Agenda item

Joe Garcia, Executive Director of Operations, James Pavey, Regional Operations Manager, and Ray Savage, Strategy & Partnerships Manager, South East Coast Ambulance Service NHS Foundation Trust were in attendance for this item.

(1)      The Chair welcomed the guests to the Committee and with agreement proceeded directly to questions. 

(2)      Members enquired about the Kent and Medway Stroke Review including service modelling, improvement of service for stroke patients and travel times.  Mr Savage informed the committee that there had been no issues with the modelling and that the Trust was still on track to deliver requirements, with no changes based on the proposed option currently being discussed.  Mr Pavey reiterated from the ambulance service perspective it is about the taking the patient to the right place first time.  He said that work undertaken from the Trauma Network, due to no trauma centre being available in Kent had led to actual lives being saved as the outcome has been better.  Mr Pavey highlighted that the Trust has been trialling Ipad use for online consultation with a Stroke Consultant, in the Ashford and Thanet area. 

(3)      Members enquired about handover delays.  Mr Pavey advised that handover delays were and remain an issue in Kent as well as nationally and that NHS England and NHS Improvement took a very close interest in this.  He said that winter would see a low tolerance for handover delay and improve patient safety.  Mr Pavey said that the Trust had employed a Senior Nurse with a community background to help lead, discuss and improve things for the region.  He said that the Trust have made some significant progress, through system-wide solutions but that they were not being complacent. Mr Garcia confirmed that the Senior Nurse role had led to the overall handover delay being at a level lower than it had been in the last two and half years on some sites, but not all.

(4)      Members asked about response times, fleet management and recruitment.  Mr Garcia said that in relation to response times it was recognised that the Trust is challenged in category 3 responses.  He said that the Ambulance Response Programme (ARP) introduced a change to the way the Trust responds.  Mr Garcia emphasised that the Trust was well above the national average for high acuity, categories 1 and 2, but that brings in to the equation the resourcing issues that the Trust has.  He said that Kent has seen a greater increase in terms of activity  in comparison to other areas in the region over the last ten years and was performing well.  Mr Garcia said that there was an anticipated improvement to all categories and bring category 3 under one hour on 90% of all those cases.

(5)      Mr Garcia said that the Trust had purchased 101 new vehicles for this year.  Mr Garcia said that he had also purchased 30 second hand vehicles for winter so that the Trust could take advantage of the significant levels of recruitment that had been undertaken.  He confirmed that the Trust will have an additional 174 FTE by December 2018 and would increase further by the end of January 2019.   Mr Garcia emphasised that this was with a view to accelerating the required workforce trajectory that was identified in the ‘Demand and Capacity’ review which had been agreed by all CCGs.  He said that in vehicle terms the Trust would have a net increase over the next year by a further 60 compared to this time last year and by 75 by the end of 2020/21.

(6)      Mr Pavey confirmed that there was a significant number of private providers available to be able to meet areas of peak demand.  Mr Garcia emphasised that that ‘Demand and Capacity’ review should help increase the workforce and reduce demand for private provision.

(7)      Mr Inett asked about CCG performance requirements, workforce and retention.  Mr Garcia said that following last years CQC inspection the Trust had a Quality Summit which defined the support that the system could give for hospital handovers.  He said that this was split into east and west, predominantly Kent, East Sussex and the rest of the region.  He confirmed work taskforces were led by Chief Operating Officers from acute trusts, with the whole process chaired by NHS Improvement, leading to successful system wide involvement in comparison to this time last year. 

(8)      Mr Garcia confirmed that nationally paramedics have been banded up a level which had in turn impacted on banding throughout the Trust.  He said they were in the process of taking a business case to the Board to increase banding for specialist paramedics and had introduced changes to work patterns by running rotational pilots where staff rotate through a primary care setting and ambulance response setting to give variation to the working experience.

(9)      A Member enquired about Brexit and the associated impacts on the Trust.  Mr Pavey acknowledged that there is a lot of uncertainty with Kent which was particularly challenged at times with road networks, exemplified by when Operation Stack was implemented.  He said that it was a very difficult thing to predict in terms of impact but there was contingency planning being undertaken with agency counterparts.

(10)   RESOLVED that the report be noted, and SECAmb be requested to provide an update in June 2019.