Agenda item

Geraint Davies (Director of Commissioning, SECAmb) and Patricia Davies (Accountable Officer, NHS Dartford, Gravesham and Swale CCG and NHS Swale CCG) were in attendance for this item.

(1)       The Chairman welcomed the guests to the Committee. Mr Davies began by outlining the background to the retriage pilot which was introduced during Winter 2014/15. The pilot saw clinicians taking up to an extra ten minutes to retriage calls that had come across from 111 to 999 as requiring an emergency response.  An initial review into the pilot by NHS England found that there was no detrimental impact to patients but there had been a failure in the Trust’s internal governance processes. He noted that three further reviews, Forensic Review, Patient Impact Review and Governance Review, were being undertaken by Monitor and he would be happy to come back and share the findings of the review with the Committee.

(2)       Mr Davies also outlined the background to the use of defibrillators in performance reporting. He explained that SECAmb followed national guidance on performance reporting; under the current guidance for Red 2 patients, a clock stop could take place if there was someone able to collect a defibrillator and bring it to the patient and a defibrillator was accessible at the time of the call. He stated that SECAmb was lobbying for this guidance to change so that defibrillators had to be by the patient’s side before a clock stop was applied. He noted that an independent review was underway to ensure the Trust had been compliant with the guidance and he would be happy to come back and share the findings of the review with the Committee

(3)       Members of the Committee then proceeded to ask a series of questions and make a number of comments. A Member enquired about pinch points and surge options. Mr Davies explained that a key pinch point was delays in the transfer of care within 15 minutes of arriving in hospital; for every 1000 hours lost in delayed transfers of care resulted in 0.4% impact on the Trust’s performance. The Trust was working with commissioners in Kent to make improvements to ambulance handover performance particularly with Darent Valley Hospital which was the worst performing hospital for transfer in Kent. The key challenge for 111 performance was the difficulty in referring patients to out-of-hour services particularly at the weekend which had resulted in some patients being inappropriately referred to an ambulance or an emergency department. He explained that surge options included playing a message during peak periods explaining that there may be a delay in answering the 111 call.

(4)       A number of questions were asked about vandalism of Public Access Defibrillators, the outcomes of Public Access Defibrillators and the consultation on proposed blue light collaboration including joint control rooms between emergency services.  Mr Davies noted that there were low levels of violence against the staff and fleet. He stated that the Trust supported the widespread availability of Public Access Defibrillators; the Trust was looking to develop outcomes for their use. He explained that the Trust and their staff saw themselves as part of the NHS, as a mobile health care system. The Trust wanted to be integrated into the NHS and had made representations to the Minister and Secretary of State. He noted that the Trust was involved in a project in Whitstable which had integrated a community paramedic into primary care; the project had enabled the Trust to understand patient demand and improve flow to the acute patient pathway.

(5)       The Chairman invited Mr Inett to speak. Mr Inett stated that Healthwatch Kent had been aware of the concerns relating to the retriage process and the use of defibrillators in ambulance performance before they were reported in the press as it was a member of the Kent and Medway Quality Surveillance Group. Mr Davies stated that the Trust had collectively met with the six Healthwatchs in the areas where SECAmb provide services and was looking forward to engaging further with Healthwatch volunteers and officers in the future. The Trust was looking at how to incorporate Healthwatch representatives onto its boards and committees.

(6)       RESOLVED that the report be noted and SECAmb be requested to share the findings of the Forensic, Patient Impact and Governance Reviews of the Retriage Pilot and the independent review into the use of defibrillators in performance reporting at the April meeting of the Committee.