Agenda item

This report updates the committee on the South East Coast Ambulance Service Foundation Trust, with a focus on key developments since the Committee was last updated in March 2020. These key areas include: Performance and Performance Recovery, Go live of NHS 111 Clinical Assessment Service contract, Staff Wellbeing, Estate developments in Medway and Sheppey, and the Joint Response Unit.

Discussion:

Members considered a report regarding the South East Coast Ambulance Service Foundation Trust (SECAmb), with a focus on key developments since the Committee was last updated in March 2020. These key areas included: performance and performance recovery, Go live of NHS 111 Clinical Assessment Service (CAS) contract, staff Wellbeing, estate developments in Medway and Sheppey, and the Joint Response Unit.

The following issues were discussed:

·       Enhanced 111 Clinical Assessment Service – noting the wide area this service would cover, what measures had been put in place to ensure this new integrated service worked effectively was queried. An assurance was sought that the Trust was confident that data sharing and access to patient data was robust enough to allow this more integrated way of working, particularly in relation to people with mental health issues, which had worsened due to Covid, and also in respect of frequent attenders  SECAmb representatives noted this was a new contract which significantly enhanced a service that was already developing. The key to making this work successfully was to share data with partners in a secure way to ensure the best possible decisions and signposting to the most appropriate service. Anyone using the service would be able to seek clinical support from a wider team than before at the point of the initial phone call.

A comment was made that callers to 111 were being referred to their GP when they had called in the first place due to difficulties in contacting their GP. Whether there were sufficient clinical staff available to respond to calls was questioned. A Trust representative advised that the abandonment rate (i.e. calls not able to be answered) was 4%, which was in line with the target. The concern about call backs not taking place would be looked at but the Trust was not aware of any significant problems.

·       Preparations for end of EU transition period – the preparedness of the Trust to cope with any disruptions to the road network after 1 January 2021 was questioned. SECAmb representatives assured Members this was on the Trust’s radar and they were working with partners to be as prepared as possible. The Trust planned to test worst case scenarios that were being developed and then assess their plans in the light of that. The Trust had identified where staff lived and their work travel plans and hotels would be used where necessary as well as staff operating from alternative sites closer to their homes. In response to a concern about disruption to the road network which affected the ability to transport patients who needed specialist treatment, Members were advised that, in the event of a worst case scenario, the Trust was looking at using alternative sites in Kent and London.

·       Call answering times – in response to a question about performance for answering calls, a Trust representative advised that this had varied over the last few months but was in line with the national average. The rate of calls not answered was very low which indicated calls were being answered even during periods of high demand. Details of the average wait time to answer calls would be circulated to Members. The Trust confirmed that the mutual aid provided to the London Ambulance Service in March 2020 had not impacted on the Trust’s response times.

·       Stability of senior leadership team – noting previous assurances to the Committee about the stability of the senior team, the point was made that significant change in the senior leadership team was still occurring. Trust representatives advised that the only expected changes were a new senior manager for the West Area, which had been an internal promotion, and the retirement of the Executive Director of Operations in the next 6 months.

·       Performance – a request was made for the next update to the Committee to include details of how the Trust planned to improve performance in Categories 3 and 4. Member were advised that improving performance in these categories was a challenge and targets were often missed. There was an improvement plan in place and the hope was that performance would improve but this would remain a challenge given the extent of the rural areas covered by the Trust. In addition, as the response rates were averages, the response times well outside these averages was questioned.

·       Bullying and harassment – a point was made that, until the results of more recent staff surveys were available, it was not possible to be fully assured that historic concerns had been fully addressed. In addition, a comment was made about how the report had provided a greater assurance than in the past that the Trust was addressing these issues. A Trust representative acknowledged bullying and harassment were historic issues for the Trust but assured the Committee that plans to prevent this re-occurring were fully embedded, supported by further, improved training for management and a zero-tolerance approach.

·       Covid response – acknowledging the Trust’s excellent response to the first wave, the Trust was asked to assure Members that they were confident they could deal with the second wave. The Committee was assured that the Trust was in a good position to meet the challenges of a second Covid wave as well as the wider winter pressures. Stocks of PPE were good, and staff were aware of when and how to use PPE. Regular audits of cleaning took place. Staff had been encouraged to take annual leave in the summer and were well rested, supported and protected.

·       Joint Response Unit – Members were advised that this combined unit of officers from the Kent Special Constabulary and paramedics was working well and hopefully could be rolled out across the Trust. Members asked that their thanks to William Bellamy, SECAmb’s Senior Operational Manger, for setting up this Unit be recorded.

·       Live Conveyancing Review – noting that 24% of conveyances to hospital were from calls to 111 and 63% to 999, it was queried whether this ratio was expected to change. Members were advised that a communications plan would be launched in December to promote and encourage 111 as the first point of call in non-life-threatening situations and hopefully more calls in future would go through 111. This together with the enhanced clinical assessment service was expected to reduce the number of conveyances to hospital arising from calls to 111 due to the wider team of experts available to sign post callers. 

·       Jumbulance – it was clarified that this was a coach type vehicle which could transfer up to 5 stretcher patients at the same time. If necessary, it would have been used in the first wave of Covid to transport patients to the London Nightingale Hospitals but had never been used to its full capacity. For the second wave, it was not planned to use this service in this way.

·       Access to Medway Maritime Hospital – noting the difficulties there could be for vehicles to access the hospital, whether the Trust were in discussions about an alternative location for the hospital was queried. A Trust representative advised they were working with the Integrated Care Partnership and the hospital to plan for how to better expedite ambulance handovers, including ensuring patients were taken to the correct service and not automatically to hospital.

There was general acknowledgement amongst Members that the Trust had made improvements and was heading in the right direction.

Decision:

The Committee noted the report and thanked the representatives from SECAmb for their attendance.