South East Coast Ambulance Service NHS Foundation Trust. Council of Governors. Friday 28 th September, Epsom Downs Racecourse, Surrey, KT18 5LQ

Transcription

1 South East Coast Ambulance Service NHS Foundation Trust Council of Governors Friday 28 th September, 2012 Epsom Downs Racecourse, Surrey, KT18 5LQ Present: Tony Thorne (TT) Chairman Ian Smith (IS) Public Governor, Surrey (Deputy Lead Governor) Ted Coleman (TC) Public Governor, West Sussex Colin Hall (CH) Public Governor, Medway Paul Jordan (PJ) Public Governor, Surrey Robin Kenworthy (RK) Public Governor, Kent Terry Steeples (TS) Public Governor, East Sussex Nigel Sweet (NS) Staff-Elected Governor (Operational) Marian Trendell (MT) Appointed Governor, Sussex Partnership NHS Foundation Trust Margaret Bridges (MBri) Public Governor, Kent Paul Ellis (PE) Staff-Elected Governor (Operational) Mike Hewgill (MH) Appointed Governor, East Kent Hospitals NHS FT Jean Gaston-Parry (JGP) Public Governor, Brighton and Hove Maggie Fenton (MF) Public Governor, Kent Karen Bryan (KB) Appointed Governor, University of Surrey Angela Rayner (AR) Staff-Elected Governor (Non-Operational) Brian Rockell (BR) Public Governor, East Sussex In attendance: Paul Sutton (PS) Chief Executive Jane Pateman (JP) Medical Director Darren Reynolds (DR) Head of Voluntary Services Janet Cole (JCo) PA support to Paul Jordan Minute Taker: Liz Boocock (LB) Corporate Services Coordinator, Membership & Governor Engagement 39 Chair s introduction 39.1 The Chair welcomed all members to the meeting TT noted that unfortunately some members who had hoped to attend had not been able to do so TT advised that in the coming months, the CoG will interact with the Board on the Trust s Annual Plan for PS is to circulate an update of the strategy before the November meeting; this will Page 1 of 9

2 be discussed at the meeting and the CoG will have the opportunity to provide input to the plan at the January CoG meeting. 40 Apologies for absence 40.1 Apologies were received from: Ken Davies Terry Daubney Paula Parker Alison Arnold Mark Buckton Marjory Broughton Sandra Field Helen Medlock Charlie Doyle Alex Sienkiewicz 41 Declarations of Interest 41.1 There were no declarations of interest. 42 Minutes from the previous meeting and matters arising 42.1 JGP noted that her comment at the last meeting was that time was wasted when a crew arrived at a patient s house and they were not in, rather than that time was wasted when the crew could not find people s houses NS noted that as he listened to the Board earlier, he had been reassured by the level of tenacity Non-Executive Directors (NEDs) exhibited in asking questions and seeking assurance around the issues in the Emergency Operations Centres (EOCs). He noted that under 30.5 (CFR (Community First Responder) report) he would like to see NEDs explore the implications for CFRs in this period where there are staffing difficulties in the EOCs. This related particularly to the need to keep the safety of CFRs in sight. TT advised that PS, Darren Reynolds (Head of Voluntary Services) and CFR team leaders have raised this; further advising that the NEDS will follow it up through the Board. PS noted that this is one of many drivers behind the need to ensure the Trust s call-taking performance gets back quickly to a good level.. 43 Questions from the public 43.1 Question: when a CFR is working in an area by himself/herself, how often does SECAmb stay in touch with them? DR responded that when the CFRs were operational the Trust has EOC staff working to ensure that CFRs are despatched to the right calls. As regards those not signed on, DR advised that local CFR team leaders should stay in touch with their CFRs, and CFRs should raise issues through the team leaders in the first instance, who will escalate things to the Trust if necessary. Page 2 of 9

3 43.2 Question: Will the new Patient Transport Service (PTS) in Surrey be accessible to people with hearing impairments, or problems using the telephone? PS noted that Ted Potage, the questioner, had worked with SECAmb for many years and he emphasised SECAmb s on-going commitment to be accessible to all, and while SECAmb was not responsible for the booking service in Surrey he would be keen to ensure it was accessible. AR reported that she has followed this up with PTS managers and there will be a text SMS service and hopefully text relay. Mr Potage noted that these do not fully cover the various needs people have, but advised that his view is that SECAmb is doing the best it can with the resources available Rodney Ash (public FT member) noted that he is part of a small group looking at aborted and cancelled PTS journeys as it is time lost by SECAmb and costs are incurred. He assured those present that the Patient Transport Bureau is aware of the issues Mr Ash requested that the Trust s press release of 18 th Sept regarding its planning application for Brighton Make Ready Centre in Falmer had implied that all PTS services would move to the Falmer site too. He assumes that this is incorrect but would like clarification. PS advised that Mr Ash should talk to James Kennedy (Director of Finance) who has responsibility for the Make Ready programme, and PS would make the introduction Mr Ash asked about the Trust s position regarding selling Crowborough station and PS responded that this property was on the market and the Trust was currently receiving bids. Mr Ash further enquired about where a Community Response Post would be sited in the area, and asked whether the Trust had considered making use of a tethered car. PS advised that the Trust was looking at what provision would be appropriate for the area Mr Ash advised that on the Trust s website, it is not possible to open the page with details of Sussex governors. PS advised that this will be rectified A husband and wife advised that they wished to pay the Trust a compliment. They had on occasion needed to call the ambulance service and could not speak too highly of the service received. They had experienced a very swift response, and the paramedics were kind and professional. TT thanked them for their compliment and advised that it always good to hear positive feedback and the Trust receives a good number of compliments which are always very well-received by SECAmb staff. 44 Chief Executive s Report 44.1 PS noted that SECAmb is adapting to the requirements of its patients and public, and that not all patients want or need to be transported to hospital. SECAmb has an important job to support those that would rather be treated on scene, or at home. PS noted that there has been an increase in the number of calls received, but the responses (the number of times the ambulance is despatched) have declined because of the Hear and Treat service now offered by the Trust. There has also been a decrease in the volume of patients transported to hospital as the Trust is finding Page 3 of 9

4 appropriate alternative care pathways. PS did note the frustration of crew members where they spend a lot of time responding to patients who do not require care PS noted that handover capture (recording how long clinical handover takes at hospital) has risen to 46% during this quarter, which is an improvement, with more work to do. Important benefits of swift handovers include: patients get fast access to the care they need, they are not left on stretchers for long periods of time, and the Trust is not losing capacity at hospitals but can redeploy those ambulances more effectively PS advised that SECAmb has won the Sussex and Surrey PTS contracts, and Sussex services are now running with Surrey due to start on 1 October. PS noted that there are, as with any big change, some issues including ensuring the correct fleet is available, and these issues will continue to be looked at in order to improve the level of care delivered to patients and the productivity of PTS, if it is to remain competitive and retain the contracts PS noted that the new 111 phone number for non-emergency care is an important system-wide response from the NHS to provide the appropriate response to patients. SECAmb won the regional 111 contract in partnership with Harmoni and is working hard to deliver this, and to hit the tight timescales ready to go live in March Important work continues on the Directory of Services (DoS) which is crucial to enable the effective navigation of patients through to the right service PS advised that unfortunately call answering times at our EOCs had slipped, noting that historically SECAmb s performance has been good. Because answering the call quickly is crucial, action has been taken quickly to mitigate against long waiting times. The Trust is introducing a series of short term remedial measures while it recruits more staff On commissioning, PS provided a summary noting that the Trust is engaging with the Clinical Commissioning Groups (CCGs) that are emerging across the patch, and this remains a key priority moving forward. The Trust will invest time to help educate CCGs about what SECAmb does PS provided a briefing on the Hindhead coach crash some weeks ago, noting that unfortunately there were a number of fatalities, and this became a major incident for SECAmb. There were commendations from external partners, including police and the fire service, on how well SECAmb managed the incident. PS extended his and the Trust s external partners compliments to all staff involved. PS advised that the staff involved have been offered support as it was a potentially affecting incident. TT noted that operational staff have to cope with incidents throughout their career but recognised that the team was tested in an unusual environment and came through very well, demonstrating that there is a real substance to how the team has been trained. The CoG endorsed this, noting it was a job very well done, and agreed it was superbly handled. 45 CE s report questions from CoG Page 4 of 9

5 45.1 IS requested that extra lines be added to the performance dashboard for Hear and Treat, for comparison purposes. TT agreed that this would be done. ACTION: Hear and Treat line to be added to performance dashboard 45.2 BR made an observation on the endorsement just given by CoG regarding the way the Hindhead incident was handled. He noted that governors sometimes feel a little removed from the work of front line crews, and that he had recently been in the EOC where he observed call takers who, he felt, tried extremely hard and did very well. He had also attended the recent survivor event where patients were re-united with the staff who saved their lives. BR noted that this was very positive for both the staff and patients, and commended the Trust for organising the event NS asked whether the staffing problems at EoC were related to the new Red 1 and 2 call categorisation, and questioned whether the drop in meeting response time targets could be connected to the longer times people are waiting for 999 calls to be answered, that is, does the clock for our 8 minute response start when the call is connected or answered? PS advised that NS was correct that the clock for our response time starts when a caller is connected to the service, so it is the case that call waiting times are adversely affecting our response times It was suggested that it may be helpful to compile and compare response rates for Red 1 and 2 calls in different areas of the SECAmb s patch. TT noted that the impact of the new categorisation is something PS and the team are looking into; they will reflect on their findings and bring these to the November meeting of the Council in summary, once they have been presented to the Board. TT noted that it is currently too soon to have definitive answers, and the Trust is unsure what targets the government will set going forward. ACTION: Summary of impacts of Red 1 and 2 to be brought to the CoG in November 45.5 TC asked whether during the major incident at Hindhead, where SECAmb staff did very well, there was any knock-on effect to the service provided elsewhere. He noted that it would have been an opportunity to use CFRs to improve on the response. PS advised that any major incident goes through different phases and that recovery-to-normal included ensuring those on shift all night get a break; the Trust has reported in detail to the Department of Health about this. There are mechanisms in place to mobilize additional staff, and PS will have further talks with DR about mobilising CFRs in major incidents. TT advised he would bring a response on this to the next meeting. PS noted that SECAmb has a track record of mobilising CFRs e.g. during recent bad weather when crews could not get to patients in some areas and CFRs living in those areas were able to respond. ACTION: Response to question about CFRs responding during major incidents to be brought to November CoG Page 5 of 9

6 45.6 MH commented on Hear and Treat and See and Treat and their impact on acute (hospital) services, noting that this area of the health economy is seeing an increase in demand. MH asked if it was worth feeding this back to commissioners, noting that resources are available to adapt to the changing environment. PS advised that this work was underway PE highlighted a challenge that crews face with GP admissions. He noted that crews often feel unable to challenge GPs about taking patients to hospital, even where it seems clear that transport is not the best pathway for a patient. PS advised that the Trust increasingly tries to triage patients at the point of call, but it is quite a delicate issue and the Trust is talking with the CCGs about ways to safely change the current system. The Trust faces a similar challenge with referrals from nursing homes. Analysis is being undertaken in Sussex to understand the issues, which should then give transferable data on issues across the patch. PS noted that in Sussex in particular a lot of work needs to be done to help motivate GPs to avoid unnecessary admissions. 46 Meeting arrangements going forwards 46.1 TT reminded the Council of the decision to move to separate Board and Council meetings dates to enable both meetings to have the time to effectively operate. He advised that public CoG dates for the remaining months of this financial year will remain unchanged, and going forward next year s dates are as near as possible to this year s. TT reiterated the Trust s commitment to ensure the continued interaction between the Board and CoG and to ask NEDs, Committee leads and appropriate executives to attend CoG meetings throughout the year TC reported that he had recently attended the Audit Committee as an observer and found it informative, noting that governors should attend other Board Committees. TT confirmed that a programme will be established for Council members to observe board committee in action; the first was the audit committee. In setting the programme it was essential to get a balance between the council gaining an understanding of how committees functioned and committees continuing to feel free to engage in tough debate and address gritty issues. TT noted that if there were concerns about activity or functioning of Committees, the relevant NED or Committee lead would be invited to the CoG meetings. TC noted that this sounds a useful process. 47 Governor activities 47.1 IS thanked the members of the public who had come today, and thanked the CoG members for all the time they have put in attending a variety of events throughout the year, and recruiting members. He noted that the Council had helped to construct the content of the Deputy Lead Governor s report to be given at the AGM PS noted that the governor activity table presented should include the fact that MB had attended the Foundation Council. RK had also attended some events not captured on the table, as had TT. Governors were reminded that they should fill in the governor activities form online to record their activity. Page 6 of 9

7 47.3 RK wished to record that CFRs have done a wonderful job at a number of events this year DR noted that CFRs had informed his team that they wanted to see a dashboard of their own performance, so it would be reflected in the wider SECAmb programme IS noted the need to record thanks to the Surrey Retirement Association for their support at several events throughout the year. 48 Governor Development Working Group 48.1 MBri thanked members for noting the report and minutes of the last GDWG which had been circulated in advance. MBri reported that the group had had initial concerns around the assurance process once the Board and CoG meetings moved to separate meeting dates, but that these had now been partially allayed. She advised that the existing two-way communication between Board and Council should be maintained under the new arrangements MBri advised that the GDWG had now been in place for more than a year, and as part of the agreed process for all Committees of the CoG to look at their own effectiveness and performance, MBri and IA are developing a template to facilitate the review, which will be tested by the GWDG before rolling out to other Committees, if they wish to use it TT noted the intention to report back in November regarding each Committee s assessment of their own performance and membership, and advised that the Nominations Committee had already undertaken its own review, the results of which would be reported at the next meeting. 49 Membership Development Committee 49.1 AR thanked members for noting the comprehensive report of the activities of the Committee It was confirmed that CFRs and volunteer car drivers would now be opted into membership, and this would mean an increase in membership numbers and it afford volunteers the opportunity to get involved in the Trust in other ways AR noted that the MDC had provided scrutiny on the process of appointing members of the public and key stakeholder organisations to the Trust s Inclusion Hub Advisory Group (IHAG), which is a diverse and enthusiastic group. There had been twice as many applicants as posts available. AR thanked the MDC for their hard work in completing this task AR reported that all IHAG applicants had been contacted, and those who were unsuccessful had been encouraged to stay involved. Rodney Ash commented that he had not received any contact from the Trust regarding his application and AR committed to investigate and apologised if this was the case. Page 7 of 9

8 49.5 AR advised that the MDC had helped design the governors stall in the exhibition space and reminded those present in the audience to take the opportunity to talk to governors at the stall at the AGM. 50 Questions from the public 50.1 Question: Does SECAmb collate statistics on mental health and the use of mental health pathways? It would be good to see statistics about this PS reported that over the past few years, SECAmb has undertaken work in Surrey looking at patient care records to identify the types of mental health conditions that typically present through the 999 system. This information will guide decisions about the additional training given to Paramedic Practitioners and Critical Care Paramedics, that is, what competencies should front line staff have in order to undertake an appropriate assessment of patients with mental health issues being conveyed to hospitals by SECAmb? 50.3 PS advised that recording mental health activity has been a challenge for the Trust. Jane Pateman (Medical Director) noted that it is a particular challenge for 999 call takers to identify a mental health call. She advised that SECAmb would like to improve the quality of its records to enable the Trust to identify frequent callers to 999 who may have mental health issues. This would enable patients with known mental health needs and care packages to be identified to crews, aiding our staff in choosing the best pathways for these patients MT noted that she is happy to work with the team on taking this work forward, and would be happy to meet with public members who have an interest in this issue RK noted that the newly acquired PTS contracts mean the Trust will receive an increased frequency of calls from mental health patients. It would be important that PTS crews also have the ability and skills to provide appropriate care RK noted that he was pleased that SECAmb had won the PTS contract in Surrey. He advised that SECAmb had now won a lot of commissions in the South East Coast area and asked if SECAmb had the required flexibility to deliver these services. PS responded that the Directory of Service will allow SECAmb to access all the urgent/unscheduled services across the patch and signpost this simply to the public. He noted that SECAmb will work with CCGs and be instrumental in supplying a blended response. TT noted that it was for this reason that PS, the Board, and the Council were keen on SECAmb delivering the 111 service There was discussion about whether dementia should be classified as a mental health issue. It was suggested that the Trust should work closely with the Alzheimer s Society and utilise their crisis line. Page 8 of 9

9 51 Review of meeting effectiveness and AOB 51.1 TT thanked the CoG for their hard work throughout the year, and in the absence of any other business, closed the meeting The next meeting will be held on 28 th November, 2012, at the Salomons (Walter Nunn Room), Canterbury Christ Church University, TN3 0TG. Page 9 of 9