Agenda item

To receive a presentation from the North West Ambulance Trust on various matters including:

      The Foundation Trust application;

      Update on Community First Responders and Co-responders Scheme;

      Response times.

The Vice Chairman welcomed the following representatives of the North West Ambulance Service (NWAS) to the meeting:

      Paul Ferguson, Deputy Director of Service Development

      Carol Hall, Assistant Director Foundation Trust Delivery

      Sarah Smith, Assistant Director Corporate Communications.

The representatives briefed the Committee on various current issues that related to the Ambulance Trust:

Taking Healthcare to the Patient – this was a Department of Health initiative to transform ambulance services.  There were a number of strands:

      Call Connect – this was designed to improve the speed of responses and NWAS had invested in Emergency Control Centres, increased staffing levels especially call handling staff, improved technology and increased the levels of front-line operational resources.  There was now a performance target for Emergency Response times that was measured from the time that the 999 call was connected.  The target was that 95% of calls were answered within 5 seconds, NWAS reported that more patients were receiving a response within target;

      Hear and Treat – this had led to increased use of paramedic assessment for minor calls within Emergency Control Centres, an Advanced Paramedic Role had been developed, an alternative call categorisation and prioritisation system had been developed (NHS Pathways), a Regional Operational Control Centre had been established to oversee operations such as monitoring activity levels and service pressures and a new Operational Support Control Centre had been introduced in Carlisle;

      See and Treat – a Clinical leadership programme had begun and higher education programmes introduced for existing and future paramedics; 42 new Advanced Paramedics had been recruited, Care Pathways had been improved for Heart Attack and Stroke patients in line with clinical networks and a capacity management/health control system had been developed in partnership with Primary Care Trusts (PCTs) to assist in directing patients to appropriate care.

P Ferguson then briefed on performance in relation to Central and Eastern Cheshire PCT.  He explained that NWAS had shown consistent Category A8 and A19 performance despite a continuous increase in 999 call volume.  This had been due to the introduction of Call Connect.  The overall Category A performance for the PCT was 66.5% with the overall NWAS performance being 74.8%.  A Performance Improvement Plan had been developed in conjunction with the PCT and a number of challenges identified including growth in activity and hospital turnaround times.

S Smith briefed on the unannounced inspection by the Care Quality Commission (CQC) in July of the NWAS infection control procedures.  The CQC had issued NWAS with a warning notice on cleanliness followed by an inspection report outlining specific areas where the Trust had to make improvements.  A number of measures had been put in place including identifying Infection Control Champions (from among existing staff), the recruitment of a Specialist Paramedic of Infection Control and £100,000 investment into deep cleaning of vehicles.  A number of actions were planned including an audit of vehicles for cleanliness, a deep clean of all vehicles by end of September 2009, an increased and regular programme of deep cleaning of ambulances throughout the year, a review of decontamination procedures and training/learning for staff, replacement of all bag/valve masks on all vehicles and recruitment of two more Infection Control Specialist Healthcare professionals.

The NWAS representatives then briefed on their Plan to deal with the flu pandemic and explained that this had been further developed taking into account lessons learned from the first wave of flu; Business Continuity Plans were being refined in preparation for wave 2 and winter; and staff health and safety issues were being addressed.

The Committee was advised of further action following on from Cheshire County Council’s Scrutiny Review of Community First Responders – this included a PCT led Community First Responder Development Group had been established with membership from Nantwich Town Council and Audlem Parish Council, new CFR schemes had been introduced in Holmes Chapel, Audlem and Alsager with further schemes introduced for Winsford and Crewe (in association with St John Ambulance) and a Co-Responders scheme was to be piloted with Cheshire Fire and Rescue Service in Nantwich.

C Hall then briefed on the NWAS bid for Foundation Trust status.  She explained that Foundation Trusts were NHS organisations and based on NHS principles of free care based on need, not ability to pay.  A Foundation Trust enabled greater patient, public and staff involvement through the opportunity to become a Member.   Members of a Foundation Trust would be able to have a say, raise awareness of ambulance services, represent the views and needs of the local community, influence future proposals, stand for election for the Council of Governors and vote in elections for the Council of Governors.  

Foundation Trusts had organisational and financial freedoms and could make longer term plans that reflected the requirements of the local community.  A Consultation Process would be implemented and views sought on vision and values, direction of travel, governance arrangements and membership.  A period of awareness raising had been undertaken and full consultation plans included meetings at a wide range of geographically spread venues, staff engagement, attendance at existing meetings and forums and information on the website. 

During discussion of the presentation the following issues were raised:

      The system would allow for prioritisation to be done within categories;

      Who determined who an Appropriate Care Provider was?  In response the Committee was advised that the Capacity Management System would include details of care providers as advised to NWAS; the system was also capable of conducting real-time monitoring to ensure the most up to date information was available to paramedics;

      How did NWAS deal with stroke patients – Members were advised that paramedics were fully trained in dealing with stroke patients and would ensure that patients were transported to a specialist unit of which there was one at each of the Acute Trusts in Cheshire East;

      What was the protocol regarding single responders – in response the Committee was advised that in this case the responder was required to carry out their own risk assessment;

      The Committee was advised that NWAS did have a cleaning regime in place but was undertaking a deep clean of all vehicles which involved taking it out of use and removing all the component parts within to enable a chemical and heat/steam clean to take place;

      All patients who arrived at a hospital whether in an ambulance or by their own means would have to go through the Triage system and would be seen based on clinical need;

      Defibrilators were checked on a regular basis and the NWAS was shortly to develop a database of defibrillators.

RESOLVED:  that the presentation from the North West Ambulance Trust be noted and regular updates provided to the Committee.