Agenda item

The Director of Commissioning, South East Coast Ambulance Trust (SECAMb) will be present to update the Committee on NHS 111, conditions on the SECAMb licence and the defibrillator policy.

Discussion:

The Chairman stated that since the despatch of the agenda for the meeting the Members of the Committee had been made aware of the publication of the report by Deloitte into the Red 3/Green 5 Pilot review but had not had sufficient time to thoroughly read the report.  He confirmed that the Committee knew the Chairman of the South East Coast AmbulanceTrust had resigned and that the Trust’s Chief Executive was taking mutually agreed leave of absence.

The Acting Chief Executive and Director of Commissioning from SECAMb explained that because of the publication of the Deloitte report he intended to just give a brief update and synopsis of the report. 

He stated that the Trust accepted that the pilot had been conducted outside of the normal governance process and that it had caused a non-compliance of the Trust’s contractual standards.  A new Chairman of the Trust had been appointed, Sir Peter Dixon who came from Imperial College in London so had wide experience.  He confirmed to the Committee that the pilot had stopped last winter and that a review of patient harm had concluded that there had been no harm to patients as a result of the pilot.  A further report would be published in June and he offered to come back to the Committee at that point to go through the findings in more detail.  Monitor had requested a governance review and this was being conducted to ensure that the appropriate governance measures are put in place.

The possibility of a return Member visit to NHS 111 Control Centre in Ashford was suggested and Members agreed this would be helpful, particularly for new Members of the Committee.

While concern was expressed about the pilot the Committee spoke favourably about SECAMb and its previously very good reputation.  The Trust was commended for its innovative approaches over the years and for the work it had been undertaking in relation to frequent attenders at accident and emergency with people with mental health problems.

There was a general view expressed that the NHS 111 service had not been working well and some examples of this were expressed during discussion.  The Acting Chief Executive and Director of Commissioning, SECAMb, explained that there were ongoing reviews of the way that the NHS 111 service was working to see how it could be improved.  He stated that, unlike many areas of the country, the South East Coast had not experienced quite the same staffing problems but there were ongoing issues with ensuring sufficient staff over weekends.

In responding to Members’ questions it was stated that the staff at the NHS 111 call centres needed to keep to the script as they were not clinicians, however they did have an option of escalating a call to a clinician where appropriate.  Some Members felt that the lack of opportunity to deviate from a script was unhelpful.  The suggestion was made that the commissioners of the NHS 111 service should act proactively and invest further in training and development of the service to ensure that it was fit for purpose rather than reacting to a report into a service failure.

The Healthwatch Medway representative expressed grave concerns about the contractual standard (imposed by the CCG) of having a target of no more than 10% of NHS 111 calls being transferred to 999 received.  It was stated that should this number be exceeded there would need to be dialogue with the commissioners as to how and why this has happened.  An offer was made, and accepted, for the Healthwatch Medway representative to discuss the contractual standards outside of the meeting.

Discussion took place about the morale of staff and the Acting Chief Executive and Director of Commissioning, SECAMb, stated that the morale was now low and that this had not been helped by the recent negative, and often inaccurate, press coverage.  He emphasised the importance of putting forward more positive comments.

Reference was made to a pilot in East Kent against which NHS 111 would be benchmarking itself to see whether further improvements could be made to the service.  It was agreed that this would be shared with the Committee later in the year.

Decision:

The Committee:

(a)  Agreed that a Member visit to NHS 111 in Ashford is arranged;

(b)  Requested a further report on the benchmarking with the East Kent pilot on NHS 111 and 999 be brought to the Committee later in Autumn 2016;

(c)  Requested an update on staffing at NHS 111, including training undertaken.