Agenda item

Winter pressures and preparations

Minutes:

The Chair welcomed Peter Mulcahy QAM, Head of the Paramedic Emergency Service, from the North West Ambulance Service (NWAS) who gave a presentation highlighting the pressures they would face and the preparations they had made in readiness for the forthcoming winter season.

 

It was reported that winter planning was a Department of Health directive which commenced during the summer months. NWAS was also accountable to the commissioners – Blackpool Clinical Commissioning Group (CCG). Some of the preparations not referenced in the PowerPoint slides included:

·  From the 1st December 2017, a command structure (senior managers) in place both in and out of hours;

·  Liaison officers based in hospitals to ensure smooth handover of patients;

·  St John's Ambulance and other third party providers in place to support;

·  The fleet service having their own plan for maintaining emergency vehicles; and

·  Audit teams in place to monitor 999 calls.

 

On 999 calls, it was reported that patients with mental health problems were known to take up considerable time with call handlers. It was acknowledged that NWAS was not the expert on mental health and was working with Lancashire Care Foundation Trust (LCFT) to employ appropriately trained people to work in call centres to field these calls.

 

The Committee was also informed that Hazardous Area Response Teams (HART) from Manchester and Liverpool would be called upon to support the rest of the NWAS region.

 

Each year NWAS developed a Strategic Winter Capacity Plan for its entire region and a Local Winter Plan for each area including Lancashire and Cumbria. Planning would be continuous up to and throughout the winter season with regular meetings to ensure that focus was maintained. NWAS covered the five counties of Lancashire, Cumbria, Greater Manchester, Merseyside and Cheshire. The benefit of having a plan that covered five counties was that resources from one county could be used in another.

 

Some paramedics were placed in the Emergency Control Centre as support call takers to advise on the most appropriate treatment. The Police would also work in the control room on key dates.

 

Regarding their communications strategy, NWAS would be supporting the national Stay Well This Winter campaign providing information locally and assisting partner organisations in spreading the messages.

 

The Committee was informed that over the festive period during 2016/17, emergency calls had increased by 24% with approximately 180 calls received per hour over New Year's Eve and New Year's Day. Over the December period NWAS had dealt with on average 150 calls per hour. The Committee expressed concern at the amount of resources used during this period and that the main cause of this increase related to incidents involving alcohol.  Communication from NWAS and NHS partners would focus on this aspect in the run up to the Christmas period. It was suggested that the County Council's Communications Team assist the implementation of the NWAS communication strategy. Members were also reminded of the benefits in utilising social media to help spread the message.

 

In terms of winter planning for care homes, it was reported that NWAS responded to a considerable number of call outs. NWAS was currently visiting care homes throughout the region, training staff on making better assessments of the patient's needs.

 

Members were informed that flu jabs were now available from NWAS staff. Last year, 62% of staff at NWAS took up the flu jab.

 

One member sought assurance that planning was sufficient and implementable if there was a bad winter. Members were reassured by NWAS that there were no gaps in their system. However, NWAS could not guarantee that ambulances would not be delayed in respect of any increase in Delayed Transfers of Care within the hospitals. It was reported that interaction between the hospitals and NWAS was good.

 

Regarding vacancies NWAS would nearly be at full establishment by the end of December. It was noted that the service did not actively seek recruitment of staff externally or from overseas. However, it was noted that the Polish paramedic qualification was akin to the UK qualification. NWAS had also worked with the University of Central Lancashire and the University of Cumbria on the creation of paramedic courses for staff to attend on a day release basis.

 

As part of the budget process a contingency fund was specifically set aside for winter to cover for additional vehicles, etc. Additional funding was also provided either nationally from the Department of Health or locally from the commissioners during the winter season.

 

The Committee was informed that Lancashire had a Local Health Resilience Partnership which scrutinised all Lancashire hospitals' plans regarding their periods of most activity.

 

Members asked if the potential impact of flooding formed a part of winter planning for NWAS. The NWAS had a Generic Major Incident Plan with flood plans rolled out across the County through the Local Resilience Forum. It was also noted that NWAS had a good working relationship with Highways England.

 

With regard to the NHS Five Year Forward View and the Sustainability and Transformation Partnerships, it was explained that in the future there would be less ambulances and more appropriate care for the patient at the front end of the journey. Emphasis was also being placed on health prevention and promotion, interfacility transfers and how the service worked with health care professionals. NWAS was also looking to increase capacity in their contact centres over the next few years.

 

Resolved: That;

 

  i.  The Committee welcomed the North West Ambulance Service was meeting its recruitment targets;

  ii.  The County Council's Communications Team be recommended to assist the North West Ambulance Service on the implementation of their communications strategy for the forthcoming winter season; and

  iii.  A site visit to North West Ambulance Service's regional headquarters be arranged for members of the Committee to attend.

 

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