Meeting documents

To receive a presentation from Mark Ainsworth, Director of Operations and Andrew Battye, Head of Operations at South Central Ambulance Service NHS Foundation Trust.

The Committee was provided with a presentation from Andrew Battye, Head of Operations at South Central Ambulance Service NHS Foundation Trust.

The Ambulance Response Program (ARP) was the largest change to Ambulance response since the late 70’s. It identified the most appropriate resource that needed to be measured; this resulted in different time parameters. It is no longer a percentage of achievement, but now looks at the average (mean, to improve response to more patients.

The system benefits were that life threatening categories were measured by response and conveyance, conveying resource was measured for all calls and a review of the response model. Risks included the possibility of skewed numbers as a result of low numbers in some categories. There is a risk of false negatives in the data due to measurement.

Responses were sorted into 4 categories. Category 1 were the highest priority patients; unconscious, not breathing and drowning. These had 7 minutes initial response on average. Category 2 were the higher priority patients; chest pain, stroke and breathing difficulties. These had a 17 minutes average conveying resource time.

Category 3 were lower acuity patients; abdominal pain, fall with injury and minor with and road traffic incident. This had an average 2 hours conveying resource time. Category 4 patients were the lowest acuity patients; fall without injury and generally unwell. These had an average 3 hours average conveying resource time.

Demand was growing for the ambulance service. In response to questions from members, Andrew Battye explained that this was in part due to an ageing population. Despite the growing demand, performance had remained similar with minor shifts in the response times. For 2019/20, at the 50th percentile, there had been a 3 second increase, at the 75th percentile, a 7 second decrease and at the 90th percentile a 2 second decrease. The performances for 2019/20 at the 50th, 75th and 90th percentile were 6:31, 9:55 and 17:17 respectively.

South Bucks contains sections of both the M40 and the M25 motorways. It was reported that since 1st April 2019, there had been 55 incidents on the M25 and 102 incidents on the M40.

Hospital handover times were reported to have improved significantly. At Wexham Park Hospital, the introduction of a new Emergency department had drastically reduced handover excesses. At Stoke Mandeville hospital, there had been a modest reduction in handover excesses.

Delays can cause a knock-on effect where patients could need greater care. For example if a patient was on the ground due to a fall, they can be treated on the spot if the response time is within a certain timeframe. However, if they are on the ground for an extended period, there is a need for further care. This causes extra delays for the ambulance service.

It was reported that there is a significant challenge in recruiting and retaining ambulance staff. GPs were now recruiting paramedics with better working conditions. Paramedics had a greater suicide rate than the rest of the population. Team leaders within the ambulance service helped manage staff and ensure their wellbeing. Cost of housing was an issue and staff regularly left for more affordable areas. In response to questions from Members, it was reported there was currently no London weighting available for ambulance staff in the area. Andrew Battye informed Members he was looking to contact the South Bucks MP to express his concerns about this.

Reference was made to negotiations which had taken place with a mortgage lender about getting preferential rates for ambulance staff. The lack of affordable and key worker housing in the region was a problem. 

The ambulance fleet vehicles are currently maintained and run for up to 10 years. There were 52 new vehicles ordered and roll out will start in November.

RESOLVED – That the South Central Ambulance Service be thanked for their presentation.