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Declarations of Interest
There were no Declarations of Interest on this occasion.
The Committee agreed to make the following amendments to the minutes under item 34:
· A spelling error in the 2nd paragraph should read “within”.
· The 4th bullet point should read “patient”.
Resolved – That, subject to the amendments referred to above, the minutes of the meeting held on 16 October 2023 be confirmed and signed by the Chairman.
WMAS will be in attendance at the meeting to provide further data and narrative around performance, and respond to the Committees questions.
Vivek Khashu, Strategy and Engagement Director, Mark Docherty, Clinical Director, Nick Henry, Paramedic Practice and Patient Safety Director and Murray MacGregor, Communications Director, presented the West Midlands Ambulance Service Performance Update to the Committee.
The Committee received incidents, transport and conveyance data, operational demand and handover delay data and average Category 2 response times.
The Committee noted the following comments and responses to questions:
· The ambulance data incorporated Stoke-on-Trent.
· UHNM was a major trauma centre so response times around the hospital were likely to be lower due to the number of ambulances in and around the hospital.
· Handover delays were a system wide issue and were related to capacity within all parts of the system. More patients were accessing A&E as an alternative to primary care services and the committee discussed the need for more communications to highlight the most appropriate pathway for individuals and care. The West Midlands Ambulance Service (WMAS) had a public health strategy and were working with partners in the ICS. The Committee commented on the role for Public Health and Local Authorities to keep people healthier for longer.
· The ambulance activity was reducing over a sustained period as WMAS had found alternative pathways for patients.
· WMAS were recommending an independent review of the required resourcing to improve performance and present scenarios to WMAS of what the ambulance model could look like across the West Midlands. The last ambulance review in the region was in 2009. The Committee endorsed the proposal for an independent review.
· An ambulance crew would attend 7-8 jobs in a 12-hour period pre-COVID. The current Staffordshire average was 3.2 jobs in a 12-hour period. This was partially due to hospital handover delays; however, the other causes were unknown, and the independent review would identify these causes.
· The Committee noted that patients were triaged on arrival at A&E.
· Concerns were raised around patients who self-presented to hospital when they needed an ambulance but had made the journey independently due to high ambulance wait times. Their condition, particularly if driving, may had put themselves and others at risk.
· In some incidences, Category 2 or 3 calls had become Category 1 calls due to ambulance delays and the patient’s condition had deteriorated.
· Walsall Hospital A&E handover performance was amongst the best in the country as they operated a different handover model within the hospital.
· Frail and elderly people were at risk of significant injury as a result of a fall. The WMAS had been working with the SSOT ICB to get more lifting aids in care homes for patients who had had a fall.
· SSOT ICB had commissioned the fire service to provide a falls service however these schemes were not usually sustainable due to short term funding. The fire service were not CQC registered to provide patient care and without adequate training, a patient risked further injury.
· The Ambulance Service had also changed its guidance on patients who had fallen, where they had previously recommended that those patients did not eat ... view the full minutes text for item 40.