The Role of Ambulance Services in Delivering Closer Collaboration between Emergency Services Inside Government's Blue Light Services Integration Event Yvonne Ormston Chief Executive, North East Ambulance Service NHS FT AACE Board Member
The Ambulance Service in Context Increased demand -15% over 3 years. 10.68 Million 999 calls Reduced performance against national targets Red Rate Travelling time cycle times handover delays at hospital Paramedic shortages Good performance on Quality Indicators (AQIs) Variation in investment by commissioners 10 per head
NAO Report - NHS Ambulance Services January 2017 Demand continues to grow Funding has not matched demand Handover delays ½ million hours lost Progress in delivering new models of care variable Struggling to meet response times Different operating frameworks 999, NHS 111, PTS GP Out of Hours Urgent care Centres Working within an increasingly complex health system
National Audit Office
NHS Direction for Ambulance Services 5 Year Forward View Urgent & Emergency Care Review Sustainability & Transformation Plans See & Convey Hear & Treat See & Treat Treating people at home admissions to hospital Develop Clinical Hubs real and virtual Moving away from traditional see & convey to a mobile community treatment provider
Ambulance Service 2020 and Beyond
Sustainability & Transformation Plans 44 STPs across England Addressing the affordability gap Ambulance Trusts Involved in several STPs Central to acute services reconfiguration & development of out of hospital services to reduce reliance on hospitals Carter efficiencies Back office functions Estate Procurement
Emergency Service Collaboration At a National Level AACE CFOA NPCC Joint Emergency services Interoperability Programme (JESIP) + multi-agency testing Emergency Services Collaboration Working Group (ESCWG) Co-funding a post to support & drive work forward Managing Inter-Service Demand Group Mental Health Co-responding
Managing Demand between Police & Ambulance AACE/NPCC Guidance Document National Governance Local Government SLA s/mou s Reduction of inappropriate demand Improved operational communications Compliance monitoring Local Policy Reviews Non-life threatening Enforced entry (NEAS/Police/Fire) Shared performance data Better intelligence Improvement areas e.g. RTC s Consistent data set agreed - benchmarking
Managing Demand between Police & Ambulance AACE/NPCC Front line support NEAS police support cards Alternative signposting Improved control room liaison Awareness & familiarisation Paramedic in control room THRIVE risk assessment Direct communication with scene ambulance dispatches time spent on scene LAS enhanced triage for MPs calls
Managing Demand between Police & Ambulance AACE/NPCC Joint Responses Police officer & medical practitioner on scene assessment releasing police time (Leicestershire) LAS Joint Response Unit in 10 London Boroughs 3 months responded to 6,500 police incidents 4,700 cancelled DCA s Average response time 5 minutes time spent on scene West Midland Birmingham City Centre Temporary Minor Injuries Unit Many related to weekend alcohol related incidents
Managing Demand between Police & Ambulance AACE/NPCC Mental Health Mental Health Crisis care Concordat S136 Mental Health Act Low clinical priority low priority response National agreement aim to respond within 30 minutes WMAS Street Triage Paramedic / Police / Mental Health Professional response car 3 months 500 calls 60 x S136 avoided 138 requests for DCA avoided Frequent users identified police custody
Consensus Statement Saving Lives and Improving Health & Well- Being AACE / CFOA Working together to enhance lives & increase efficiency Robust governance of standards & competencies Effective co-responder schemes Co-location & shared infrastructure Innovative programmes to improve health & well-being Opportunities to improve efficiencies & effectiveness and reduce waste
Huge number of examples across the country Co-responding Conveyance Public Health Falls Safeguarding / vulnerable people Estate Procurement Fleet Training Shared intelligence Culture / OD e.g. Blue Light MIND campaign
What makes collaboration successful? Strong, open, honest relationships at a senior level Shared vision & alignment with organisational goals Good programme management Good, open communications with staff Fail Fast abandon quickly if need to Not profiting
Thank You And Any Questions?