Agenda item

NWAS Ambulance Response Programme Performance Report for period 7 August 2017- 31 December 2017.

Jerry Hawker, Chief Executive of NHS Eastern Cheshire Clinical Commissioning Group (CCG), attended the meeting, in the capacity of commissioner to present the North West Ambulance Service (NWAS) Ambulance Response Programme Performance Report for period 7 August 2017-31 December 2017.

Jerry advised the Committee that NWAS had experienced significant challenges over the last two years.

In July 2017, the Secretary of State had introduced new ambulance response standards for the NHS in England.  NWAS had rolled out the new reports, this was to be completed by August 2018.

Until now, ambulance services were measured on the time it took for a call handler to receive an emergency call, to the vehicle arriving at the scene, the target for this was eight minutes.  The process had now moved away from call handlers to trained clinicians being the call handlers and that enabled more time on the call to assess the urgency of the patient.  This process was part computer generated and part clinical.  Patients would be asked a set of questions that would determine the urgency of a call and then a trained clinician (a General Practioner (GP) or former GP) would make an additional clinical decision.

Jerry explained the new changes enabled ambulance vehicles to be utilised more effectively and efficiently.

NWAS targets were based on the performance of the provider, not the CCGs and this was the same for the whole of the north-west.  This has led to significant disparity across urban and rural areas.

The four new standards were:

·         Category One: for calls about people who had time-dependent, life-threatening injuries and illnesses, they would be responded to in an average time of 7 minutes;

·         Category Two: for emergency calls such as a stroke or major burn incidents and these calls would be responded to in an average time of 18 minutes;

·         Category Three: for urgent calls that are not life threatening but not severe accidents such as falls, these calls would be responded to in 120 minutes (2 hours); and

·         Category Four: for none urgent calls, these calls would be responded to in 180 minutes (3 hours).

Category one and two were the most critical, NWAS had responded to category one 90% of the time in 15 minutes and category two 90% of the time in 40 minutes.  Jerry acknowledged that NWAS had not met the performance standards but that the scale of change for all ambulance services across the country had been challenging.  The statistics particularly for Cheshire showed that NWAS had maintained performance, although this reflected as better than other areas in the north west.  One key area was the time it took the clinicians to make a decision and dispatch a vehicle, sometimes Rapid Response cars were despatched but then an ambulance was needed which had resulted in two or three vehicles arriving to the same scene.

The Committee were advised that an action plan would be available from the 16 February 2018.

The Committee asked if waiting times at the Emergency Department impacted on the resources for vehicles, Jerry advised the turnaround time for the NHS was 15 minutes but the average for the north west was 30-35 minutes.  The Committee noted that both Macclesfield and Leighton hospitals were recognised as two of the best performing hospitals.

The Committee asked for clarification on the category despatch times, Jerry advised for all four categories, this was from the time of the call to the time at the scene of the incident, not the time it took to get to hospital.

There was discussion about Paramedics treating patients in their own homes, Jerry clarified that work was being done to assess if the patient could be treated at the scene rather than transporting them to hospital.

The Committee asked about the role of Cheshire Fire and Rescue, as they had previously started to take on responsibilities for some medical responses.  Jerry confirmed that the Fire Union stopped the support and this had now been withdrawn.

RESOLVED:

(a)  That Jerry Hawker be thanked for his attendance and presentation;

(b)  That the presentation be received and noted;

(c)  That the Committee add an item for NWAS to the Work Programme to scrutinise the action plan and continued performance and invite representatives from NWAS later in the year.