Agenda item

The Committee will hear from representatives from South Central Ambulance Service about the performance of the service against national standards, the impact of Covid, workforce challenges and the findings from the recent CQC report.

Presenters:

Mr M Begley, Head of Operations, Aylesbury Vale & Milton Keynes

Mr A Battye, Head of Operations, South Buckinghamshire & East Berkshire

Papers:

Overview report of the service

Powerpoint presentation

The Chairman welcomed Mr M Begley, Head of Operations (Aylesbury Vale & Milton Keynes) and Mr A Battye, Head of Operations (South Buckinghamshire & East Berkshire).

During their presentation, they made the following main points.

·       South Central Ambulance Service’s (SCAS) key areas of work – 999 service, NHS 111, delivering integrated urgent care in partnership with other providers.

·       SCAS also offers a range of commercial services – non-emergency patient transport service, logistics, first aid training, the national pandemic flu service as well as resilience and specialist operations.

·       SCAS worked in partnership with Air Ambulances, Community First Responders, Co-responders, Student responders and volunteer car drivers.

·       Longer-term service changes and developments, initiated in response to Covid-19, had become integrated in the strategic planning cycle.

·       The impact of Covid-19 included staff fatigue, mental health pressures, long lasting effects of witnessing upsetting scenes and the feeling of hopeless, particularly at the start of the pandemic.

·       SCAS had a clear strategy which promoted an integrated approach and focussed around enabling people to access the right care, first time; saving lives and improving outcomes and supporting people in their own homes.

·       Ambulance crews were given iPads to help work smarter.

·       The Blue Light hub in Milton Keynes was a great example of having all services under one roof which meant that communities received an enhanced service.

·       There were lots of contributory factors which impacted on handover delays, including seeing sicker patients, Hospital capacity and also some patients needed to be seen somewhere else.

·       There was recognition of the significant pressure on GPs and how the system was always looking to do things differently.

During the discussion, Members asked the following questions.

·       In response to a question about the challenges around recruitment and retention, Mr Battye explained that other areas of the health system were recruiting to similar roles.  The south of the county had the highest vacancy rates due, in part, to the high cost of living.  He went on to say that the salary was set nationally so people in Buckinghamshire were paid the equivalent to those in York, for example.  SCAS was looking to introduce incentives for working in Wycombe or South Bucks.  The need for key worker housing was acknowledged.

·       In order to bridge some of the current vacancies, private provision was being used but it was recognised that the longer-term plan would be to recruit people to SCAS and to reduce the reliance on private providers.

·       Buckinghamshire New University were currently offering a paramedic degree and efforts were being made to encourage the students to stay in the area on completing their degree.  It was noted that it took 5 years to train paramedics.

·       A Member asked whether SCAS were still using standby points in places like Princes Risborough.  Mr Begley confirmed that, due to increased demand, this policy was not always possible as ambulance crews were responding to calls on a continuous basis.  He went on to say that there was a critical care team based in Buckingham.

·       In response to a question in relation to the eligibility criteria for the Patient Transfer Service (PTS), Mr Battye explained that the criteria were set within the PTS contract and patients were assessed accordingly.  Members commented that a number of voluntary car schemes were available – Community Impact Bucks was specifically mentioned.

·       In response to a question about first aid training, Mr Begley confirmed that this was not currently being delivered by SCAS as their focus had to be on delivering core services.  It was acknowledged that there were other organisations who provided this training.

·       Mr Battye confirmed that the new Wycombe site would be an ambulance only station and not a blue light hub but there would be more meeting space at the new station. He went on to say that the service had received excellent support from the Fire Service and the Military during the Covid pandemic.

·       Following the recent CQC inspection which raised concerns in relation to safeguarding, a Member asked for more details on this.  Mr Battye responded by saying that whilst no organisation wanted a negative CQC inspection, SCAS welcomed the report and said that in direct response to the findings, SCAS had brought in safeguarding specialists, although he reiterated that no patients were harmed.  SCAS were reviewing the report and looking at ways to introduce improvements.  An action plan had been developed which was currently being monitored by the Board.  The Chairman requested that the Committee had sight of the action plan.  Mr Begley and Mr Battye agreed to take this back.

Action: Mr Begley/Mr Battye

·       In response to a question about the impact of HS2 disruption on ambulance response times, Mr Battye explained that SCAS was represented at HS2 meetings and SCAS had access to a computer system which would re-route the crews to avoid the road delays.  Mr Begley added that there was also traffic disruption caused by East/West rail in the North of the County which also impacted on response times.

·       A Member asked whether the pressure on primary care services had resulted in more demand on the ambulance service as, particularly elderly patients, might not be able to access their GP and cited a specific example.  Mr Battye asked the Member to provide further details after the meeting.  The Member asked whether comparative data could be provided showing pre-covid call-outs to a person’s home and the current figures.

Action: Mr Begley/Mr Battye

·       A Member expressed concern about the 111 service and the call waiting times for patients and asked what SCAS was doing to get key public messages out there so people were well informed about where to go.  Mr Battye responded by saying that not all calls which came through the 111 service were for SCAS.  He went on to say that the Clinical Commissioning Group were responsible for public communications.  He provided an example at Wexham Park where there was a primary care unit at the Hospital, run by GPs but he recognised that there was space at the Hospital to provide this.  He went on to say that the 111 service had experienced a significant increase in demand and some SCAS staff had been redeployed to help-out.  The pressure on 111 was a national problem and there were recruitment challenges at a national level.

The Chairman thanked Mr Begley and Mr Battye for attending the meeting and suggested that some Members might be interested in visiting the SCAS Control Centre in future.