Presentations/updates by Trust Chief Executive and representative of Community First Responders Team
Minutes:
The Committee considered a presentation/report (Schedule 1 to the signed minutes) of the Chief Executive of West Midlands Ambulance Service University NHS Foundation Trust (WMAS) updating them on the operation of the Community First Responders (CFR) Service in the County. This followed scrutiny of decisions taken by the Trust in April 2020 to make changes to:- (i) vehicles used by CFRs; (ii) range of drugs routinely carried by CFRs in their voluntary capacity and; (iii) training received, and qualifications attained by CRFs, at their meeting in June 2020.
The meeting was attended by Mark Doherty, Director of Nursing and Clinical Commissioning and Vivek Khashu, Strategy and Engagement Director from the Trust together with Paul Sergeant and Jane White from the Staffordshire CFR Team.
The Committee submitted the following questions to the Trust in advance of the meeting to facilitate their key lines of enquiry:-
· “The changes to the Staffordshire CFRs came into place in April 2020, has there been any appreciable change in the level of Staffordshire’s Community First Responders supporting the West Midlands Ambulance Service in the period between April and November”?
· “Are there any surveys undertaken on engagement/volunteer satisfaction and have the results of these changed significantly between April and November”?
· “Have there been any significant changes in the number of hours supported or in the percent of calls that the Staffordshire First Responders have attended”?
· “Is there anything relevant to anyone who might have had their lives and life-chances affected by the implementation of these changes”?
· “Has the development of a Staffordshire Community First Responder training and development plan been created and has this been launched with the Staffordshire Community First Responders”?
· “What is the assessment of the changes implemented from back in April 2020”?
The representatives of Staffordshire CFRs also provided Members with a PowerPoint presentation (slides attached at Appendix A to the signed minutes) which outlined the impact of the above-mentioned changes from their perspective.
During their presentation, the representatives of the Trust provided the Committee with answers to the above-mentioned questions. They said that 37 CFRs had resigned from the scheme since April 2020 for various reasons. However, a further 92 applications from prospective volunteers had been shortlisted for consideration which, if successful, would result in a net increase in operational CFRs in the County. Whilst the Trust had previously undertaken Staff Satisfaction Surveys, these had not included CFRs although they said they had been captured in other consultation and engagement initiatives. They confirmed that volunteer hours provided by CFRs were not currently recorded by the Trust. However, their contributions had provided valuable assistance in meeting and maintaining required service standards. It was expected that a new nationally accredited training and development course for CFRs would be implemented in 2021.
The representatives also outlined the Trust’s response to the 2020 Covid-19 Pandemic which they said had been robust. They spoke of various innovations currently being implemented with the aim of improving healthcare provision, notwithstanding the pandemic, including the use of electric vehicles. However, they referred to serious concerns regarding significant delays in transferring patients from ambulances at acute hospital Trusts, which had arisen since their previous attendance at the Committee.
During their presentation the representatives of the CFRs gave Members background to the operation of the Scheme in Staffordshire including an insight into those who had volunteered. The Scheme had charitable status and raised funds in a variety of ways including sponsorship from local businesses, donations from Parish Councils and other community groups etc. Besides responding to medical emergencies, CFRs work also included checking Community Defibrillators, delivering training and giving demonstrations to community groups. Continuing, they expressed their great disappointment at the lack of consultation by the Trust prior to the changes being implemented and refuted some of the explanations and justifications which had been put forward to the Committee at their meeting in June 2020. They also expressed concern over the long-term impact of the changes on the morale of CFRs and operation of the scheme.
In the full and wide-ranging discussion which ensued, the Trust re-affirmed their firm commitment to the scheme which they said would continue as an integral part of their service to Staffordshire residents. They highlighted their performance against national key indicators which had been maintained notwithstanding the changes and additional pressures arising from the 2020 Covid-19 Pandemic. They explained that the key role of CFRs was to provide a first response to medical emergencies rather than services which would otherwise be provided by fully equipped ambulances crewed by trained paramedics. In response to the concerns expressed both by the Committee and representatives of the CFRs, the Trust sought assistance in compiling evidence/examples of occasions where these standards had been compromised as a result of the above-mentioned changes. They also undertook to provide further detailed performance metrics for rural areas of the County by postcode so that individual Members could be given assurance that their areas had not been adversely affected.
The Trust went onto acknowledge the criticisms expressed by the representatives of CFRs regarding the lack of prior consultation over the above-mentioned changes, which had left volunteers feeing disrespected and devalued. They therefore assured the Committee of their intensions to work towards a more constructive/inclusive relationship with CFRs in the future which included seeking views on a review of their Standard Operating Procedure for deployment. The Committee remained concerned about the apparent lack of dialogue and potential impact on service delivery in the County and offered to facilitate further informal meetings between the parties, as necessary, to cover such matters as training and development and implementation of the Standard Operating Procedure going forward.
The Chairman then thanked the representatives of health for interesting and informative presentations and the opportunity to give meaningful scrutiny to their work for the benefit of residents of the County.
RESOLVED – (a) That the reports/presentations be received and noted.
(b) That Members provide evidence/examples of occasions where required service standards had been compromised as a result of the above-mentioned changes to the Community First Responders (CFR) Scheme and that further scrutiny be given to the matter, as necessary.
(c) That further details of West Midlands Ambulance Service University NHS Foundation Trust’s (WMAS) performance in respect of response times by area be provided to individual Members on request.
(d) That the Trust consider:- (i) including CFRs in future Staff Satisfaction surveys in the interest of inclusivity and; (ii) reviewing the existing four mile radius from incident for deployment of CFRs in their Standard Operating Procedure, following consultation with volunteers.
(e) That the Staffordshire CFRs be thanked on behalf of the Committee for their valuable contribution to the work of the Trust in delivering essential health services to the residents of Staffordshire.
(f) That further informal consultation and engagement meetings between Staffordshire CFRs and WMAS be brokered by the Committee, as required, in order to promote dialogue, co-operation and a more effective working relationship between the parties.