Agenda item

11:50

Aubrey Bell, Area Manager for Oxfordshire at South Central Ambulance Service will discuss the performance of the Ambulance Service in Oxfordshire, with a particular focus on rural areas (JHO10).

Steve West, Operations Director (Thames Valley) and Aubrey Bell, Area Manager (Oxfordshire), of South Central Ambulance Trust attended the meeting to discuss their report to the Committee on response standards and demand for the year 2013/14 and to respond to questions. Mr West introduced the report (JHO10) pointing out that within Oxfordshire demand had risen by 7% and category A red calls (potentially life threatening) had risen by 9%. Currently, within the organisation, the number of red calls had risen by 34%. The service had also seen a change in the pattern of 111 activity and the Trust was currently in the process of changing rotas to match this change in demand. This would pose a real challenge for the workforce and a consultation period on these plans was to follow later on in the year.

Within Oxfordshire performance statistics remained strong. However, as resources were becoming stretched, a number of initiatives, in essence different ways of working, had been put in place to address some of the challenges which the service was facing. For example, an interaction programme had been set up in the West Oxfordshire area to inform the public of the sites where defibrillators were; and the Trust were working with a private provider on the potentiality of a pilot for a satellite across the area.  Talks with the military were currently in progress in the Thame area.

In order to give some context, the Committee was given a presentation on response times for red category patients and this was followed by a question and answer period.

A member asked if, in the future, average response times and variance around that average could be recorded, thus giving a clearer picture, adding that it appeared unfair that the Trust had missed the target by 4 seconds for Red 2 calls,

A member asked why the response times had worsened in parts of the county over the past few years. Mr West responded that hospitals had recorded an increase in acuity of patients presenting. Part of the increase was caused by the implementation of the 111 system. More calls were being classed as red calls, which had an effect on the percentage of patients SCAS were trying to respond to. Mr Bell responded also that it was difficult to put resource into areas where there were small numbers of calls per week. However, this was constantly under review and a variety of mitigating actions were being taken in these areas, such as the presence of co-responder teams.

In response to a question about why the 111 system was causing an increase in callout, Mr West explained that a joint audit had been carried out with consultants in the John Radcliffe hospital and it had found that 98% of patients calling were identified as appropriate care pathways, albeit with a different profile than it was historically.

A member asked whether the Trust was managing to maintain and recruit staff in sufficient numbers to meet the increased demand for extra resources required in different locations. Mr West replied that this had been a problem area and the Trust was looking at other resources, for example use of St John’s private and voluntary ambulance support. The Trust was contracting with a number of private companies for paramedics, of which there was a shortage. However, despite the volatility in demand, its long term strategic objective was to use its own resource to staff its workforce.

A member commented that it would assist the Committee with any action it wished to take if it knew there was a health problem in a particular area caused by the increase in demand for resources. Mr West explained that the Government set the national standard (75% - 8 minute response) and the Trust was required to deliver it across the whole of the South Central area. Moreover it was committed to getting to patients as quickly as possible whether it be to an urban or rural area. He added that there was evidence that defibrillators improved patient survival - it was then important to get the patient to the right treatment centre. It was his view that it would be worth reviewing how the Trust was performing clinically with outcomes for patients across its footprint. To this end, work was already taking place with stroke victims.

The Chairman reminded members that the OCCG were to be invited to the Committee’s November meeting, alongside SCAS to consider the Trust/OCCG consultation strategy for future plans. He thanked Mr West and Mr Bell for their report and for their attendance.