To consider performance in meeting targets for response times.

The Committee considered the Service’s performance in meeting targets for response times.

Mr Derek Laird, Locality Director, presented the report.  He said that performance in responding to Category A calls in September so far, at 81.3%, was the best Herefordshire had ever had.  In response to the new standardised performance reporting system introduced with effect from April 2008 Herefordshire Primary Care Trust had provided additional funding that had allowed additional resources to be deployed in Herefordshire.  He described a number of service enhancements.  He added that Members were welcome to make appointments to visit local ambulance stations or visit the control centre at Bransford.

In the course of discussion the following principal points were made:

·         It was noted that when a call was received allowing for, on average, 90 seconds to process the call this left only 6 and a half minutes to meet the response target.  Mr Laird acknowledged that this was challenging.

·         Asked about the deployment of Community First Responders (CFR), Mr Laird stated that CFRs were never deployed without having sent a vehicle.  The CFR scheme was successful but was not a replacement for the service.

·         A question was asked about an incident in Ledbury where someone had needed assistance 150 yards from the ambulance station but no one had been available.  It was asserted that the first detail for the Ledbury ambulance each morning was to be deployed to Malvern, It was asked how much time the resource based at Ledbury was out of the County.

Mr Laird replied that 1 car and 1 ambulance were based at Ledbury and available between 9.00 am and 9.00 pm .  Of 22 Category A calls in Ledbury in August the response target had been missed on 6 occasions, all of them out of hours.  Twenty-four hour cover in all the Market Towns would be ideal but there was a clear resource implication for the Commissioners. 

Five emergency vehicles were deployed out of hours.   These were based at Hereford and Leominster.  Ledbury received 8% of calls and it was therefore hard to justify deploying this resource there.

·         It was noted that the Committee had previously formally requested that CFR Schemes be funded.  Mr Laird said that he agreed with this view.  He was urged to pursue the matter.

·         Asked about deployment of the air ambulance Mr Laird advised that Herefordshire was the largest user of the air ambulance.  The main costs were tied up in the lease and staff, so cost was no disincentive to its use.  The ambulance was deployed whenever it was thought it might be needed. 

·         Mr Laird noted that there would always be times when response times would be missed, for example Friday and Saturday nights when there were a number of drink related incidents that had to be dealt with.

·         It was asked what the process was for addressing underperformance citing response times for category A calls in the HR8 Ledbury postcode in May–July 2008 of 50%, 57% and 57% respectively.  Mr Laird replied that the formal position was that the Trust was only obliged to hit the target for the Region as a whole.  However, his aim was to hit the response target across the Counties within the locality for which he was responsible (Herefordshire, Shropshire and Worcestershire.)  A review of the data was held every six months to see if moving resources or changing the hours of provision would improve performance or clinical care.  It remained the case, however, that there were financial constraints.

·         It was remarked that there was a need to view the system as a whole taking account, for example, of turnround times at the hospital.

·         It was proposed that there should be a formal review of the ambulance service with particular reference to the Market Towns of Ledbury and Ross-on-Wye. This would need to look beyond the response times themselves to the outcomes achieved and experiences on the ground of residents.

RESOLVED:

That    (a)        a formal review be undertaken of the  Service provided by the West Midlands Ambulance Service (WMAS) NHS Trust in Herefordshire with particular reference to the Market Towns of Ledbury (postcode HR8) and Ross- on-Wye (postcode (HR9), with the added intention of ensuring that there is no drift of resource from Herefordshire to other parts of the West Midlands Region following the creation of the regional WMAS NHS Trust;

            (b)       the efforts made to improve response times within Herefordshire be noted; and

            (c)        that the projected improvement in response times for September bringing them into line with Shropshire and Worcestershire be welcomed.