To receive a presentation on the work of the West Midlands Ambulance Service NHS Trust together with an overview of the Trusts current plans.

The Committee received a presentation from Mr P Murtagh, Commissioning Director West Midlands Ambulance Service.  The presentation is attached as Appendix 1.  During the presentation, he highlighted the following areas:

·         That there was a transformational strategy in place to move from functioning as a traditional ambulance service to becoming an integrated healthcare provider. 

·         That the Service was the only Ambulance Service to have achieved all its operational performance indicators in 2010-11.  This was challenging in rural areas of Herefordshire.

·         That the Quality and Risk Profile was improving  on a monthly basis.

·         That the move to Foundation status was entering its final phase, and the Trust should become a Foundation Trust by the end of the July 2012.  The change would mean greater involvement from the public, and accountability for the Trust.   There were 8,500 public members, from which a 15 Members of the 29 Council of Governors were elected. 

·         The Make Ready system was in place, with large hubs which serviced local ambulance crews.  Herefordshire was one of the first counties to open a hub, a system that maximised the time paramedics could be on the road by providing them with operational ready ambulances.

In the ensuing discussion, the following points were raised:

·         That there was concern over the timing of the consultation that had been issued regarding the operational change to the service and the subsequent closure of ambulance stations.    The consultation had been issued over the Council’s purdah period during the elections in 2011, and no response had been possible.

·         That the work that was being undertaken by the Service was designed to free up resources by improving clinical performance and efficiency.  The Make Ready Hubs would allow clinical staff more time with patients.  He said that the greater clarity would be provided by including local ambulance stations on the map in the presentation.  The Hubs would only have ambulances in them at night, because operational crews would be spread across the County during the day.

·         That whilst there had been a drop in performance against targets in July and August 2011, this was as a result of a number of staff undergoing advanced paramedic training. At the lowest point, the Service had still attained 84.62% of its targets.  Following the training, the Bromyard community paramedic scheme had hit 100% of its target (to reach all cases within 8 minutes) in September.  This scheme had proved to be invaluable, and would be rolled out across the County from April.  The Chairman commented that whilst this was a welcomed scheme, he did not want to see the County’s resources stretched with an emphasis on achieving targets in urban areas.

·         Herefordshire would not be marginalised, and the service would still be a local one throughout the County.  It was important that a rural presence should be maintained, and there were staff within the call centres who were dedicated to specific local areas within the area covered by the centre.  In reply to a specific question from a Member, he said that there was both a local and regional Gold Command structure.

·         Mr N Henry (General Manager, West Mercia Ambulance Service) undertook to provide the Committee with data on the number of Community First Responders that there were in the County.   Whilst it was relatively simple to become a First Responder, it was much harder to gain experience in the role, as there were few callouts in rural areas.

·         It was noted that 94% of ambulances in Herefordshire carried paramedics. 

·         That whilst the Make Ready system was based on a South Staffordshire model which had not achieved its targets for a year, performance in South Staffordshire would have been significantly lower without the system in place.

·         That the NHS Pathway model had gone live in June last year, and there had been a steady rise in calls that were able to channel patients through alternative care pathways than the acute hospital. The Vice Chairman asked that statistical evidence that demonstrated the improvements should be provided to the Committee. 

·         That the correct drugs were available on ambulances to treat conditions such as cardiac thrombosis.

·         A Member pointed out that whilst 1 in 4 ambulances were not attaining the target of reaching the patient in eight minutes, there was apparently no measure to indicate how long these calls were taking.  He asked whether there was an analysis of those calls where the target was not hit, and where in the County this was most likely to occur.  Mr Murtagh said that the Community Response Manager was looking at this area. 

·         That whilst there was no representation from Herefordshire on the proposed Members Council for the Foundation Trust, the Trust had worked with the Local Government Association in order to

The Chairman thanked Mr Murtagh for his presentation.

Recommendation:  that representations should be made at the highest level that there should be a Governor on the West Mercia Ambulance Service Foundation Trust Members Council from Herefordshire Public Services.