Agenda item

To receive a presentation by the Welsh Ambulance Services NHS Trust on ambulance performance in the Betsi Cadwaladr University Health Board area.

That the presentation be noted.

            The Chair welcomed Andrew Long, Area Manager North, and Richard Lee, Director of Operations, Welsh Ambulance Services NHS Trust, and invited them to give a presentation on ambulance performance in the Betsi Cadwaladr University Health Board area.

            Andrew Long advised that the purpose of the presentation was to explain the transformation which had been taking place in ambulance services in Wales, highlight some of the positive developments, and explain where further work needed to be done.  He said it was also an opportunity to share  the Welsh Ambulance Services experiences of implementing the Clinical Response Model to date, highlight what had been learnt along the way, and put the introduction of the Clinical /response Model in the context of wider organisational and system change.  The main points of the presentation were as follows:

• NHS Wales and Welsh Ambulance Services NHS Trust
• conditions for change – our operating environment
• designing ambulance into unscheduled care
• what did we do?
• moving from red to amber response
• what does the future look like for WAST and our staff and patients?
• frequent callers
• hear and treat
• clinical desk effectiveness  and clinical desk in Police
• performance, response and demand
• Hospital lost hours
• a new way forward

Councillor Marion Bateman commented on the issue of repeat calls to the ambulance services by individuals who did not require urgent or necessary medical treatment.  She referred to a scheme in England whereby individuals were given a ‘buddy’ number to contact in the first instance to assess the call and avoid the request for an ambulance to attend if not necessary.  Richard Lee referred to the Frequent Callers initiative to deal with repeat callers to the Ambulance Service and cited as an example a patient who had phoned emergency services 600 times in a year and who was in need of support but not medical treatment.  He commented on the alternative options to be considered before an ambulance was despatched if urgent medical treatment was not needed and cited referral to a GP, a visit from a community nurse, support from the third sector or provision of alternative transport, as examples.  He reported on the success in reducing the number of ambulance call-outs and advised that the control rooms prevented approximately 2,000 unnecessary ambulance call-outs a month.   He also referred to the ‘Come to See me’ initiative which involved sending the ‘right’ NHS service to treat a patient. 

Commenting on ambulance response times, Members were informed that less than 20 calls to the ambulance service were red emergencies.  The target for red calls was 7 minutes and 59 seconds which could include community first responders arriving within that time.  Officers took the opportunity to emphasise the importance of large buildings such as County Hall being equipped with a defibrillator which can save lives and costs less than £1,000.

Officers referred to the increase in the training of advanced paramedic practitioners to provide additional skills to the service and advised that funding was currently being secured to provide an advanced practitioner at Dobshill Ambulance base.  Councillor McGuill commented that whilst one practitioner was a step in the right direction there was still a need for more staff. The officer agreed that there was a need to develop the service and that an education programme was in place to enable paramedics to undertake additional learning and there was enthusiasm amongst paramedics to take-up the programme.

Councillor Ian Smith queried the cross border arrangements with England.   Andy Long explained that the Welsh Ambulance Services NHS Trust had good cross border arrangements with the Countess of Chester Hospital and said that the approach going forward was to take less people to hospital and to treat more people at home and assist people to leave hospital if they were well enough.

Councillor Kevin Hughes asked if there had been an increase in assaults on staff.  Officers responded that there were no increases in the number of assaults, however, as activities had increased some staff wear body cameras.  Officers explained that the Welsh Ambulance Services NHS Trust had a zero tolerance approach to violence and abusive behaviour towards staff and had well-being strategies and other initiatives and skills in place to protect and support staff.

Councillor Hilary McGuill asked if the link falls service provided by the North Wales Fire Service was still in operation.  Rob Smith responded that BCUHB had tasked the Community Asset Team in North Wales for this as they were responsible for the service.  The issue of funding was raised and discussion took place around the challenges to be met concerning nursing and care homes and the need to work collaboratively with the Health Board to seek an alternative to a request for the ambulance service to respond to falls. 

In response to a further question from Councillor McGuill concerning the role of the falls assistant and how it would be delivered in the future, Officers explained that the role of the falls assistant would continue and would be delivered in each geographical area in an appropriate way, for example  in rural areas a volunteer system may be more appropriate.  Councillor McGuill referred to an initiative where homes are provided with a lifting cushion which can be used in the event of a fall.

The Chair thanked Andrew Long and Richard Lee for their attendance and detailed answers to Members questions.

RESOLVED:

That the presentation be noted.