Agenda item

6.1

Steve Rendi, Head of Emergency Operations (South Yorkshire), Yorkshire Ambulance Service (YAS), and Gareth Flanders, Head of Quality, YAS, gave a joint presentation which updated the Committee on the work of YAS.  The presentation focused on the Service’s coverage, services provided, the national/regional context, A&E performance in Sheffield and quality.  It also set out the priorities for improvement contained in the Quality Account 2013/14 and the priorities for improvement for 2015/16. 

6.2

Members made various comments and asked a number of questions, to which responses were provided as follows:-

·                One person in each ambulance team was a qualified paramedic and the service target was for 50% from the service being so qualified.  It should be noted that approximately 30% of 999 calls were capable of being treated on site.

·                A Workforce Plan had been developed whereby paramedics would work with a more junior colleague, with the aim of upskilling some of the junior operatives.

·                A patient story video had been used for training purposes, together with learning from complaints and incidents.

·                Staff would stay with a patient for sufficient time to assess the effects of any pain relief which had been administered.  This would depend on individual patient needs and patients would not be moved unless given appropriate pain relief.

·                Figures showing the trend in Red call demand (for the sickest patients) could be provided in the Quality Account.

·                There were presently 25 paramedic vacancies across South Yorkshire.  Recruitment was a national problem, with more paramedics being recruited from abroad.

·                The National Staff Survey results were contained in an action plan which was included in the Quality Account.

·                The introduction of a new Band 4 role would have no immediate impact on the numbers of paramedics.  It was part of a career pathway to becoming a qualified paramedic and there was a rolling programme to upskill 70% of Band 3 operatives to Band 4.

·                Applications for paramedic vacancies would be welcomed from those working for other NHS providers and consideration would be given to the Committee’s suggestion of adopting a more pro-active approach to this.

·                The YAS provided clinical staff for the Yorkshire Air Ambulance with four staff from South Yorkshire having completed the training to act in this capacity. 

·                Each paramedic had a report form to complete in relation to each call, which included information on the pain score.  Staff were continually being educated to ensure completion of these forms, from which action plans were developed.  The reporting of pain scores had improved and consideration was now being given to the use of electronic recording.  Tough electronic boards were presently being used in West Yorkshire and these were to be introduced in South Yorkshire in September 2015.

·                In relation to End of Life patients, partnership work was taking place which was looking at the right place-right time theme.  Obviously, ambulance staff would not know the individual patient and an assessment would be made at the time of the appropriate pathway.  The introduction of a clinical hub in the 999 call centre and the use of the tough book would contribute to improving this process.

·                The Quality Account would include details of strategies to reduce patient falls.

·                Patient feedback was based on six questions which covered the patient experience from initial call to the attending ambulance crew.  The friends and family statement was also included, together with a comments text box.  This information was used for training purposes and would be included by means of a chart in the Quality Account.

·                In relation to the priorities, a CQUIN (Commissioning for Quality and Innovation) 3 report had been submitted and these had all been achieved, apart from the national response times.  This was currently under discussion with the Trust Commissioners.  The priorities would be RAG rated in the Quality Account.

·                Work was being undertaken with staff to ensure a better balance between work and break time and it was managers’ role to support this.  These were very challenging times, with demand being very high at the moment, and it was important to ensure that staff had adequate rest and took leave.

·                The YAS worked with acute partners in relation to pressures on A&E services on a local and regional level. 

·                A geographical breakdown of where timing targets were not being achieved would be circulated to Members, as would further information on survival to discharge.

·                The movement to electronic recording would assist with patients receiving appropriate treatment.

·                Bad, as well as good, patient experiences were included in the patient stories.

·                Staff were aware of the need for recognition of both verbal and non-verbal communication, so that they could check for pain with patients where there were language issues.

·                The 11.5% increase in Red call demand had been reported to the Clinical Commissioning Group.

6.3

RESOLVED: That the Committee:-

(a)       thanks Steve Rendi and Gareth Flanders for their contribution to the meeting;

(b)       notes the contents of the presentation and responses to questions;

(c)        requests that the Yorkshire Ambulance Service Quality Account 2014/15 be drafted so as to take account of the audience to which it was to be presented, with particular reference to the inclusion of:-

(i)        proof, trends and context to make it more meaningful;

(ii)       an explanation of how indicators were determined;

(iii)      actions being taken where targets were not being met; and

(iv)      further information about the impact of continued underperformance on the eight minute target; and

(d)       notes that the Committee’s response to the presentation, based on the Committee’s discussions, would be drafted by the Policy and Improvement Officer.