EMRTS DELIVERY ASSURANCE GROUP

Transcription

1 2.3.2 Appendix 2 EMRTS DELIVERY ASSURANCE GROUP ACTION NOTES OF THE MEETING HELD ON WEDNESDAY, 7 TH SEPTEMBER, 2016 IN SEMINAR ROOM 5, MPEC, PRINCESS OF WALES HOSPITAL, BRIDGEND PRESENT: VC: Stephen Harrhy, Chief Ambulance Services Commissioner, EASC (Chair) Colin Eaketts, Welsh Government (CE) Dindi Gill, Interim EMRTS National Director (DG) Hamish Laing, Medical Director, ABM UHB (HL) Mark Winter, EMRTS Service Manager (MW) Matthew Edwards, EMRTS Programme Manager (ME) Rachael Edwards, Head of Operations - Clinical Contact Centres, WAST (RE) Karen Preece, Asst Medical Director, HDda UHB (KP) Wendy Warren, Head of Planning - Civil Contingencies, AB UHB (WW) Meinir Williams, Hospital Director, BC UHB (MWi) IN ATTENDANCE: Prof Ronan Lyons, Swansea University (RL) Professor Belinda Gabbe, Head of Pre-hospital, Emergency and Trauma Research, School of Public Health and Preventive Medicine, Monash University, Melbourne (BG) 1 Welcome and Introductions The Chair welcomed attendees to the EMRTS Delivery Assurance Group and facilitated the necessary introductions. 2 Apologies for Absence Apologies for absence were received from Alice Casey, Bob Hudson, Angela Hughes, Kath McGrath, Nicola Prygodzicz, David Rawlinson and Eifion Williams. 3 Minutes of Previous Meeting These were agreed as a true and accurate record. 4 Matters Arising There were no matters arising. 1

2 5 Log ME outlined outstanding actions that are not part of the agenda for today s meeting, these included: 0616/02 Chair & ME to prepare a starter for ten agenda plan and circulate to the group 0616/06 EMRTS Organisational Structure to be reviewed at December DAG meeting 0616/09 Search & Rescue (SAR) and Helimed 61 (Caernarfon) data to be included in subsequent EMRTS Governance Reports 0616/18 ME suggested that the Risk Register is coded as RED and needs to be updated to reflect the current position of all risks for consideration at the next DAG meeting ME 6 Independent Service Evaluation Professor Lyons provided a presentation on the Independent Evaluation. The group was reminded that: this is an independent 3 year evaluation the Year 1 report has been circulated for comment with a view to finalising this in the next month the evaluation was commissioned as per condition of WG funding approval the evaluation is funded as part of BJC the evaluation report will feed into the WG Gateway Review report has been refined based on feedback received including executive summary and un-met need section Year 1 has focussed on putting datasets in place, ongoing data flows and setting the stage for ongoing work in Years 2 & 3 A discussion was then held, discussion points included: activity has delivered against the activity targets set out in business case process those that were part of the business case process were commended for this in terms of activity levels to date, it was felt that the awareness of the service has now raised and that this would have a positive impact on activity levels in subsequent years whilst total data included all EMRTS patient contacts, the graphs only included those conveyed by EMRTS (air or road) on a neonatal aspect, this service had been started at a later date and this is reflected in neonatal activity levels the need to build a safe sustainable service on a 24 hour basis and how this debate would take place the need to understand what is within the scope of the report and 2

3 what is not the need to ensure that the independence of the evaluation is retained throughout the whole evaluation period to understand if the best use is being made of the resources available to the service to note the parameters that exist weather conditions, flying times do aircraft and RRVs need to be based in the same place? going forward the commissioning model cannot be guided by what was included in the specification included in the BJC but needs to reflect the future direction of the service the need to quantify the early intervention by EMRTS and patient conveyance directly to most appropriate specialist unit, this to include the non-nhs cost The Chair summarised the discussion and: thanked Professor Lyons for leading this evaluation agreed the need to discuss the resource required to complete this work commended the service for its work in the first year noted that further comments were still to be received stressed the need to retain the independence of the evaluation commented that the collaborative commissioning approach will be of significant importance going forward indicated that in the areas where things can be improved, these opportunities are maximised and are built into the commissioning framework noted the need for further discussions around equity, what are the choices, what are the associated benefits and risks? Colin and Ronan agreed to meet to consider any comments from WG. The following timetable was agreed in terms of finalising and circulating the Year 1 Evaluation Report: 1. 7 th Sept DAG to consider initial report 2. 21/22 nd Sept Chair to report to EASC Committee Meeting 3. Finalise Evaluation Report 4. Report and key findings sent to Cabinet Secretary 5. Date TBC Gateway Review 6. Early October Publicity and circulation of Evaluation Report In terms of WG Gateway Review, the Chair and CE advised that they would be meeting on Thursday 8 th September to discuss these arrangements. It 3

4 was agreed that it would be helpful if the Gateway Review report provided a clear steer around the process ahead in terms of expansion. It was agreed that the Chair would be SRO for the Gateway Review and would be required to take Chair s action outside of DAG meetings, this will be handled appropriately e.g. via where comments are required. 7 Revised Draft Terms of Reference ME explained that changes made following discussion at the last meeting included: Changing the name of the DAG to reflect the commissioning role of the group Reflecting EASC as the new commissioner Ensuring relationships with relevant collaboratives and networks Updating membership details The latest version was not available, ME agreed to circulate to DAG members following this meeting. ME 8 National Director Role HL reminded the group that a discussion had taken place on the proposed recruitment process for the position of EMRTS National Director, these comments have now been addressed and approval was requested from the DAG to proceed to advert. It was noted that the post is being advertised with very flexible employment terms to make it of interest to a wide range of applicants, not just from within Wales. The post to be advertised as a secondment basis for up to 3 years. The DAG provided approval to proceed to advert. HL 9 EMRTS Annual Report DG advised that the National Report is available bilingually and: summarises the services offered by EMRTS focuses on the organisational and clinical governance structure confirms the favourable financial position at end of year 1 provides some key headline data defines some of the success of the first year DG commented that positive feedback had been received in terms of layout and structure from outside of the service, including other retrieval services. 4

5 The EMRTS s first Annual Report was noted by the Group. 10 North Wales AA Implementation Group MWi provided an update on the establishment of a multi-agency group in North Wales to: discuss the current position at the Caernarfon base and to address any immediate concerns consider longer term options for the future of the service ensure all options are mutually beneficial for all stakeholders recognise and strengthen aspects of the service model that already work well It was noted that: the Chair has met with the Clinical Lead for the Caernarfon base, Dr John Glen the group is being established with representatives from Betsi Cadwaldr UHB, WAST, WAACT and EMRTS a pre-meet with WAST colleagues is taking place Monday 12 th September meetings of the NW AA Implementation Group have been scheduled to Dec 2016, further meetings to be arranged in to 2017 the first meeting to take place 29 th September 2016 with the Chair keen to understand the governance arrangements as they currently stand work will be required to understand the unmet need, including to ensure that SAR and Helimed 61 data is included in any gap analysis undertaken. It was agreed that there is a need to share the Independent Service Evaluation with members of this group when available. ME Academic and Public Health Wales input is required here and this will now be considered further. An update will be provided at the next meeting of the DAG. MWi MWi 11 4 th Aircraft Helimed 67 As agreed at the DAG meeting held 2 nd June, the proposal for the fourth aircraft has been circulated to group members along with a draft evaluation criteria. 5

6 The proposal outlines key principles of the feasibility study that will take place until end of December 2016, these include: Operational hours Monday to Thursday Helicopter, pilot and CCP costs funded by the WAACT Charity Tasking of the aircraft via the Air Support Desk Guided by operational SOP and supported by EMRTS Top Cover Consultant Tuesdays and Wednesdays utilised for training and public relations Clinical governance for neonates and paediatrics remains with the transporting team Comments are requested on the draft evaluation criteria, this will now be circulated to the stakeholders identified within for their comment - to ensure the data captured allows robust evaluation following this study period. ALL A letter of support has been received from WHSSC and MOUs have been signed by the WATCh paediatric transfer and North Wales Neonatal Transport teams to participate in this study. It is hoped that CHANTS South Wales also sign the MOU over coming days. Meetings are now required with stakeholders to consider the sustainability of this service going forward. ME This development was noted and approved by the Group. 12 PHEM Car Update DG reported that: the PHEM car was part of the supervised training for the x2 PHEM trainees this service operated throughout May and June on a Friday and Saturday between exposure was less than anticipated throughout this period there was a high stand down rate a report is being prepared and this will included feedback from the trainees A discussion was held on the use of the PHEM car next year. It was agreed there is a need to understand and evaluate pre hospital critical care in the area. 13 Collaborative Commissioning 6

7 It was agreed that the next meeting of the DAG would focus on agreeing a collaborative commissioning framework. Further thought would now be given to this and shared with the group to ensure that colleagues are in a position to attend in person and contribute to this work. Chair/DG/ME The Chair confirmed that this would focus on outcomes-based commissioning. 14 Wales Air Ambulance Charity Angela was unable to attend this meeting and would provide an update at the next meeting of the group. 15 End of Year Finance Report The enclosed finance report as at the end of month 4 (July 2016) and budget plan for 2016/2017 were considered. The group approved and noted: the revenue financial position as at 31/07/16 the budget plan for 2016/2017 and the use of non-recurrent carry forward surplus from 2015/16 of 169k included in the plan the cost avoidance and recovery actions included in the financial plan for 2016/17 16 Any Other Business HL noted that the interim National Directors Dr Rhys Thomas and Dr Dinendra Gill had undertaken this role on a job share basis to date. Dr Thomas has now accepted a substantive Consultant Anaesthetist position with Hywel Dda UHB. Dr Gill has kindly agreed to undertake the role of interim National Director until the substantive National Director appointment is made. The Chair placed the Group s thanks to Dr Thomas on record, and expressed gratitude to Dr Gill for his additional commitment to the service during this period until the substantive appointment. The following attachments were noted by the group for information: Legacy Report prepared by WHSSC DAG Decision Log Letter prepared by Dr John Glen relating to EMRTS neonatal response Paper prepared by Dr Dindi Gill regarding Masters in Critical Care at Cardiff University 7

8 Clinical Database Update EMRTS Governance Report Quarter /17 17 Date of Next Meeting: 2pm, Tuesday 6 th December 2016 at Wales Air Ambulance Charity HQ, Dafen, Llanelli, SA14 8LQ 8