A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

Council and councillors

Agenda item

EAST MIDLANDS AMBULANCE SERVICE

To receive a presentation from Lee Brentnall, Ambulance Operations Manager for Communications, Engagement and Safeguarding.

Minutes:

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Before the presentation on the East Midlands Ambulance Service, Reverend Christopher Armstrong read out his deputation (appended to the minutes) to the Committee. 

 

In response to a question from Councillor Waller, Reverend Armstrong confirmed that the people who had suffered falls and experienced long wait times were very elderly, with some in their nineties.

 

The Chairman gave Mr Brentnall an opportunity to respond to the deputation at this point in time and Mr Brentnall asked Reverend Armstrong to accept his apologies that he had not received a reply to his original letter to the Chief Executive. The rest of the points that had been made in the deputation would be addressed in the presentation. 

 

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Following the deputation a presentation on the East Midlands Ambulance Service (appended to the minutes) was delivered by Lee Brentnall, Ambulance Operations Manager for Communications, Engagement and Safeguarding.

 

During discussions the following points were noted:

 

·         Category 4 calls were less urgent and were often referred on to other providers such as GPs and Pharmacists. These calls related to those who had illnesses such as diarrhea or vomiting, or who had urine infections. 

·         In the future there would be greater collaboration with the Community Health team as, if they could now guarantee a service within two hours for certain conditions, it would avoid the need to take patients to hospital.

·         130 additional staff had been recruited across a two year period which enabled more ambulances than ever before to be out on the roads. Despite this, targets could still not be met because of handover performance and the amount of time lost waiting outside a hospital.

·         Although delays in handover was a national problem, it was exacerbated in Rutland because it was surrounded by some of the worst performing hospitals in the country. This was an NHS problem that needed to be tackled by working together more closely.

·         Of the 999 calls received, only 50% were taken to hospital. The rest were given urgent appointments or sometimes, after arrival on the scene and assessment, did not end up going to hospital at all. The workforce were skillful in their assessments and were able to leave more people, safely, in their own homes.

·         Ambulance staff arrived at hospital right up to the end of their shifts. If they then had to wait 4 hours to drop off their patient their working day was greatly extended. This had a knock on effect because the working time directive meant staff had to have an 11 hour break which resulted in the service being understaffed the next day. Winter 2019/20 had been the worst ever for delays.

·         A ‘pod’ facility which held up to 10 patients had been put in place as a temporary winter pressures measure which meant that ambulances could offload and get back on the road. However there was very strict guidance on when this measure could be deployed.

·         Rutland army and community responders attended 4000 emergency calls across Leicester, Leicestershire and Rutland (LLR) but none of these influenced the performance targets.

·         If a patient faced a wait of an hour or more for an ambulance, nurses would call them every 20 minutes to give advice and reassurance, and if symptoms had changed, would escalate the call.

·         GP Connect allowed paramedics to access GP records so that they could see the patient’s last 5 interactions and therefore make more informed judgements.

·         EMAS was organising a community engagement event with Healthwatch in Rutland.

·         Broken limbs could fall into either a category 2 or 3 call. The call taker would go through a set of questions and the computer would then generate a code which related to one of these categories. This accredited system was regularly reviewed to check that the codes consistently correctly matched the categories.  Dispatchers were able to escalate the calls if there were other external factors to consider but if there were already a high volume of category 1 and 2 calls then it became very difficult to do so.

·         CQC had given the service an overall good rating because of the improvement journey they had taken over the past 2 years. The service had been rated outstanding for the care it delivered.

·         The details for the EMAS Patient and Advice Liaison Service would be shared with the Committee and Reverend Armstrong.

·         EMAS had recently gone out to commission ‘heat maps’ of the areas they covered. These maps would highlight any areas where there were a particular concentration of calls and where the wait times were longest.

·         Rapid response teams tended to be kept in their own geographical area but the crews manning them could come from further afield if private providers had been used.

·         Although Councillors had been told some time ago that the reconfiguration of the Leicester hospitals would alleviate the problem of drop off times this had not been the case.

·         Councillor Waller felt that age should be an important factor when determining the call category as it was not acceptable to have residents who were in their eighties and nineties waiting for four hours.

 

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