Agenda item

In attendance: Ray Savage (Strategy and Partnerships Manager, Kent & Medway, East Sussex), Tracy Stocker (Associate Director of Operations) and Steve Emerton (Executive Director for Strategy and Business Development) from South East Coast Ambulance Service NHS Foundation Trust.

1.    The Chair welcomed representatives from the Trust to the Committee. He invited them to introduce themselves and provide a short summary of the paper.

2.    Mr Emerton highlighted the following from the report:

a.    There had been a number of staff changes since the last report to the Committee, including a new Chief Executive Officer and Director of HR & Organisational Development. An operational restructure had also seen the appointment of a number of new colleagues.

b.    The 2019 CQC rating of the Trust was “Good”, with Outstanding service in Urgent and Emergency Care.

c.    The Trust continued to work hard to mobilise the new 111 Clinical Assessment Service, commencing in April 2020.

d.    Alternative care pathways were being worked on in order to reduce the pressure on A&E services.

e.    The implementation of a Clinical Education Transformation Project in response to a poor Ofsted visit in 2019.

f.     A targeted effort was underway to improve the response time for Category 3 patients.

3.    In terms of handover delays, Mr Emerton explained that the Trust understood what worked well to reduce them and more work was needed to share that best practice. 

4.    The Trust was seeing increased demand for their service (in particular due to the Covid-19 virus). Key to managing that was close partnership working in terms of working out the most suitable clinical pathway for a patient and knowing which hospitals had capacity.

5.    A Member asked how many of the “new” ambulances were located in Kent. Mr Emerton offered to bring those details back to the Committee but confirmed they were all located where the demand capacity review showed additional resource was required.

6.    A Member asked where stroke patients would be sent to as the Pembury Stroke Ward had temporarily closed. Mr Savage explained that the Kent & Medway stroke review had provided good insight into this area. Depending on their location, patients would be taken to hospital in East Surrey, Eastbourne, Maidstone or Darent Valley – wherever their nearest receiving appropriate hospital was.

7.    In response to a question about rurality, Mr Emerton explained that it was an area of challenge in terms of response times because of the prohibitive cost associated with serving the area. There was some quality work underway which would look to optimise response times in those areas. He also highlighted that this was a national challenge, not just applicable to Kent.

8.    A Member drew upon a Freedom of Information (FOI) request they had submitted to SECAmb in relation to the length of time taken for Thanet residents to get to the William Harvey Hospital after calling 999. The Member believed the figures were worrying and demonstrated a poor response time. Mr Emerton explained that all calls were categorised and responded to accordingly. Each call had a context which may explain the cause of the perceived delay. Reasons may have included, though not be limited to, additional treatment at home; consultant input into the most appropriate pathway; volume of road traffic. He was happy to address individual cases for concern outside of the meeting. Overall, Mr Savage explained that Thanet produced some of the best response times across the Trust area. 

9.    The Member felt it would be useful for all Members to see response times for their district. They also requested that the data around response times on blue lights from Thanet to William Harvey Hospital be circulated to the Committee.

10. A Member asked a question around managing the expectation of patients whilst they waited for an ambulance, particularly those that were vulnerable or elderly. Mr Emerton explained 999 responders regularly assessed the risk to a patient whilst they were waiting, and if they were deemed to be at risk of harm then the call would be escalated. The NHS Pathways platform, which was used to categorise patients, was continually updated to ensure conditions were categorised appropriately and tended to be risk averse in terms of acuity. But Mr Emerton did offer to look into cases where the Trust had got it wrong in the past and see if there were lessons that could be learnt.

11. Ms Stocker informed HOSC of the falls work the Trust was involved in. They were working with partners to consider how falls could be prevented but also what the right course of action was for those that did fall. A pilot was underway in Thanet and the Trust and its partners would seek to learn from that.

12. The Chair thanked the guests for attending and welcomed the good progress that had been reported.

13. RESOLVED that the report be noted.