Agenda item

To review response to the NWAS Ambulance Service Review (report to follow)

The Committee considered a report of the Director of Legal Services and Monitoring Officer relating to responses received in connection with a review of North West Ambulance Services (NWAS) carried out on 19 February 2016 and 24 March 2016.

On 19 February 2016, the Committee had undertaken a full day spotlight review of NWAS. The committee interviewed a variety of stakeholders about how their organisation contributed towards ambulance services, what they considered were the future challenges for services and what initiatives might contribute towards making improvements to performance and provide better outcomes for patients in Cheshire East.

The meeting held on 19 February 2016 was used as a ‘fact finding’ day and adjourned for a further half day session on 24 March 2016, when the Committee received additional information and discussed its conclusions and recommendations The committee had published its findings, conclusions and recommendations in a formal report on 29 April 2016. Participants in the process had been invited to respond to the recommendations by Friday 19 August 2016.

The committee considered responses from:

·         Department of Health;

·         NWAS;

·         Interim Director of Adult Social Care and Independent Living;

·         Healthwatch;

·         Eastern Cheshire and South Cheshire CCGs

·          

On behalf of NWAS, Mike Moore referred to a national pilot scheme called ‘Dispatch on Disposition’ which was a new way for ambulance services to respond to 999 calls. The new way of dispatching had a number of objectives including:

·         Reduction in the number of inappropriate ambulance responses by increasing the percentage of patients treated by telephone advice;

·          Improved accuracy of triage of ambulance incidents, ensuring the most appropriate and timely response to meet the patients clinical needs;

·         Improved response to the most critical, life-threatening ambulance incidents (Red 1 incidents)

·         Improvements in performance against the ambulance response time targets.

The changes to the dispatch process did not apply to incidents identified as immediately life-threatening (Red 1 incidents), where an ambulance would continue to be dispatched immediately. The process related to non-Red 1 incidents, whereby patients would be triaged over the telephone before dispatching an ambulance. The additional time spent on the telephone provided an opportunity to identify the most appropriate response which in some cases may not be an ambulance.

It was expected that from October 2016, the ‘Dispatch on Disposition’ system could be used in the North West.

In response to a question about how the inequity between Rural and Urban areas could be addressed over a large area like the North West region, Mike reminded the committee that although all CCGs across the region commissioned Ambulance Services, Blackpool CCG took the lead on behalf of all North West CCGs.

As of 1 September 2016, System Delivery Groups had been replaced by A&E Delivery boards whose role would be to influence quality initiatives. The main priority for the delivery boards had been to achieve a reduction in conveyance by ambulance and an improvement in performance through, for example, better triage arrangements on a Cheshire/ Wirral footprint.

In response to a question about whether authority would be given to paramedics to prescribe drugs in future as had occurred in some of the trial areas, Tracy Parker – Priest informed the Committee that the statistical analysis of the pilot areas had not been evaluated yet and that CCGs would wish to see that evaluation before a decision was taken.

Members also raised the need for better co-ordination between mental health commissioners and NWAS in view of the proposals later on ion the agenda to reduce the number of locally available beds for adult metal care

Mike also explained the desire to recruit more first responders. However recruitment was quite a lengthy process taking up to three months which included DBS (Disclosure and Barring Service) checks.

RESOLVED –

(a)  That the Communities and Health Portfolio holder be requested to take up directly with Blackpool CCG, this committees concerns about the inequity in the current arrangements between urban and rural areas.

(b)  That the Communities and Health Portfolio holder be also requested to undertook a publicity drive to encourage more first responders to volunteer through the press, partnership organisations, Cheshire Association of Local Councils (CHALC);

(c)  That details of the evaluation of the trail which has authorised paramedics to prescribe drugs in some other local authority areas be brought to this committee when available;

(d)  That CWP be requested to liaise with NWAS on the proposed mental health redesign proposals;