Agenda item

Sarah Byrom, Director of Performance and Patient Experience, will brief the Committee as follows:

      response time figures (to follow);

      update on Foundation Trust status;

      cross boundary work; and

      the work of the Community First Responders.

Sarah Byrom, Director of Performance and Patient Experience, briefed the Committee on performance, highlights, complementary resources and Chain of Survival.

As previously advised to the Committee, response time standards had been replaced by 2 categories:

      Category A (red calls) which required a response in 8 minutes with a 19 minute transport standard; and

      Category C (green calls) which were broken down into Green 1, 2, 3 and 4 with response times and telephone assessment times still to be agreed. 

There were also 13 new Quality Indicators covering various items including “outcome from cardiac arrest”, “outcome from stroke”, “time to answer call”, “service experience” and “time to treatment”. 

Ms Byrom outlined the headlines relating to performance which indicated that performance across Central and Eastern Cheshire had improved; for Category A8 performance for the year to date showed response times as 72.8% against the Government target of 75% and for October alone the rate was 74.72%. 

She referred to service reconfigurations of wider NHS services and the impact they would have on the ambulance service, for example, when an ambulance had to transfer a patient to a centre of excellence which may be out of the area, meaning turnaround times would take longer.  A new initiative - Primary Percutaneous Coronary Intervention (PPCI) - had now been introduced across Cheshire East. 

A number of new developments included new clinical indicators allowing more focus on clinical care; expansion of the Urgent Care Service, the introduction of a Clinical Supervision model which had introduced a more effective supervisory structure and recruitment, the expansion of the Community Resuscitation Team, patient surveys undertaken at Leighton Hospital and unconditional registration with the Care Quality Commission.  Positive feedback had been received from patient surveys but there were still issues around eligibility criteria and the inconsistent use of the electronic booking system for patient transport.

Future challenges included increased activity, winter demands, financial climate, changing commissioning arrangements and market testing for the Patient Transport Services. 

In relation to complementary resources in Cheshire East there were 8 Community First Responders (CFR) schemes with 51 trained responders; there were 27 Public Access Defibrillation (PAD) sites.  In the near future, further CFR schemes and PAD sites were to be introduced; presentations were being given to Parish Councils, a Co-Responder scheme was in place in Nantwich and Heartstart UK training had been given to local communities as well as introducing a schools programme – Heartstart was basic life support training given to local communities.  The Chain of Survival Strategy was outlined which aimed to reduce levels of mortality and morbidity associated with emergency situations occurring outside hospitals; it involved partnership working to strengthen the immediate response options which existed and to complement the NWAS provision too.  Currently, a Regional Coordinator had been appointed with a start date of January 2012, County Level leaders were shortly to be interviewed and a County Group was under development; the Chain of Survival Strategy would be implemented in January 2012. 

Finally, the Committee was briefed on the current position with Foundation Trust status – NWAS was currently undergoing an assessment with the Strategic Health Authority following which the application would be submitted to the Department of Health.  It was hoped that Monitor would authorise Foundation Trust status around September 2012.

Members of the Committee were then given the opportunity to ask any questions or raise issues as follows:

      How quality was measured and whether figures were kept on survival rates?  In response, the Committee was advised that a Care Bundle was used in relation to Acute Myocardial Infarction cases and measurements were taken of how many parts of the Bundle package were implemented; this was reported to the NWAS Board on a regular basis;

      Whether there was dependence on Community First Response teams particularly to reach response time targets and what would be put in place should volunteer numbers reduce?  In response, Members were advised that CFRs were complementary to other services and were part of the overall response process.  There were also Co-Responders teams with the Fire Service and these roles were not voluntary as they used retained fire officers.  There were clear roles and responsibilities set out;  a database was used to show the strength of each scheme;

      The impact of cross boundary work – it was explained that this was difficult to measure but as well as NWAS vehicles moving out of the area, there were also vehicles from elsewhere moving into the North West; the important point was that vehicles were moved in response to the current situation, for example, at times of high numbers of flu cases, vehicles would be moved to areas where cases were especially high.

RESOLVED:  that

(a) the update be noted; and

(b) NWAS be invited back to a meeting in approximately six months time with current response time figures, further information on Community First Responders schemes and details of Care Bundles used for Acute Myocardial Infarction and stroke cases.