Agenda item

(To receive a report from Richard Henderson (Acting Chief Executive – East Midlands Ambulance Service (EMAS)) which provides the Committee with an outline of the key areas of performance within the East Midlands Ambulance Service and, in particular, the Lincolnshire Division.  Andy Hill (Manager – Lincolnshire Division of East Midlands Ambulance Service) will be in attendance for this item)

Consideration was given to a report from Richard Henderson (Acting Chief Executive, East Midlands Ambulance Service (EMAS)) which provided the Committee with an outline of the key areas of performance within the East Midlands Ambulance Service and, in particular, the Lincolnshire Division.

Andy Hill (General Manager, Lincolnshire Division, EMAS) and Stephen Kennedy (Assistant General Manager, Lincolnshire Division, EMAS) were in attendance for this item.

Members were given an overview of the report and provided with the key points from the report.

During both Quarters 3 and 4, the Lincolnshire Division had not achieved the Red 1 performance target nor had they achieved Red 2 performance targets.

It was reported that Red 2 performance in Quarter 4 had dropped by 7% in comparison with Quarter 3 which coincided with changes to response criteria and removal of EMAS ability to downgrade red calls.  As a result both EMAS overall and the Lincolnshire Division witnessed an increase in Red 2 calls (29%) which required a response.

There were a number of mitigating circumstances for the poor performance which included an increase in activity, the ability to manage in terms of triage, loss of resources in terms of drift and delays and resources held in queues.  It was stressed to the Committee that these were reasons which contributed to the disappointing performance.

Under the present contract EMAS were not commissioned to achieve national standards within Lincolnshire alone although commissioners in Lincolnshire did expect to see a continuous improvement towards these standards. EMAS remained active with Healthwatch and an EMAS Healthwatch Task Group had been formed to consider and action initiatives in response to local needs.

Engagement with the System Resilience Groups (SRGs) and Urgent Care Working Groups was well established with representation and participation regular and inclusive.

Unique initiatives with partner organisations, including the CCGs, Integration Executive and the Local Resilience Forum (LRF) were ongoing in support of the necessary improvements.

Proactive work on hospital delays with staff at United Lincolnshire Hospitals NHS Trust (ULHT) had shown improvement although it was acknowledged that more work was required.

External expert and consultant support, advice, critique and audit had been sourced and the results of this work, including the findings, would be shared with commissioners to ensure the plan for EMAS was robust and sufficiently focused on delivery of the required outcomes.  To-date commissioner feedback was reported to be very positive and supportive.

The following initiatives had also been developed to improve performance:-

·       Mental Health Car Initiative;

·       Mobile Incident Unit, Butlins, Skegness;

·       Clinical Assessment Car Initiative;

·       South Lincolnshire Investments/Initiatives;

·       Joint Ambulance Conveyance Project (JACP) – Stamford, Woodhall Spa and Long Sutton;

·       Addressing patient handover delays at the acute trusts;

·       Emergency Care Practitioner utilisation; and

·       Blue Light Collaboration (Estates).

Members were given the opportunity to ask questions, during which the following points were noted:-

·       The term 'drift' was explained to the Committee.  This was the terminology used by EMAS when a vehicle responded to a call outside of Lincolnshire, or had conveyed a patient to a hospital in another county, and remained there for the duration of their shift;

·       The Committee agreed that this was a serious concern for Lincolnshire and asked how many vehicles from neighbouring counties come into Lincolnshire and remain for the duration of the shift.  It was reported that Lincolnshire was the biggest exporter of vehicles and that the resources coming back in were not equitable and left a distinct shortfall;

·       It was further clarified that the drift from EMAS was due to activity and despite ownership being taken locally by ringfencing some resources, there were frustrations in securing adequate vehicles back in to the county;

·       The Lincolnshire division were working on a local Lincolnshire driven model with LIVES, Lincolnshire Community Health Services (LCHS) and Lincolnshire Partnership NHS Foundation Trust (LPFT).  The work was considering how to put the capacity back into the system in order to reduce conveyance;

·       A suggestion was made that 30 vehicles was not sufficient for a county the size of Lincolnshire. (There were up to 38 vehicles operating in the Lincolnshire Division.  It was reported however that the resources were sufficient but the way in which they were managed was the main issue.  It was reported that the Lincolnshire division of EMAS performed better than any other division in the region despite the effect of losing resources to other divisions and, should those resources be able to deliver and operate within Lincolnshire, 30 vehicles would be sufficient;

·       Delays and issues in other divisions also had an impact on the regional provision of resources overall and wider discussions were ongoing on how to manage the regional service provision overall;

·       As Lincolnshire division was doing better than the other divisions in the region, despite not hitting the performance targets, the view overall was that Lincolnshire could therefore provide additional support to the other divisions;

·       The Committee asked that the performance information be in the same format each time it was presented so that a comparison could be made.

RESOLVED

1.    That the report and comments be noted; and

2.    That an update from the East Midlands Ambulance Service NHS Trust be added to the Work Programme for the meeting of the Health Scrutiny Committee for Lincolnshire on 20 July 2016.