To review the performance of West Midlands Ambulance Service NHS Foundation Trust (WMAS).

To enable the committee to fulfil its function to review and scrutinise the planning, provision and operation of health services (not reserved to the children and young people scrutiny committee) affecting Herefordshire, and to make  reports and recommendations on these matters.

Officers from West Midlands Ambulance Service gave a presentation to provide an overview of the key issues for the service including:

·         Activity in Herefordshire for the year to date: this had risen by around 3%, broadly consistent with overall activity for the region.

·         Non-conveyance: although the approach was to try and keep people at home, non-conveyance of patients was below the regional average. This was due to a tendency to address risk and ensure that patients’ ongoing health needs were met and appropriate pathway were followed.  

·         Ambulance usage per head of population: across the 22 commissioning groups for the region, Herefordshire did not have the highest level of use in comparison.

·         Response Programme trial: the service had taken part in this national trial designed to ensure that response standards were being met and this had informed national standards that were now in place. In Herefordshire a key challenge was to meet the 7-minute response time, and this was now measured as an average figure in recognition of the rurality of the county.

·         Response categories: changes had been made by NHS England, including differing response times for each category.

·         Performance for Herefordshire:  this was improving; category 1 responses remained a challenge, although the response programme trial had led to improved performance for every category.

·         Nature of calls: referred to as ‘chief complaints’, in Herefordshire, these were predominantly under the ‘medical / generally ill’ classification.

·         Service achievements:  the trust was the highest performing ambulance service. Estates rationalisation to develop operational hubs had led to better facilities to support response times and efficient working, and the service was working with commissioners to address demand management to ensure that calls were not being ‘stacked’.

Members responded with a number of questions and comments.

Commending the service for the achievement of a paramedic on every shift, a member asked about how this had been possible. It was explained that a graduate training scheme had brought paramedics through and their deployment supported each vehicle to be autonomous to make clinical decisions, supported by a clinical network for wider decision making.

Regarding a question on the impact of the national standard for responses to category 1 calls on staff morale, officers described that expectations were communicated to staff who were encouraged to make suggestions and provide feedback.

A member asked how the impact of moving the call centre from Worcester to the base in Dudley had been addressed as regards local knowledge and directing vehicles to calls. Officers explained that there was a despatch team working with the area to become familiar with it. There were good communications with the call centres and a dedicated Herefordshire desk to provide local focus which had improved integrated urgent care. The clinical hub was working to provide better care to make the most of care pathways.

The commissioner from Sandwell and West Birmingham Clinical Commissioning Group added that in order to support patients to access the most appropriate care there were links with the local hub and the GP out  ...  view the full minutes text for item 23