Agenda item

The Committee received a joint presentation of M Cotton, Director of Communications and T Gilchrist, Deputy Director of Quality and Patient Safety, North East Ambulance Service (NEAS) NHS Foundation Trust (for copy see file of minutes).  This had been published as a supplementary item after missing the deadline for publication.

S Gwillym, Principal Overview and Scrutiny Officer advised that the draft report had been circulated on 26 April 2022 and key performance issues were in relation to the number of 111 calls and the duration to answer calls.  In terms of signposting the calls, the bulk of referrals related to primary care at 44% followed by the ambulance service 17% and dentistry.  The Committee had received previously received presentations on GP access and availability and signposting into emergency dental services.

In terms of comparative date, NEAS had been the best performing ambulance service in the country with regards to category 1, 3 and 4 calls, 1 being the most urgent and in terms of category 2 calls, they had been the second best performing so in terms of organisations performing well, they had a proven record.

He went on to advise that issues identified for County Durham included the figures and response times which consistently lagged behind the trust average and this had been an historical issue for the Committee who were already aware that in some areas additional resources had been utilised to address and improve performance in the County.

He continued that in terms of Quality Account priorities for 2021-22  they were around emergency operations centre, management of sickness absence, improve performance and end of life care.

For 2022-23 there were four key areas for improvement, which included the reduction of handover delays which had been impacted by COVID-19 and staff sickness.  The pandemic had resulted in longer clean down times in between patients.

The Trust were also proposing to improve and learn from past incidents and prepare for the Patient Safety Incident Response Framework, improve the model and increase and improve the role of patients and their involvement in improving ambulatory care.

The third priority was the efficient use of resources by improving the clinical model, and finally to involve patients and communities to improve care.

Councillor Quinn asked whether there was a lower priority for ambulance care homes as from personal experience, there were unacceptable delays in ambulances attending nursing homes.

Councillor Howey also referred to an incident in which a priority patient in a rural area had waited 20 minutes to speak to a 999 operator and then 1.5 hours for an ambulance to arrive and when it did, it was accompanied by another four vehicles.  Ambulances were usually situated in towns across the County on standby but there was a new rule going forward that this would change to the nearest station, which could end up increasing delay times and this was a major concern for local areas.

Councillor Bell agreed that hand over times could take hours and resulted in vehicles being off the road and unable to respond to calls.

He suggested that ambulances should be allocated to individual areas to avoid five turning up at once.  With regards to 111 services the service was taking way too long, people were being advised not to go to A&E but they had no choice if they could not get through – there were people with children and health problems.  The issue with dentistry also needed to be addressed, there were new houses being built all over the County but not enough consideration giving to how those were going to be treated as there were areas in which dentists refused to take on new clients.

The Principal Overview and Scrutiny Officer advised that with regards to handover delays, NEAS had identified this as their first priority moving forward for the new period and he would respond to the consultation to advise that Members supported this priority but also include Members comments on the issues arising within the service.

In terms of the availability of dentistry, this was not something within NEAS control, although performance data had identified via  111 that dentistry was the third highest request. He reminded the Committee that the work programme would be debated at the meeting in July.

Councillor Earley advised that ambulance service staff were excellent and one of the problems which exacerbated the handover issue was the lack of investment in Durham and there were plans for a £30m extension to A&E otherwise the ambulances would continue to be held up in queues, be under pressure and deployment would continue to be an issue.  Although his own experience of the service had been excellent, he was aware of neighbours and friends that had been subjected to horrific experiences.  There were pressures on the system and A&E in Durham was a priority and the Council should be putting pressure on the government to address this.

Councillor Haney queried the terminology in the report for calls connected/offered and whether there were figures for those that were connected but remained unanswered.  He suggested that calls to 111 that connected but remained unanswered by an operator could be included in this figure and result in reducing accountability.

Councillor Andrews queried whether staff were being upskilled with regards to priority 3, hear and treat and whether there was any funding

available to make clinically led prioritisation resource appropriate.

Councillor Higgins referred to experience of calling 111 and waiting for a high priority ambulance and said that when the staff had arrived they were fantastic, but he wondered how many people would end the call rather than wait over an hour to speak to an operator.

Resolved

That the content of the presentation be noted and member comments be incorporated into the Committee’s response to the NEAS Draft Quality Account for 2021/22.