To hold a public accountability session to discuss the performance of the West Midlands Ambulance Service.

The Committee received a presentation on the West Midlands Ambulance Service from Ms M Brotherton General Manager (West Mercia) West Midlands Ambulance NHS Foundation Trust.

During her presentation, Ms Brotherton highlighted the following areas:

·         The transformational change agenda that the Service had been undertaking over the previous year that had embedded the implementation of the Make Ready ambulance service.  This allowed for faster treatments of patients and maximised the efficient use of the ambulance fleet.

·         The success of the Community Ambulance stations, which allowed ambulances from the main hub in Hereford to be based in the Market Towns. 

In the ensuing discussion, the following points were raised:

That the service had achieved 66.7% against a 75% target for Red 1 calls.   These were the most time critical and cover cardiac arrest patients who were not breathing and did not have a pulse, and the target was to get an ambulance on to the scene within eight minutes.  This was a challenging target in a rural county but these were relatively uncommon calls in Herefordshire, and the Service only received approximately one a month.  Work had been undertaken with local councils to promote the community defibrillation scheme and the Community First Responder schemes For Red 2, which were serious but less immediately time critical calls, the Service had achieved 75.7% response against a national target of 75%.  Red 19 calls, which required an ambulance to respond within nineteen minutes,  had a target of 95%, and the Service had missed this by .3%.  An ambulance had now been stationed in Leominster in order to be able to achieve this target.  It was important to note that demand for services was rising by around 5% a year.

In reply to a questions she said that:

·         Green 2 targets were 30 minutes, and 90%, both of which had been reached. This category was for falls and similar injuries.

·         The triage of calls was on the whole effective, but when the paramedic arrived on the scene the situation could vary from what had been expected.

·         That demand did fluctuate in rural areas, and Leominster had proved to be challenging in April, whilst Hay-on-Wye had in May.

·         There was a concern around the transfer of patients from the acute hospital to others in the area, as this reduced the resources available for calls.

·         That the conveyance rate of patients to hospital was 58%, which meant that 42% were treated at home or on alternative clinical pathways.

·         There was mandatory training for all staff of two days a year, and virtual learning was used.  Clinical team mentors were employed to work directly with crews.  The crew were trained to look at care pathways that did not involve the hospital.

·         The Service undertook a great deal of campaigning to keep calls to a minimum, and were active in print and social media.

·         That whilst the Fire Authority had a budget to invest in visiting the community, the Ambulance Service was run on a much leaner model, and were not able to undertake as much outreach work.  The Community Responder Manager would go into schools and parish council meetings if asked.

·         That if transfers to other hospitals in the region were proving to be an issue in a locality, then ambulances from elsewhere would be used to backfill the gap.  When deploying an ambulance, the nearest available vehicles went to the call.

·         That should the work of the hospitals be reconfigured in a way that would increase the job cycle times by making more vehicles go out of County, then the Service would need to be commissioned to increase the number of available ambulances.  The Service was working with the Wye Valley NHS Trust as the Trust undertook its service modelling.

·         That all ASDA stores would be rolling out defibrillators nationally and that there was now one in the store in Hereford.

The Chairman thanked Ms Brotherton and Mr Holloway for the presentation.