Agenda item

10.30

The Chief Executive of the South Central Ambulance Service NHS Trust (SCAS), Will Hancock, will provide members with an update on the performance of SCAS in Oxfordshire. He will also talk about changes to national performance targets.

Mr Hancock will be joined by John Black, SCAS Medical Director; John Nichols, Divisional Director for Oxfordshire and Duncan Burke, Director of Communications and Public Engagement.

The Chief Executive of the South Central Ambulance Service (SCAS), Mr Will Hancock, reported on response times and new national service indicators.

• Overall 999 and Urgent demand continues to trend upwards
• Overall Red Call performance has held well and shows improvement over the last year – remaining above the national Standard for the PCT area.
• Good improvement in the Red 8 minute performance can clearly been seen in each of the individual districts
• In early July 2011 the new Emergency Control room computer system (CAD) was introduced into Bicester. This is the final phase across SCAS and now means that all three control rooms operate on the same CAD, allowing true integration and resilience across the whole of SCAS.
• Early September saw the switching on of a single virtual telephony platform across all three control rooms, providing even greater resilience and patient safety.
• The CAD installation was wholly successful and performance during the critical 3 months post implementation (during which time staff will become fully efficient) has been significantly above planned levels.
• The expectation is that the improvements (seen particularly across West Oxfordshire and South Oxfordshire during the first part of this year) will be recovered quickly in the second half of this financial year.

Chipping Norton First Aid Unit Update

The First Aid Unit (Chipping Norton Hospital) pilot is coming to an end. This pilot has seen an Emergency Care Practitioner based at the new Hospital every week day evening and during a long day on both Saturdays and Sundays.

Its use has been pleasing, with the vast majority of patients who presented themselves being managed locally.

9 Patient experience surveys have so far been returned, with overwhelming support for the service.

Other Developments

Since April this year 11 new indicators have been introduced covering the three quality domains of safety, experience and clinical effectiveness.  They are:

Service Experience Indicator – Patient satisfaction surveys – how ambulance trusts find out what people think of the service they offer and how they are acting on that information to improve patient care.

Outcome from acute ST-elevation myocardial infarction (STEMI) indicator - STEMI is a type of heart attack. For many conditions recovery will be more likely and quicker following early treatment. Measuring patient outcomes in this way will allow services to place performance in context and stimulate discussion on how to continually improve.

Outcome from cardiac arrest: return of spontaneous circulation indicator – This indicator will measure how many patients who are in cardiac arrest (i.e. no pulse and not breathing) but following resuscitation have a pulse/ heartbeat on arrival at hospital.

Outcome from cardiac arrest to discharge indicator – This measures the effectiveness of the whole system in managing those patients who are in cardiac arrest. That is the rate of those who recover from cardiac arrest and are subsequently discharged from hospital. 

Outcome following stroke for ambulance patients’ indicator –This indicator will require ambulance services to measure the time it takes from the 999 call to arrive at a specialist stroke centre.

Proportion of calls closed with telephone advice or managed without transport to A&E indicator– Ambulance crews are often able to treat patients without the need to take them to an A&E department. Also, alternatives to A&E may be more appropriate for the patient. This indicator should reflect how the whole urgent care system is operating, rather than simply the ambulance service or A&E, because it would reflect the availability and provision of appropriate alternative urgent care destinations and treatment of patients in the home.

Re-contact rate following discharge of care indicator – To ensure that ambulance trusts are providing safe and effective care first time; every time, this indicator will measure how many callers or patients call the ambulance service back with 24 hours of the initial call being made.

Call abandonment rate –This indicator will measure how often people who phone 999 are not able to get through.

Time to answer calls – This indicator will measure how quickly 999 calls received by the ambulance service get answered.

Time to treatment by an ambulance-dispatched health professional – This will measure how long it takes for an ambulance-trained healthcare professional to arrive at the patient 9note; not necessarily an ambulance).

Category A, 8-minute response time –This indicator measures the speed of ambulance responses to the scene of potentially life-threatening incidents.

A discussion then took place in which the following points were made:

It is pleasing to see the new emphasis on clinical indicators and indicators that cover the whole patient experience. Work is going on between SCAS and clinical colleagues to improve services particularly by ensuring that patients get to the right place at the right time.

It is good to see improved times and the development of the first responder programme.

There should be more ambulance coverage in rural areas to ensure that all patients have an equal chance of recovery regardless of where they live. There should be more joining up with the Out of Hours service.

Some members questioned whether it was reasonable to expect the same service in rural areas as in urban settings.

More data on “just missed times” (i.e. more than 8 minutes) would be useful.

The number of calls taking more than 30 minutes has been reduced and rural performance has improved with 75% of calls in West Oxfordshire taking 7 minutes or less.

Ambulance demand has doubled in the last 10 years.

It is hoped that the new non-emergency 111 service, which SCAS is bidding to run, will improve the Out of Hours situation as all calls will be brought together to one call centre.

Members thanked the Chief Executive and his colleagues for attending the meeting.

The Chief Executive agreed to provide "meaningful information" on the new performance indicators as soon as it becomes available, probably early next year. He also agreed to let members have information relating to the actual length of time for calls that exceed 8 minutes. Also, the Committee will be kept informed of the outcome of discussions with the PCT about the Chipping Norton FAU pilot (since the meeting the life of the FAU has been extended to the end of January 2012).