Audit workplan has been approved and it has been reviewed by EMB.

• The workplan for Counter Fraud was approved and it was noted that the Board received its Bribery Act and Failure to Prevent legislation training at its Board Briefing on 25 February 2026.

• The latest version of the Board Assurance Framework (BAF) was reviewed and discussed

• The Director of Finance confirmed that the accounts will be produced on a Going Concern basis.

• Diane Scott was thanked (in her absence) for her contribution to the business of the Audit Committee and supporting the good level of assurance provided to the Committee.

• There had been constructive discussion between Audit committee members (NEDS) and both sets of auditors with no issues requiring escalation to Board.

13b – People Committee

The Chairs Report of the People Committee meeting held on 2 February 2026 was submitted along with the minutes of the meeting held on 8 December 2025.

Mohammed Fessal as Chair of People Committee highlighted the following salient matters:

• Discussion at the committee acknowledged the ongoing challenges around career progression, limited promotional pathways, and skill decay from hospital handover delays. Similar discussions as previously on organisational operating model and restrictions on recruitment contributory factors.

• As discussed earlier in this meeting the staff survey response rate decreased to 42%, a reflection on the previous year’s incentivized scheme. Nearly half of the questions (46/101 comparable) show worse responses from last year. The themes broadly remain the same with negative responses relating to managerial relationships, workload and development. The Committee will monitor implementation of the Action Plan.

• Review of Sexual Safety & Wellbeing Group Taskforce membership and work plan which continues to report into the Sexual Safety & Wellbeing Group which is Chaired by Professor Hopkins.

• Presentations from Engaging Managers participants demonstrated meaningful impact on confidence, leadership skills, team empowerment, and workplace behaviour.

• Sickness slightly up, however it remains low in comparison with others in the sector.

• Following documents approved:
  • Protection of Pay and Conditions of Service
  • SOSR (Some Other Substantial Reason) Annex as part of the Disciplinary Policy

• A risk identified was the Employment Rights Act, to be rolled out in 2026 and 2027, has the potential for future increases in tribunal claims due to legal changes (e.g., claims submitted on behalf of others, ACAS timescales), as well as significant impact on resources from HR and operational colleagues.

13c – Finance & Performance Committee

The Chairs Report of the Finance & Performance Committee meeting held on 17 March 2026 was submitted along with the minutes of the meeting held on 19 January 2025.

Mushtaq Khan indicated that much of the discussion at the recent meeting of the Committee has been well aired at this meeting. He therefore indicated that he would focus on those matters not previously discussed:

• Significant and persistent hospital handover delays across multiple Acute Trusts, causing 29,000 lost hours in February and materially affecting Cat 2 performance and frontline productivity.
• Activity and productivity increased, supported by improved resource availability and indications of reduced hospital delays compared to last year, although this will need to be seen whether this is sustained.

• Operational pressure requiring ongoing reliance on overtime.

• Fragility in achieving Hear & Treat and See & Convey trajectories as demand is 4% higher than last year and financial headroom is tightening.

• Commercial Services risks including contracting pressures.

• Fuel price volatility driven by global instability was a risk requiring daily monitoring by Procurement.

• Finance Strategy approved for submission to Board.

• Corporate Risk log refreshed.

• BPPC performance remains above 95%, CIP delivery is above plan, and the Trust is still forecasting break‑even at year end.

• Sickness levels remain the lowest nationally, supporting better rota stability and operational output.

13d – Quality Governance Committee

The Chairs Report of the Quality Governance Committee meeting held on 18 March 2026 was submitted along with the minutes of the meeting held on 21 January 2026.

Suzanne Banks, Chair of the QGC highlighted the salient matters discussed at the meeting held on 18 March 2026:

13d – Quality Governance Committee

The Chairs Report of the Quality Governance Committee meeting held on 18 March 2026 was submitted along with the minutes of the meeting held on 21 January 2026.

Suzanne Banks, Chair of the QGC highlighted the salient matters discussed at the meeting held on 18 March 2026:

• The salient concern remains the impact on patient safety because of handover delays and the long wait for ambulances in the community as a result of the delays.

• The lack of escalation for Paramedics when they have concerns over deteriorating patient condition. Despite constant escalation by this Trust’s clinical directors the “Safety Summit” which the Trust wants the ICB’s and Regionals NHSE to host continues to be delayed despite escalation through the Clinical Directors. This continues to be escalated.

• The Acute Trusts are now being monitored on corridor care. This has resulted in one Trust in the region reported to be leaving more patients in the back of the ambulances to remove their breach of corridor care, increasing the pressure on the ambulance staff and the quality of patient care.

• Treatment of patients by ED staff in rear of ambulance, or patients being treated in ED and put back on ambulance e.g. catheterisation, infusion etc. The Trust’s EMB have made it clear that Paramedics must not go beyond their scope of practice.

• In terms of corporate team resources it was noted that the reduction of resources in corporate teams, in particular Safeguarding, Information Governance and IT. Risks continue with regards to Safeguarding, Complaints, IT and Information Governance. The risk also extends to Procurement with regards to drivers and delivery.

• The imminent Pharmacist vacancy is a risk although a plan is in place to mitigate the risk which will be brought to the next meeting of the Committee for assurance purposes.

• HISU (High Intensity Service User) provision will no longer exist in Black Country following reduction in income from commissioners. Risk of impact on these patients and their pathway.

• MERIT funding remains unresolved with the commissioners and presents a significant risk.

• Coroners and Claims Report: Following its presentation at the Audit Committee, discussion around reporting to QGC and information required within the report had been progressed by the Director of Nursing. A Report to next QGC Committee (and Audit Committee) outlining proposed reporting and content of report alongside a year-end lessons learned report.

• Scheduled “deep dives” for future meetings in 2026/27 include Safeguarding as part of the Committees regular review, and a 6-month review following original “deep dive” on Ambulance Handover delays.

• The Committee paid tribute to the invaluable support that had been provided by Diane Scott and wanted the appreciation of the Committee for her contribution to promoting assurance placed on record.

• The current 2025/26 draft Quality Account was presented with proposal to share the update electronically with members before the next meeting and the final account to be presented at the May meeting.

• Assurance was provided that the Terms of Reference have been reviewed for the two reporting committees, Professional Standards & Learning Review Group and Health, Safety, Risk & Environment Group.

• Automation of Clinical Audit programme on track for April 2026.

• Training scheduled from April 2026 for all staff on JRCALC changes on Termination of Resuscitation.

• CIP planning for 26/27. Assurance on reviewed QIA process arrangements with Clinical Directors.

• Increase in Incident reporting for data breaches following training on IG. Positive response from increased awareness. This is positive as staff are becoming more aware and reporting breaches.

• Clinical and Quality Strategy 2026 -2029 approved.

• KPMG Make Ready Audit report received.

• KPMG Risk Management and BAF Audit report received.

03/26/14 – Board Schedule of Business

The schedule was submitted

The Date of the Next Meeting

Wednesday 27^th May 2026

There being no other business for this meeting, the Chairman brought proceedings to a close and thanked members for their attendance.