Agenda item

East Midlands Ambulance Service: Outcomes of Care Quality Commission Inspection and Ambulance Response Programme

(To receive a report from Simon Evans (Health Scrutiny Officer), which invites the Committee to consider information from the East Midlands Ambulance Service, following the publication of the Inspection report by the Care Quality Commission; and to also consider information relating to the Ambulance Response Programme.  Richard Henderson (Chief Executive of the East Midlands Ambulance Service) and David Williams (General Manager of the East Midlands Ambulance Service will be in attendance for this item)


Consideration was given to a report from Simon Evans, Health Scrutiny Officer, which invited the Committee to consider information from the East Midlands Ambulance Service, following the publication of the inspection report by the Care Quality Commission; and to also consider information relating to the Ambulance Response Programme.


The Chairman welcomed to the meeting Richard Henderson, Acting Chief Executive, EMAS, David Williams, Interim General Manager for Lincolnshire Division of EMAS and Neil Scott, Service Manager, EMAS.


Appended to the report were the following Appendices:-


            Appendix A – EMAS Lincolnshire Division Update;

Appendix B – Information relating to Ambulance Response Programme Pilot; and

Appendix C – EMAS – Lincolnshire Overview and Scrutiny Committee Briefing Paper.


The Committee was advised that on 13 June 2017, the Care Quality Commission (CQC) had published its report on the East Midlands Service NHS Trust, following inspection visits conducted between 21 - 23 February 2017; and on 3 March 2017.  The overall finding for the Trust was "Requires Improvement" for both emergency and urgent care services".  Details of the CQCs key finding were shown on pages 58 to 60 of the report presented.


Appendix A provided the Committee with an update concerning EMAS and Lincolnshire Division with regard to improvements to ratings applicable to:-


·         Safe – It was highlighted that enhanced arrangements would be put in place to ensure that lessons learnt were captured and addressed. There would be better integration of complaints and investigations teams; and better effective leadership of resolution of hospital handover delays, delivering system-wide changes and improvement;

·         Effective – There would be a revised Capacity Management Plan focussing on patient safety and patient acuity; there would be continued improvement of Medicines Management; a roll-out of pre-hospital antibiotics for Sepsis patients; improvement to survival to discharge from cardiac arrest from 5.9 to 6.9%; and direct access to Primary Percutaneous Coronary Intervention laboratories for stroke patients;

·         Well-led – The Committee was advised that leadership would be strengthened and stabilised; Vision and strategic objectives would be realigned; investment in frontline staffing and equipment; reviewing of long term activity, price and strategic reviews with commissioners; and engagement with the broader health community including A & E Delivery and Escalation Boards and Sustainability Transformation Partnership;

·         Caring – Ensuring best practice in staff support and wellbeing; reducing sickness absence; improving appraisal rates; improving statutory and mandatory training rates; improving staff engagement; and being sector lead in metal health training; and

·         Responsive – Continue to recruit staff; improve skill mix of frontline staff; reduce staff turnover for 11% to 9%; ensure career progression opportunities are offered; review and strengthened emergency resilience, following the devastating and tragic attacks in Manchester and London; financial stability allowing for long-term investment; provision of 57 double crewed ambulances; provision of 164 new defibrillators on vehicles in 2016/17 and a further 127 for coming year; introduction of new electronic patient report from solution (ePRF); and to agree plans with commissioners for long-term strategic review to support greater care focus and sustainability & transformation plans alignment.


It was also highlighted that NHS England was implementing new performance standards for emergency ambulance services; and that that the new system would provide a stronger foundation for the future by prioritising the patients in most need to ensure that they received the fastest response and by driving efficient behaviours to give the patient greater opportunity to get a response in a clinically appropriate time.  It was highlighted further that EMAS had implemented the Ambulance Response Programme on 19 July 2017.  Appendix B provided the Committee with information as to how EMAS was implementing the Ambulance Response Programme; and details of the new Ambulance Response Time Standards were shown on page 63 of the report presented.


During discussion, the following issues were raised:-


·         Ambulance delays – The Committee was advised one example of a delay in Leicester, when 25 ambulances were seen outside a hospital; as a result, ambulances had offered to help other local areas.  It was also reported that handovers at Lincoln and Boston had significantly improved;

·         Improvements to Safety – The Committee was advised that the Trust was confident of getting a 'good' safety rating from the CQC; as a result the of improvements made;

·         Reassurance was given that going forward plans would be monitored on a regular basis;

·         Investment in technology – It was noted that investment had been made as a result of receiving capital receipts from selling estate etc.;  It was felt information relating to the impact of joint funding would be useful to receive;

·         How response times would be achieved in Lincolnshire – It was reported that the response times would be met for those patients with life-threatening conditions; and being able to dispatch the right clinical resources to meet the needs of patients based on presenting conditions;

·         A request was made for an update on response times and also further information as to who sits on the EMAS Trust Board. It was agreed that information would be circulated to the Committee on the Trust Board membership; and

·         Pre-hospital administration of antibiotics.  The Committee was advised that following a successful trial in Northern Lincolnshire, this was now going to be rolled out to paramedics across greater Lincolnshire.  The Committee was advised further that Lincolnshire was the first part of the Ambulance Service to undertake the pilot; which had proved to be a success.




1.    That the outcomes of the Care Quality Commission Report of the East Midlands Ambulance Service and their response to the report be received.


2.    That the information on the Ambulance Response Programme, in which East Midlands Ambulance Service had been participating since 19 July 2017 be received.


3.    That information submitted by the East Midlands Service be noted.

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