Minutes:
The Chair welcomed to the meeting Estelle Hitchon, Director of Partnership and Engagement and Rob Jeffery, Ambulance Operations Manager, with the Welsh Ambulance Services NHS Trust who had been invited to the meeting to give a presentation on the service.
The Committee thereupon received a presentation providing an overview of the service.
Key data for 2016/17 included the following:-
· The Non-Emergency Patient Transport Service made 797,410 journeys during the year;
· The service dealt with 463,018 verified incidents which was 1.9% up on the previous year’s figure;
· The NHS Direct Wales service dealt with 301,640 calls;
· The overall operating costs in 2016/17 were £174m;
· The new 111 pathfinder service took more than 60,000 calls;
· The vehicle fleet comprised 709 vehicles;
· The service employed 2,985 staff across Wales;
· The service is commissioned by Health Boards throughout Wales and the target set by them is 65% of all calls must be responded to within 8 minutes.
The service continues to promote its behaviours, together with its statement of vision and purpose which was developed in partnership with colleagues in 2015/16. The behaviours promoted are:-
- I will be kind, caring and compassionate
- I will ask and listen
- I will be honest and open with myself and others
- I will own my decisions
The service introduced a new Clinical Response Model and benefits of the new model included the following:-
- Prioritises “sickest patient first”
- Most appropriate clinical response to incidents
- Optimal use of finite resource
- Increased hear and treat
- Right response, right time, every time
The Ambulance Services relies on the Community First Responder volunteer programme which is a vital service to the community because it is simply not possible to get to some places within 8 minutes due to the geographical challenges of some areas of Wales. The Resilient Communities initiative is also of great assistance in more rural areas as it develops the skills of the community with public access to defibrillators, teaching CPR skills to primary and secondary school children and also training secondary school children on the use of defibrillators.
The service works very closely with partners and collaboratively with other emergency services like the police e.g. clinicians are based in police control centres as they are able to give direct advice to police officers at the scene of an accident as to whether or not an ambulance is required. It was pointed out that the ambulance conveyance rate is slightly higher in Carmarthenshire than other areas and that needs to be managed.
The presentation was followed by a question and answer session during which the following questions were asked:-
· With regard to the Non-Emergency Patient Transport Service (NEPT), the officers were asked if they are happy with the communication system between the clinic, hospital and home as there are occasions where ambulance turn up 2-3 hours early and sometimes they arrive late. The Committee was advised that the service does try to reduce the amount of time that people spend in the vehicle and there is now a new structure in place for NEPT which will help greatly;
· Reference was made to the training being offered to school children and officers were asked if this included awareness of how to make 999 calls. The Committee was advised that training includes CPR, how to make an effective 999 call and also how to approach a situation safely e.g. if someone has been electrocuted. Almost 80,000 children have been taught these skills in Pembrokeshire and it was intended to roll out this initiative to other counties. Hopefully this will demonstrate a potential career path to these children;
· Asked how people can find out about becoming community volunteers, the Committee was advised that it’s mainly by word of mouth, however, information is also available on Community Health Councils’ and the Ambulance Service websites. The Committee was further advised that training and support with fundraising for defibrilators is provided. Ipads are being trialled at the moment as a means of alerting volunteers to a potential call;
· With regard to the 65% achievable target for red calls the question was asked whether the hold up with ambulances waiting to release patients at hospital was to blame. The Committee was advised that if an ambulance is waiting outside then clearly that does have an impact on the figures. However, if an ambulance is required to come back into the system then an immediate release can be requested. The Director pointed out that the entire NHS system is under pressure and it was important for everyone to work together as we all have a role to play in how we manage patients effectively. Staff in A&E departments are working hard and we need to ensure that only people who are ill enough to warrant hospital admission actually do go to hospital. Working together to minimise the delays is what it is all about;
· In response to a question as to who makes the decision between what is a red and amber emergency, the Committee was informed that a medical priority despatch system is used. It is an algorithm which allows the despatcher to ask questions which will then direct them to the appropriate categorisation. Amber and red are both blue light responses it is just that red brings in the 8 minute response time. There is a safety net in that if there is any doubt at all then that call is classified as red. It is not a triage tool, it is call prioritisation and if another red call comes in then an amber call can be diverted.
The Chair thanked Ms Hitchon and Mr Jeffery for attending the meeting and for a very interesting and informative presentation and extended the Committee’s appreciation to the ambulance service for the work that they do.