Agenda item

Resolved: to note the report.

3.1      Graham Norton (Operations Manager, Lewisham, London Ambulance Service) and Kevin Brown (Assistant Director, Operations, London Ambulance Service) provided an update on the performance of the service; the following key points were noted:

• At a previous meeting of the Committee, Members received information about the London Ambulance Service’s (LAS) improvement plans.
• A roster review to ensure adequate staffing cover was completed in September 2014. Work was on-going on implementing improvements to rest breaks; annual leave and active area cover.
• Ambulance crew handovers and waiting times at hospitals had been improved by the implementation of a new policy. Work with the urgent care centre at Lewisham Hospital had also improved.
• The service remained under demand and under pressure. It was on course to receive more than 1.9 million calls this year.
• Changes had been implemented to the control room to allow telephone advice to be given to non-urgent calls and to redirect people with minor injuries to appropriate services.
• Work had taken place with the Metropolitan Police Service to reduce the number of unnecessary calls made for ambulances; this included using fast response vehicles; providing telephone advice and providing access to mental health advice through the call control hub.
• 7.39% of calls from NHS111 had been referred back to the service to provide an ambulance. The service responded to 5299 calls per day. 700 of these were referred to NHS111.
• There was a recognised shortage of staff. The service would be recruiting in Australia and New Zealand to fill vacancies; 250 staff would be recruited by April.
• Plans were being put in place to ensure that new paramedics would be trained. However, it took a minimum of three years to train a paramedic.
• 150 to 180 staff were lost from the service each year.
• There were multiple reasons for the reduction, including, the impact of assaults on staff, housing costs and travel times as well as the high level of demand on the service.
• Fewer recruits felt that being a paramedic was a long term career choice.
• In total 850 to 1000 staff would need to be recruited over the next year to bring the service up to strength and to balance out the number of people leaving.
• Attendance times across London remained close to the national target at 61.75% of priority calls reached within eight minutes, against a target of 75%; in Lewisham the most recent attendance time figure was 64.7%.
• Attendance times had to be viewed in the context of the high levels of demand and the complexity of the urban environment. The service remained close to its maximum levels of utilisation, levels were currently 88%.
• Despite high levels of utilisation, the service had retained high quality standards for treatment of cardiac arrest and stroke.
• Levels of coordination and communication with hospitals and clinical commissioning groups had enhanced good practice.

3.2      Graham Norton (Operations Manager, Lewisham, London Ambulance Service) and Kevin Brown (Assistant Director, Operations, London Ambulance Service) responded to questions from the Committee, the following key points were noted:

• The service continued to work with partners, such as the police to reduce unnecessary calls.
• It also planned to trial new technologies to support patients and aid assessment.
• Call handlers were trained to make critical decisions, with limited information in a short amount of time.
• There was an oversupply of paramedics in Australia and New Zealand.
• The LAS would not drop the standards it expected of employees in order to recruit staff.
• There was no problem with people wanting to become paramedics, but there had been a lack of training places available. It would be three or four years before levels of trainees could catch up with the levels of demand.
• It was difficult to provide a definitive explanation for the yearly increase in calls to the service.
• The population of London was increasing, people were also living longer and people with long term conditions were also living longer in ill health.
• There were a range of factors which predicted rates of survival from cardiac arrest; including better outcomes as a result of changes to CPR and a recent awareness raising campaign.

Resolved: to note the report.