Agenda item

The Committee will review the progress in implementing the actions outlined in the recent Care Quality Commission’s report (August 2022).  This item will also be an opportunity for Members to examine the current arrangements in place for the Non-Emergency Patient Transport Service.

Presenters:

Daryl Lutchmaya, Chief Governance Officer

Paul Stevens, Assistant Director Commercial Services

Emma Crozier, PTS Area Manager

Mark Begley, Head of Operations

Papers:

Report attached

The Chairman welcomed the following presenters to the meeting:

Daryl Lutchmaya, Chief Governance Officer

Paul Stevens, Assistant Director Commercial Services

Emma Crozier, Patient Transport Service Area Manager

Mark Begley, Head of Operations

The following key points were made:

·       The Care Quality Commission (CQC) report in 2022 identified 11 must-do and 20 should-do items for South Central Ambulance Service (SCAS) to undertake.

·       There was one must-do item remaining which was to implement an escalation and decision-making process at board level.  This was  planned for December 2023.

·       The remaining should-do item was to consider ways of monitoring outcomes for patients who were not transferred to hospital to see if other pathways were  working effectively.

·       Staff wellbeing was being prioritised with 27 Freedom to Speak Up champions being appointed and winter wellness packs had been distributed to all staff An improvement plan had been launched to help staff reach their own performance targets.

During the discussion, Members asked the following questions:

·       A Member asked whether the service was responsible for ensuring that when vulnerable patients were  discharged from hospital, an appropriate care package was in place. The Assistant Director replied that SCAS deals with transporting patients to the most appropriate place and they would return a patient to hospital if they felt that the patient would be unsafe in their home.  Wraparound care was provided by a number of different health and care providers.

·       A Member asked about reasons for the significant increase in safeguarding referrals to the Council and asked if the Oliver McGowan advocacy guidelines were being followed. The Chief Governance Officer stated that SCAS was encouraging staff to identify and raise safeguarding issues and that this could account for the increase.

·       A Member asked about the situation on mandatory appraisals and training for staff, referring to the paper which states that training was below target levels. The Chief Governance Officer explained that the percentage of staff who had completed mandatory training had risen from 64% to 83%.  He added that sometimes training had to be paused due to work pressures. 

·       The Chairman asked Philippa Baker, as Place Director for the Integrated Care Board (ICB), to update Members on funding.  Philippa explained that the ICB worked very closely with SCAS, looking at services such as 999 and 111 but there was no specific update on funding for this meeting.

·       A Member asked how patient safeguarding had been impacted after the recent failure of IT software. The Head of Operations explained that the SCAS software needed to be updated and there had been challenges when the Electronic Patient Records (EPR) system failed but it had not affected the safeguarding of patients.  The Chief Governance Officer said that the Board was discussing how to prioritise its spend on updating IT systems.

·       A Member asked about the whistleblowing procedures within SCAS and asked if openness and transparency had improved. The Chief Governance Officer explained that any allegations were dealt with by the Board.  The Assistant Director of Commercial Services added that SCAS had fully embraced a freedom to speak up culture and had guardians and champions in place.  Staff were encouraged to talk to a champion about any concerns. 

·       In response to a Member question about the impact of HS2 and other construction projects on ambulance response times, the Head of Operations pointed out that Buckinghamshire was a very rural county with few main arterial routes. HS2 was a problem in Wendover and the north of the county. The East-West rail route was also a challenge, in terms of traffic disruption.  Roadworks and the installation of broadband cables also caused delays.  All these caused problems for non-emergency transport services as well as 999 responses. 

·       The Chairman asked about the level of engagement between HS2, East/West rail and SCAS.  The Head of Operations said that SCAS did receive information but there had been occasions when roads had been closed or temporary lights in place which the service did not know about.

·       In response to a Member question about the level of engagement between SCAS, the Council’s Streetworks and Highways Management team, the Head of Operations said that the control room received emails but was not notified of all road closures – some of which were the result of utility companies undertaking emergency work.

·       The Cabinet Member for Health & Wellbeing stated that she chairs regular meetings with HS2 and East/West rail and had been reassured that information on road closures was passed onto Blue light services.  She agreed to raise this again at the next meeting.

Action: Cllr Angela Mcpherson and Chairman

·       A Member asked what the regime was for cleaning vehicles and the stations where they were kept.  The Area Manager replied that vehicles were deep cleaned every 6 weeks. Each evening they were cleaned and marked as clean.  In stations, compliance walkarounds were carried out.   After the covid pandemic, a number of cleanliness requirements had been maintained.  The Head of Operations added that there were spot checks on the company who carry out the deep cleaning.

·       In response to a Member question on staffing levels, the Head of Operations pointed out that clinicians take five years to train and that there was a limited number of available candidates.  The service had employed several paramedics from Australia who were able to work in the UK for three years.  The team was working on recruitment and retention, promoting wellbeing and offering rota patterns which give a better work-life balance.  The vacancy rate across Aylesbury was around 14%.

·       In response to a Member question about reasons why staff were leaving the service, the Head of Operations said there were various factors, including career progression and personal reasons, such as moving closer to family.   The Area Manager added that the Patient Transport Service currently had a 5% vacancy rate in Buckinghamshire.

The Chairman thanked the presenters for attending and responding to Member questions.