Agenda item

To receive an update on South Central Ambulance Service’s performance. (30 mins)

Paul Jefferies, Area Manager (Berkshire) and Mark Ainsworth, Operations Manager South Central Ambulance Service (SCAS) provided Members with an update on SCAS.

During the discussion of this item the following points were made:

·         Members had previously asked about SCAS’ key financial challenges.  Paul Jefferies indicated that all of the NHS was facing financial constraints.  Whilst SCAS had a financial recovery plan in place, the Trust was still expected to be overspent at the end of the financial year.  

·         Demand had been lower than planned which meant a reduced income and margin.  Demand levels were starting to increase back to the levels of previous years.  There had been a slight increase in the use of NHS 111 and there had been good education around the appropriate use of the service.

·         Councillor Miall questioned whether other ambulance trusts in the country were experiencing a drop in demand and was informed that pockets in the north of the country were continuing to see an increase in demand but this was not so much the case with the southern trusts.

·         Councillor Shepherd-DuBey asked what impact weather had on demand levels.  Mark Ainsworth commented it had not been a very hot summer which often led to an increase in respiratory complaints.  Demand also tended to increase in cold winters.

·         Councillor Shepherd-DuBey commented that the CQC inspection report stated that the Trust must ensure that staff were aware of the appropriate steps to take to reduce the risks to patients left unattended in Patient Transport Services (PTS) ambulances because of staff working alone, and questioned how this was being addressed.  Mark Ainsworth explained that the PTS was a commercial tender.  Staff relied on an accurate assessment when the transport was booked.  The vehicles sometimes did multiple picks up so patients could be left unattended briefly at these times.  He also explained that the PTS did not transport patients who had a high level of acuity.

·         Councillor Clark expressed concern at the number of Red misses between 1 April and 31 October 2015.  Paul Jefferies indicated that the diagram provided covered the whole of Berkshire and that the Red 1 and Red 2 rates were lower in Wokingham.  Very recently co-responding had been set up with the Fire and Rescue Service, under which firefighters attended some medical calls.  Councillor Swaddle asked whether co-responding was taking place at fire stations other than Wokingham and was notified that areas where the most benefit could be achieved such as Hungerford, Slough and Langley, were being considered.  There were 19 schemes in Hampshire.  A rapid response vehicle also covered the Wokingham area.  Consideration was given to how rapid response vehicles were allocated to ensure appropriate coverage.

·         Members asked the representatives for their views on Government proposals for the Police and Crime Commissioner take control over the Fire Service and were informed that SCAS tried to align more with the health services, however emergency response was only a small part of its work.

·         The introduction of the National Ambulance Response Pilot (NARP) had seen improvements for patient benefits and outcomes.

·         Mark Ainsworth commented that the national standard for Red 1 and Red 2 8 minute response times was 75%.  It was more challenging to achieve such targets in more rural areas.  In response to a comment from Councillor Miall that 75% as a target for Red 1 calls seemed low, Mark Ainsworth indicated that SCAS received approximately 40 Red 1 calls a day across the four counties it served and that it was a challenge to identify where incidents would occur.  Resources and the use of community responders were maximised.  An ambulance still had to be sent within 19 minutes of the call if a community responder was first at the scene and undertaking immediate lifesaving.

·         In response to a Member question Paul Jefferies explained the arrangements in place should there be a major incident in the area such as a terrorist attack.

·         The Committee asked about the impact of the night time economy and was informed that a jointly commissioned SOS bus was based in Reading and a specialist practitioner, either a nurse or a paramedic, was provided.

·         Councillor Miall asked the reason for the marked increase in Hear and Treats in July and August 2015 and was notified that this was the result of increased clinicians in the contact centre and also the upgrade of the NHS Pathways system.  Hear and Treats for Wokingham was on average 9%.

·         It was noted that Air Ambulances would soon be starting to fly approximately four times a night.

·         Councillor Richards requested information regarding the recruitment and retention of staff.  There was a shortage of paramedics across the country.  Currently there were 200 paramedic vacancies.  SCAS was working actively with Northampton, Portsmouth and Oxford Brooks universities.  173 UCAS Paramedic Science students were being supported through the provision of placements.  67 staff were due to graduate between January and September and a further 65 were going through the UCAS pathway.  SCAS had also recruited paramedics from Australia and Poland.  Paul Jefferies explained that international recruits had to be accredited by the Health and Care Professions Council.

·         Mark Ainsworth commented that there was a high attrition rate as paramedics were not restricted to working in the ambulance service.  Higher wages were potentially available elsewhere and Thames Valley was an expensive area to live.  SCAS endeavoured to present itself as an attractive employer which cared for its staff and helped to progress careers. SCAS and Oxford Health were working in partnership and had rotational posts.

·         Councillor Swaddle questioned whether targets were being met for staff undergoing mandatory training.  Training was undertaken via e-learning or face to face.  Managers were able to view if target levels were being achieved.  Mark Ainsworth indicated that such training was part of paramedics’ registration requirements.  Whilst SCAS was still not 100% compliant staff could be taken off shift to enable them to undertake e-learning and this had improved training levels.

RESOLVED:  That Paul Jefferies and Mark Ainsworth be thanked for their presentation.