Councillors and committees

Agenda item

South East Coast Ambulance Service Update

Purpose of the Report: This report updates the Committee on the South East Coast Ambulance Service, with special focus on the recent CQC report, Executive leadership development, performance reporting and associated strategic operational updates, alongside other local performance and development initiatives for Surrey.

 

Minutes:

Declaration of Interests:

 

None

 

Witnesses:

 

Helen Wilshaw-Roberts, Strategy & Partnerships Manager – West, SECAmb

Steve Emerton, Executive Director of Strategy and Business Development, SECAmb

Andy Cashman, Regional Operations Manager: West, SECAmb

Sumona Chatterjee, Executive Director of Strategic Commissioning, Surrey Heartlands CCG

Matthew Parris, Healthwatch Surrey

 

Key points raised during the discussion:

 

  1. The report was briefly introduced by the Executive Director of Strategy and Business Development who explained that the Trust had moved from an Inadequate to a Requires Improvement Care Quality Commission (CQC) rating.
  2. Witnesses were asked for an update on the new executive team employed by the Trust. It was explained that the previous Chief Executive, Daren Mochrie, had taken on a new role and Dr Fionna Moore would be acting as the SECAmb Interim Chief Executive. A new Chief Executive had been appointed and the Executive Director of Strategy and Business Development would update the Committee on the progress of this appointment in due course.
  3. It was confirmed that following the Demand and Capacity Review, it was recognised that a significant amount of investment was required to see improvements in the Trust. A contract variation agreed with the commissioners has placed a significant investment in the Trust for 2018 / 2019 and continues into 19/20 and 20/21. The investment in the Trust is dependent on the current contract review process and would be around £34-43million growth per annum over the next two years
  4. It was queried how much emphasis was given to triage by the Trust as it seemed to work well with the Crawley Ambulance triage programme. The Strategy & Partnerships Manager – West explained that the Crawley Ambulance triage programme had been successful in helping with the current gap in crisis response teams and the ability for an emergency response for people suffering a mental health crisis. The model consists of an advanced mental health practitioner and a paramedic that respond to calls. The result had been effective assistance had been provided and the Trust was working with Sussex Partnership and Foundation Trust to assess the most appropriate model of care for people experiencing such emergency crisis - this would then be assessed for wider rollout requirement further across Surrey and Kent.
  5. It was explained that the Targeted Dispatch Model would ensure the right resources get to the right places and people. There was a concern there will be a greater number of people being conveyed to the acute centres as resources available to the Trust improve. It was added that there were now midwives in the control centre environment for the Surrey Heartlands area which would reduce the number of conveyances to hospitals and this would be extended to Sussex and Kent in due course.

 

Zully Grant-Duff arrived at the meeting at 10.35am

 

  1. It was queried what issues were stopping the Trust from improving ambulance response times and how these were being tackled. The Regional Operations Manager – West explained that the investment secured had enabled the Trust to secure additional resources and make improvements. The demands on the Trust had been modelled from historic data and rotas had been re-profiled for operational staff. Hospital handover work had been done and has seen significant improvements in turnaround times but continues to be an issue in winter periods. The introduction of the national Ambulance Response Programme (ARP) has allowed the Trust to think about how calls are triaged with more time being available to make decisions. It was added that improvements are regularly monitored with commissioners as part of an action plan. The Executive Director of Strategic Commissioning stated that the operational workforce trajectory was recognised as an important factor for improvement and circa 2000 operational staff, including over 1000 paramedics, would be operational in total to deliver key standards. Resources will include those secured via private ambulance providers.
  2. It was confirmed that staffing had been included within the Demand and Capacity Review and investment for this had been agreed.
  3. There was a discussion around the particular difficulties the Trust was facing with trying to improve C3 and C4 ambulance response times and the role of non-emergency transport vehicles in this. The Trust recognised that it was unacceptable that there were long delays with C3 and C4 calls. It was explained that lower category calls into the control centre were regularly reviewed and re-categorised if needed, and that call-backs were made where appropriate and followed with situation updates. It was explained that an audit of decisions taken by call takers was undertaken regularly to ensure decisions taken were appropriate.
  4. A Member of the Committee queried the ambulance quality indicators in Table 2a of the report asking when the Trust would see an improvement of performance for all call categories and, also, how the Trust was addressing the ‘Must do’ actions raised in the CQC report. It was explained that there was a great amount of activity being undertaken to improve process, oversight of call handling and the deployment of clinicians especially in the control centre environment. There were plans to bring 38 nurses into the control centre environment. There was currently a lot of work going on to improve performance across the Trust.
  5. The representative from Healthwatch Surrey explained that there was a wide variation of patient experiences with SECAmb services. They gave the example of a lady who had fallen over and waited over four hours for an ambulance, which highlighted the issues of long waiting times. They explained that in contrast good feedback had been received on the conduct and professionalism of ambulance staff.
  6. Members of the Committee congratulated the Trust on the improvements to the service.
  7. The Executive Director of Strategy and Business Development stated that compliance would be delivered with Category 1,2,3,4 calls in Quarter 1 of 2019/20, all things being equal. Weekly discussions are being held with NHS commissioners to reflect on the challenges in achieving this. The Executive Director of Strategic Commissioning stated that work was being undertaken with SECAmb regularly to ensure ARP standards were met. The issues of call stacking will be addressed, as ARP standards were met.
  8. With regards to how the Trust can give assurance it would be fit for the future, it was explained that work was being undertaken with commissioners and partners to shape the future of the Trust. The five year strategic plan is currently being refreshed and allows the Trust to think about shaping pathways for the future.

 

 

Actions/further information to be provided:

 

None

 

Resolved:

 

For the Health, Integration and Commissioning Select Committee to receive an update report on the performance of SECAmb in September 2019. For this report to include an update on:

 

  • the Performance of all Categories (1,2,3,4) of ambulance response times,
  • the work of the new Chief Executive since joining the Trust and governance arrangements,
  • recruitment, hospital handover times and any funding issues.

 

Supporting documents: