Agenda item

(To consider a report from Richard Henderson (Chief Executive of the East Midlands Ambulance Service NHS Trust (EMAS), on the developments and performance of EMAS in Lincolnshire.  The item will focus on how the national Ambulance Response Programme (ARP), introduced in July 2017, is progressing.  The ARP is introducing a new performance management regime to ambulance services in England)

The Committee gave consideration to a report from the East Midlands Ambulance Service NHS Trust, which provided information from the East Midlands Ambulance Service on:-

·         Response time information by Clinical Commissioning Group area, in accordance with the new Ambulance Response Programme standards;

·         Handover delays at hospitals;

·         The role of Lincolnshire Integrated Voluntary Emergency Services (LIVES);

·         The Ambulance Response programme and its impact on staff rotas and the types of vehicles; and

·         The new Urgent Care Tier (from 1 April 2018).

The Chairman welcomed to the meeting Richard Henderson, Chief Executive, East Midlands Ambulance Service NHS Trust, Ben Holdaway, Director of Operations, East Midlands Ambulance Service NHS Trust, and Mike Naylor, Director of Finance, East Midlands Ambulance Service NHS Trust. 

Appendix A to the report provided the Committee with NHS England Ambulance Response Programme Standards.

The Chief Executive, East Midlands Ambulance Service Trust introduced the report and responded to questions raised, which included the following issues:-

·         Ambulance drift from areas such as Skegness to out of county, how this still impacted on ambulance cover.  The Committee was advised that all efforts were made to hand over patients in a timely manner; at A & E departments, but at times crews were delayed; and that if an ambulance crew was drawn away from its area, another crew would be moved closer to the area to respond to any emergencies;

·         One member felt that there needed to be dedicated ambulance provision along the coastal strip during the summer.  It was reported that the summer months did put pressure on the service; and that to accommodate demand the service worked differently with its partners.  The Committee was advised that there was a specific summer plan and that additional resources for that period had already been booked.  One member felt that it would be useful for the Committee to have sight of the summer plan;

·         Confirmation was given that EMAS worked alongside LIVES and the Fire and Rescue Service;

·         Handover Delays – It was reported that Lincolnshire had some of the highest handover delays in the EMAS region.  A table on page five of the report provided the Committee with a breakdown of handover times, Both Lincoln County and Boston Pilgrim's figures were highlighted as having the highest number of handover delays.  The Committee was advised that the correct figures for Lincoln County should read 300 for 1hr+ losses; and 985 for Total Hrs Lost.  The Committee was advised further that EMAS was working with United Lincolnshire Hospitals NHS Trust (ULHT) to improve the position.  It was highlighted that the handover delays were putting significant pressure on EMAS to respond to patients in the community, which then in turn had an impact on response times.  It was reported that the handover delays were as a result of the non-availability of consultants and nurses.  It was also highlighted that the handover delays were not just a problem for Lincolnshire, it was a national issue as well;

·         Confirmation was given that the Emergency Ambulance Cost Adjustment was still applied to ambulance finances;

·         Urgent Care Tier – The Committee was advised that on 2 April 2018 EMAS was introducing an Urgent Care Tier.  This tier of transport would be predominantly allocated to jobs that had been requested by a Health Care professional who had requested transport, for one of their patients to go to hospital.  The main purpose of the tier was to reduce some of the long delays for patients that fell into this category often experienced;

·         Consideration of the New Ambulance Response Time Standards as detailed at Appendix A;

·         Ambulance Response Programme – It was reported that on 13 July 2017, NHS England had announced that all English Ambulance Trusts would move to a new way of working, using a revised clinical code.  It was noted that EMAS had migrated to the ARP pilot on the 19 July 2017;

·         Double-Crewed Ambulances – A question was asked as to how much the new model was costing.  The Committee was advised that the new model would rely upon more Double Crewed Ambulances and less on Fast Response Vehicles.  A table on page 7 provided details relating to the current and proposed figures relating to Double Crewed Ambulances and Fast Response Vehicles.  The Committee was advised that the new rotas did not include any additional staff, as EMAS was re-profiling its staff in a different way to best meet the Ambulance Response Programme.  It was highlighted that the on cost for a double crewed ambulance was approximately £70.00 an hour;

·         EMAS recording system – The Committee was advised that EMAS had a new data recording system, which was working very well; and

·         EMAS confirmed that they were involved with eight STP Plans; and that they would be making sure that they were aware of any local changes.

The Committee welcomed the report and agreed to accept quarterly progress updates from EMAS going forward.

RESOLVED

1.    That the East Midlands Ambulance Service NHS Trust – Update Report be received.

2.    That a progress report from EMAS be received by the Health Scrutiny Committee for Lincolnshire on a quarterly basis.