To consider an update following reviews of the Trust.

The Committee considered an update following reviews of the Trust and also considered the information in the Trust update which had been published as a separate agenda item.

Mr Noel Orbell, Community Response Manager (CRM) for the Hereford and Worcester Divisions gave a presentation on the work of the Community Response Department.  This covered the Department’s aims, the number of Community First Responders (CFRs) (61 in the 2 Counties organised into 16 schemes who had responded to 596 emergencies in the last 6 months), their level of training, their distribution within the two Counties, and public access defibrillation sites within the two Counties; partnership working and achievements to support community engagement and planned developments.

In discussion the following principal points were made:

·         The CRM said there were three levels of response for CFRs each requiring a different level of training:  basic, intermediate and enhanced.  The basic training involved 2 days training.  The intermediate training involved 8 days over 4 weekends.   Currently all the CFRs in the County were at an intermediate level.  It was intended to seek to introduce training to the enhanced level, which cost £5,000 per person, but a business case was required and there was no agreed timetable.

The training for a paramedic involved a two year university course supported by in-house training.

Training to use a defibrillator involved 4 hours training that needed to be refreshed every 12 months. 

·         Clarification was sought of the reasons why only 50% of nursing homes had taken up the offer of a free defibrillator.   It was suggested that staff turnover might be one issue, noting the requirement for a 12 month refresher course.  It was asked whether the Trust could give consideration to incorporating the training into other health and safety training that employers would be required to give.   It was noted that some large organisations had taken a decision that they would not accommodate defibrillators in their premises.

·         That it would be helpful if evidence could be provided demonstrating to nursing homes the numbers of lives saved by having a defibrillator on site.  It was requested that a briefing note be prepared on the cost/benefit of providing defibrillators.

·         The effectiveness of defibrillators was also considered noting that there were circumstances in which defibrillation would not work.

·         It was asked whether the number of CFRs and their level of training provided a sufficient level of resilience in support of the trained ambulance crews. 

The General Manager commented that additional resource was always welcome and the Service was targeting areas where it wished to see further CFR recruits.  It was noted that the budget for CFRs was currently held regionally.

The Director of Public Health commented that whilst recognising the commitment of CFRs it was important to understand the level of service CFRs could provide and what outcomes they were expected to deliver.  Additional resources allocated to CFRs could mean a reduction in another area of activity.

·         The measurement of patient outcomes was discussed noting the somewhat arbitrary nature of targets that simply measured the time taken to attend an incident. The General Manager commented that the national targets for attending incidents were being reviewed by the Government.  Although there was some analysis of clinical outcomes the necessary data was not at the moment held electronically.  It was planned to develop an electronically based system within the Region in 2011.

·         The issue of bed shortages at the hospital was discussed.  Mr Woodford, Chief Executive of the Hospitals Trust, commented that a number of initiatives had either been implemented or were close to implementation that would lead to improvements and reduce pressures on beds.

·         The General Manager commented that work was continuing to reduce ambulance turnround times.  There was a good working relationship between the hospital and WMS.

·         Asked whether there were any plans to close Ledbury ambulance station, noting that it was proposed that several hundred new homes were to be built in the Town, the General Manager replied that there were currently no plans to close any ambulance station.  He added that if an ambulance station were to be closed this did not in itself mean a reduction in cover.  In modelling future service needs housing growth would be one factor that would be taken into account.

The Director of Public Health commented that the Committee’s focus on the ambulance service had contributed to improvements, although there would always be a desire for additional resource.  It was suggested that the Chairman and Vice-Chairman should consider what further scrutiny of the service would be beneficial.

RESOLVED:

That    (a) a briefing note be provided on the cost/benefit of providing defibrillators; and

            (b)  the Chairman and Vice-Chairman of the Committee be authorised to consider what further reporting on the ambulance service should be included in the Committee’s work programme.