The West Midlands Ambulance Service Authority - A Summary of Recommendations
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1 Committee and Date (Healthy Communities Scrutiny Committee 26 th July 2011) Cabinet 19 th October pm Item Public 6.1 Report of the West Midlands Ambulance Service Task and Finish Group Responsible Officer Fiona Howe Tel: Fax Summary 1.1 This report presents the recommendations of the West Midlands Ambulance Service Task and Finish Group on its review of performance and current developments taking place within West Midlands Ambulance Service NHS Trust (WMAS). The Healthy Communities Scrutiny Committee, at its meeting on 26 th July 2011, approved the Group s recommendations as set out in paragraph Recommendations 2.1 Cabinet is asked to support the recommendations of the Task & Finish Group set out in paragraph 13 of the report. REPORT 3 Risk Assessment and Opportunities Appraisal 3.1 There are no identified issues relating to Risk Management, Human Rights or community associated with this report. Consultation is a key element of effective scrutiny. 4. Financial Implications 4.1 There are no direct financial implications identified in this report.
2 5. Background 5.1 The WMAS Task and Finish Group, chaired by David Minnery, was established in 2009, following the Lightfoot efficiency review of the service to monitor the outcome and make recommendations based upon evidence collected. The Group met on several occasions to monitor performance information. 5.2 The remit of the Group moved onto the WMAS consultation bid for Foundation Trust (FT) status earlier this year and following a further three meetings to examine the Trust s proposals and its plans for service improvement and development, the Group presented its draft response which was approved by Healthy Communities Scrutiny Committee in January With this breadth of focus, the Task and Finish Group took up an invitation to observe call handling at WMAS Trust headquarters at Brierley Hill on 28 January and to observe the new Make Ready system at WMAS operation centre at Staffordshire Tollgate on 18 March. The Task and Finish Group has developed five recommendations based on its findings, as detailed below. 6. WMAS Bid for Foundation Trust Status Update 6.1 The Consultation period ended on 6 February and the results are published in an Initial Findings Consultation Document on the WMAS website in which it is noted 81% (329) of 406 respondents were in favour of proposals. (Document link: Proposals are currently under local scrutiny by the Strategic Health Authority and if approved, will go before the Secretary of State late summer Recommendation A: That a progress report on the Bid for Foundation Trust from WMAS be requested and added to the Committee s Work Programme and that WMAS be recommended to provide an update on Foundation Trust status for the public as soon as possible. 7. Issues arising from The Group s visits to WMAS 7.1 Following the Group s visits to Brierley Hill and Staffordshire Tollgate earlier this year, further issues were identified by the Group which were put to WMAS and to Shrewsbury and Telford Hospitals NHS Trust (SaTH) at a meeting on 23 May. A list of the issues identified with response from WMAS and SaTH is attached at Appendix A. 7.2 A main concern of the Group following the first visit was around the process and turnaround time for patient transfer in order to reduce ambulance waiting time at hospitals. The Group noted that the target turnaround time of 90% in 15 minutes was being reached, however there were periods when demand was excessive. There was a need for health professionals to work more effectively to ensure referrals were co-ordinated. Work was taking place to 2
3 reduce the number of patients being referred to acute services and to reduce delayed discharge. 7.3 Recommendation B: That a progress report be commissioned on Delayed Patient Discharge together with co-ordinated and appropriate referrals and added to the Healthy Communities Scrutiny Committee s Work Programme in November when the Primary Care Trust is also due to report the outcome of the pilot scheme on the Early Supported Patient Discharge Programme. 8. Make Ready System (Visit to Tollgate) 8.1 Members were able to observe the system on their visit to Stafford in March which had been operating there for around 12 years and which answered many of their questions. The system is being rolled out to Hereford currently with one central Hub station. Plans to roll the system out to Shropshire within the next 12 to 15 months could be delayed if there are difficulties in identifying a suitable site for a hub station. 8.2 The Group have raised questions on plans to reduce WMAS estates noting that current provisions are under-utilised. Many of the Ambulance Stations require major investment to bring them up to a fit for purpose standard and funding would be better directed to patient care, rather than improving existing structures. With the creation of a Hub station, and an increased number of community response sites, based upon historical need, a paramedic car would be the first responder, while a community ambulance would be moved into the area, and brought to the scene if required. Other vehicles would be relocated to provide rolling cover ensuring a community ambulance was situated in a suitable location to provide emergency service for all areas of the county. The system would provide a more enhanced service. 8.3 Work is currently taking place on a communications strategy which WMAS have undertaken to share with the Committee once this is complete before making information available to the public. The Group have welcomed the introduction of the new system and believe that the public should be notified of its advantages and how the service will be enhanced at the earliest opportunity. 8.4 Recommendation C: That the Healthy Communities Scrutiny Committee considers the Communication Strategy, once this is available, to assess whether the introduction of Make Ready, and reduction of the Trust s estates in Shropshire constitutes a substantial variation or development in service which would require a statutory 3 month consultation. 8.5 Recommendation D: That when the Communication Strategy is reviewed, the Committee also request an update on the new NHS Pathways telephone Triage system, due to go live at Tollgate in July and Millennium Point in October, together with progress in rolling out the electronic patient record system which has been trialled in Coventry and Warwickshire. The new system aims to ensure patients get to the right service first time. 3
4 9. Performance Monitoring 9.1 The Secretary of Stated announced last December a new set of 11 clinical quality indicators effective from April This means the replacement of the Category B, 19 minute respond target to a more quality approach on matters important to patients. The new targets, red green and blue are indicated in the performance summary for April-May attached at Appendix B. 9.2 The Group still remain concerned that whilst the Trust is meeting its Red 8 minute target for the region and for the West Mercia Area as a whole, targets for Shropshire County remain unmet and in many instances have fallen behind performance last reported to the Group in November. Questions were raised on whether WMAS can operate successfully if proposals to reconfigure hospital services in Shropshire go ahead and the Group noted that WMAS is working closely with SaTH on workstreams to ensure transport and clinical pathways are as safe as possible and that commissioners had provided assurance that if changes were required, funding would be made available. 9.3 Recommendation E: That the Healthy Communities Scrutiny Committee continues to monitor performance and as new systems are progressed, seeks further evidence from WMAS on how it plans to achieve its Red 8 minute target for Shropshire County. 10. Additional Information - Quality Account 10.1 The Group, at its final meeting on 23 May, considered the Trust s draft Quality Account for 2011/12. It is a requirement for healthcare providers working for or on behalf of the NHS to publicise an annual report about the quality of the services they provide, looking at safety, experience and outcomes. The report also sets out where they are doing well and where improvements can be made with priorities for the coming year, thus aiming to enhance accountability for the public The Group s comments were submitted to SaTH, as part of a joint response with Telford & Wrekin Council. A major focus through the Joint Committee has been on the reconfiguration of acute services, recognising that work of the WMAS is key to its success. Copies of the response were circulated to Members. 11. Acknowledgments 11.1 The Task & Finish Group would like to thank WMAS staff at Brierley Hill and Staffordshire Tollgate for their time and hospitality and for answering the Groups questions and queries; other officers from WMAS who have attended meetings and in particular Nick Henry, Area Manager, West Mercia who has visited the Group and answered questions on a number of occasions The Group were very impressed with the Make Ready system, and other plans to improve services, which they believe is good news and would like the public to hear about it too. 4
5 12. Members of the Task and Finish Group: Cllr David Minnery (Chairman) Cllr Gerald Dakin Cllr Tracey Huffer Cllr Liz Parsons Cllr Madge Shineton Cllr Tina Woodward 13. Recommendations (a) (b) (c) (d) (e) That a progress report on the Bid for Foundation Trust from WMAS be requested and added to the Healthy Communities Scrutiny Committee s Work Programme and that WMAS be recommended to provide an update on Foundation Trust status for the public as soon as possible. That a progress report be commissioned on Delayed Patient Discharge together with co-ordinated and appropriate referrals and added to the Committee s Work Programme in November when the Primary Care Trust is also due to report the outcome of the pilot scheme on the Early Supported Patient Discharge Programme. That the Committee considers the Communication Strategy, once this is available, to assess whether the introduction of Make Ready, and reduction of the Trust s estates in Shropshire constitutes a substantial variation or development in service which would require a statutory 3 month consultation. That when the Communication Strategy is reviewed, the Committee also request an update on the new NHS Pathways telephone Triage system, due to go live at Tollgate in July and Millennium Point in October, together with progress in rolling out the electronic patient record system which has been trialled in Coventry and Warwickshire. The new system aims to ensure patients get to the right service first time. That the Committee continues to monitor performance and as new systems are progressed, seeks further evidence from WMAS on how it plans to achieve its Red 8 minute target for Shropshire County. List of Background Papers (This MUST be completed for all reports, but does not include items containing exempt or confidential information) Consultation Document: Efficiency Review Report Lightfoot Solutions Consultation Document: We need your views Because it s your Ambulance Service Draft Quality Account Cabinet Member (Portfolio Holder) All Local Member All 5
6 Appendices Appendix A: Summary of Questions and Response from WMAS Appendix B: Performance Summary for April-May
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