To consider the response to the recommendations made in the scrutiny review of the West Midlands Ambulance Service in Herefordshire.

The Committee considered the response to the recommendations made in the scrutiny review of the West Midlands Ambulance Service in Herefordshire.

The Committee had approved the scrutiny review of the Ambulance Service in February and invited responses.  The joint response received from Herefordshire Primary Care Trust (PCT) and West Midlands Ambulance Service Trust (WMAS) and the response from Herefordshire Hospitals Trust had been circulated with the agenda papers.  A revised response from Herefordshire Primary Care Trust and West Midlands Ambulance Service Trust had subsequently been issued.

In the ensuing discussion the following principal points were made: 

·         The Chairman of the Committee and the Chairman of the Review Group that had conducted the scrutiny review both expressed their disappointment at the formal written joint response from the PCT and WMAS.  They considered that the response did not appear to reflect the initial comments made by the PCT and WMAS in response to the review at the Committee’s meeting in February.  In particular the formal response contained no acknowledgement that the concern about resource issues that had prompted the review had any foundation, despite the fact that the Chief Executive of WMAS had since promised and provided additional resource in Ledbury. 

·         The WMAS Locality Director commented that WMAS was in general supportive of the recommendations in the scrutiny review and reiterated his thanks to the review group for the professional way in which they had conducted the review.  He emphasised that WMAS was acting on the recommendations and he would report on progress.   

He clarified that Ledbury had not formally been provided with 24 hours a day ambulance cover.  However, as far as possible the service had maintained 24 hour cover of Ledbury, staffing resources permitting.

He added that in addition to resource, two of the main challenges raised by the scrutiny review were monitoring of patient outcomes and financial support for the Community First Responder Scheme.

·         The Director of Integrated Commissioning stated that no assurance could be given that an additional vehicle would be deployed solely for use within Herefordshire. Vehicles needed to be deployed according to the operating model.  This provided cover and flexibility and was in the best interests of residents as a whole.

·         The Committee was informed that two further reviews of ambulance provision were underway.  WMAS was undertaking its own review of provision in the County.  In addition the Regional Specialised Commissioning Team, responsible for commissioning the ambulance service on behalf of the 17 PCTs in the West Midlands Strategic Health Authority area had commissioned an independent review looking at the operational and financial effectiveness of the ambulance service across the region.  It was agreed to provide the Committee with the terms of reference of the reviews and the timetable for their completion.

·         In response to questions about the funding and management of Community First Responders the Locality Manager reported that a Community First Responder (CFR) Manager had now been appointed for the County for the first time, previously one post having covered both Herefordshire and Worcestershire.  He personally supported increased financial support for the Scheme but if it were to be fully funded this would have implications across the Country.   A Member suggested consideration should be given to using Herefordshire as a pilot for a fully funded CFR scheme to demonstrate the benefits to a rural community.

·         A specific example was quoted where it had taken 45 minutes for an ambulance to reach a patient in the North West of the county and the patient had died.

·         The response from the Hospitals Trust to the scrutiny review was welcomed as clear, open and self-explanatory.  A specific question was asked about the detail of the protocol for ambulance handover set out at page 16 of the agenda papers which the Chief Executive undertook to revisit. 

·         The Locality Director reiterated that WMAS had little criticism to make of Hereford Hospital’s performance in turnaround times.  The difficulty was that because it was the only acute hospital, when a problem did arise it could escalate and become serious.

In conclusion Members indicated that they drew reassurance from the explanation given in reply to concerns expressed during the debate.   It was proposed it be recorded that their noting of the receipt of the written response of the PCT and WMAS took account of those explanations.

RESOLVED:

That    (a)        the written responses to the findings of the review of the West Midlands Ambulance Service in Herefordshire be noted, on the basis that the further explanation provided in response to the concerns expressed by Members at the meeting provided reassurance that the scrutiny review findings and recommendations were being given serious consideration; and

(b)       on conclusion of the two separate reviews of the ambulance service led by WMAS and the PCT respectively their findings should both be reported to the Committee, together with a report on progress in response to the recommendations in the scrutiny review, at which time consideration would then be given to the need for any further reports to be made.