In attendance from South East Coast Ambulance Service for this item: Scott Thowney, Senior Clinical Operations Manager, Matt Webb, Associate Director of Strategic Partnerships and System Engagement, Ray Savage, Strategic Partnerships Manager (Kent & Medway, East Sussex).
1. The Chair welcomed the guests and ask that they provide an overview of their report.
2. Mr Savage explained that the “111 Clinical Assessment Service” (CAS) commenced on 1 October 2020, six months later than planned due to the pandemic. CAS ran alongside “111 First”. Call volumes (nationally) had been higher than forecast since early 2020, though SECAmb had recorded the highest number of direct appointments booked across England.
3. Mr Thowney explained the 111 process began with a triage phone call by a non-clinician, who would identify a suitable “end point”. That could include an appointment with a GP or a visit to an Emergency Department. Each “end-point” was clinically reviewed.
4. The SECAmb call centre was to relocate from Ashford to Gillingham. The guests assured the Committee that a HR consultation was underway and that they were very mindful of staff welfare. The main benefit to the move was that 111 and 999 calls would be answered from one building which would allow for enhanced synergies and dually trained staff. Co-location was not possible at the Ashford site due to size.
5. In terms of agile working (working from home or another office), Mr Thowney explained that clinicians had been working that way since 2013, though its use had increased since the pandemic and over 70% were now working agilely. Agile working was more complex for non-clinicians because calls could escalate and require clinical support. There was always a physical clinical presence at call centres to support non-clinicians.
6. The safeguarding of agile working was questioned, to which Mr Thowney explained there were annual due diligence checks carried out as well as call auditing. Employees must work from an office if they were unable to work safely and securely from home.
7. A Member asked if enhancing technology had been considered to increase productivity. Mr Thowney explained the use of technology was regularly reviewed, though elements of the process were limited as they had to use the national NHS Pathways system. The ability to book appointments for patients had proven to be a big benefit and had reduced the churn in the system, with around 90% of patients attending their pre-booked appointments.
8. Mr Goatham offered thanks to SECAmb on behalf of Healthwatch Kent, saying the provider had been very responsive in replying to and resolving patient issues.
9. Members were keen to publicise the 111 First service, and the Chair asked that SECAmb colleagues share a side of A4 with the Committee that could then be circulated on social media.
10. It was confirmed that 111 First covered dentistry emergencies and dental nurses were part of the CAS team. However, the only end-point was a dentist surgery and if one was not available (for example, during the first lockdown in the pandemic dental surgeries were closed) there was no alternative. The situation was a national issue and one that had been escalated by SECAmb.
11. A Member mused if the future of primary care access was through a route such as 111 First, as opposed to an individual GP reception. Mr Thowney acknowledged that GP receptionists did not use the triage system, and that the use of appointment booking through 111 had required a lot of work, including building confidence with GPs that only clinically appropriate patients would receive appointments through the service.
12. Support for patients with mental health emergencies was discussed. Mr Webb explained that the purpose of the 111 service was to act as a single point of access (SPA). Appropriate and clear pathways needed to link across the system, a matter that was under discussion within strategic partnerships. There was also a need to understand what pathways a patient was already on when they phoned in, and the best way of doing this was being looked into. Mental Health practitioners were part of the 111 team.
13. The Chair thanked the guests for attending the Committee and Members offered their thanks for the service provided.
14. RESOLVED that the report be noted.