Agenda item

Purpose:  To receive a short update from Duncan Burke (South Central Ambulance Service) on the changes to the performance reporting regime of the South Central Ambulance Service.

The Panel considered a report (Agenda Item 5) regarding changes to the South Central Ambulance Service (SCAS) performance reporting targets.  Duncan Burke (Director of Communications & Public Engagement, SCAS) described how the Department of Health (DoH) targets had dramatically changed in April 2011. The new system involved greater measures around clinical care and patient experience with performance reports published on the SCAS website every month. 

There was now a range of eleven indicators that were monitored under the headings of “Access”, “Response”, “Treatment”, “Disposition” and “Outcomes”.

“Access” related to call answering and call abandonment rates.  “Response” referred to time to reach life-threatening emergencies with the former “A8” and “A19” targets renamed “Red8” and “Red19”.  The Trust was no longer required to report on the less urgent Category B calls (“B19”).

“Treatment” targets referred to treatment of severe heart attack, cardiac arrest and stroke.  “Disposition” monitored how effectively call handlers answered calls and elicited the relevant information from the caller the first time.  The “Outcomes” measure reported on the overall success of treatment for cardiac arrest patients. 

The Ambulance Service worked closely with Primary Care Trust (PCT) colleagues to ensure patients received the most appropriate care pathway this was particularly important for dealing with some of the Service’s more prolific callers.

Councillor Boeck asked about the timing of call recording and impact on performance reporting.  Mr Burke, described how an ambulance would be dispatched as soon as the 999-call was connected via British Telecom.  However, a new telephony service was due to be introduced, this was likely to result in an initial drop in performance which was hoped would be back in line with the national averages by the year end.

Mr Burke described how SCAS had the highest rural demand of any Ambulance Service in the Country and therefore the “time to treatment” target was seen as particularly challenging.  The stringency of the measure had also been increased as patients had to be treated by a clinician i.e. Technician, Paramedic or Doctor and not a First Responder.

Councillor Macro enquired about the ambulance turnaround times at acute hospitals such as the Royal Berkshire NHS Foundation Hospital Trust (RBH).  Mr Burke reported that they were working closely with all acute hospital trusts to resolve such vehicle delays.  

In terms of performance SCAS was top in the Country for “Red8” response times for life-threatening calls and within the top three Ambulance Trusts for stroke care services in the Country. 

Members asked about the Computer Aided Dispatch (CAD) system for ambulances and the triage tool used by call handlers to assess life-threatening emergencies.  Mr Burke described that the software package identified symptoms which could be life-threatening and this would trigger an emergency response. A new ‘111’ call service was also being introduced as a single point of contact for all non-emergency calls. 

The Chairman enquired about the Department of Health (DoH) consultation with SCAS over setting of the new targets. Mr Burke described the dialogue that took place with the DoH and the compromises made when agreeing the targets.

Councillor Mason asked whether staff shortages of previous years were still an issue for the Trust. Mr Burke explained that due to specialist courses offered at two national Universities more newly qualified Paramedics were now available, however recruitment was still difficult due to the high cost of living in the counties of Berkshire, Buckinghamshire, Hampshire and Oxfordshire.

Councillor Jackson-Doerge enquired about pathways of care and ensuring 24-hour care. The Ambulance Service, described  the pathway for elderly ‘fallers’ and how to get them seen and treated appropriately which might stop later demand on the Ambulance Service or National Health Service (NHS). He described how more suitable care pathways were required working more closely with Social Care and Mental Health Services.

Councillor Ellison asked about the proportion of hoax calls. Mr Burke responded by explaining these were only a tiny fraction of all calls received and did not present a problem.

Councillor Linden asked about the challenges of combining with the Hampshire Ambulance Service.  Mr Burke confirmed that Hampshire was a previously poor performing Ambulance Trust and had numerous issues associated with the geography and rural nature of this area.  He confirmed however that national targets for performance had now been reached across all four counties.    

The Chairman thanked the Ambulance Service representatives, Mr Duncan Burke and Mr Keith Boyes for giving up the time to attend the Panel and congratulated them on the current performance.

RESOLVED that the update on the new performance reporting targets were noted and the South Central Ambulance Service were thanked for their presentation to the Panel.