Agenda item

·      To submit a report in relation to the above.

·      To receive a presentation by the Welsh Ambulance Service Trust.

The Chair welcomed Mr Jonathan Sweet, Welsh Ambulance Service NHS – Operations Manager and Mr Stephen Sheldon – Locality Manager to the meeting

Submitted - a report on the relationship between the Welsh Ambulance Services Trust and the Council.

The Operations Manager gave a presentation to the Committee and said that the ambulance service has changed significantly over the years from predominantly a transport service to one which provides clinical care and clinically focused transport service across Wales.  He said that there are 3 ambulance stations on Anglesey with 41 staff.  He further gave statistical information as to the priority of categories of red, amber and green incidents to the Committee.  However, during 2019/20, the pattern of demand for services continues to change, particularly in the ‘red’ demand area which has shown a significant increase; this, together with a range of other factors has led to a deterioration in response times.   He noted that it has been a challenging year across the health system in Wales and since the introduction of the new clinical response model in October 2015, the service’s response to red category calls has fallen below the target of 65% but the ambulance service is working in collaboration with the health boards to address this issue.  However, the service has undertaken action to improve performance and transform the service and in particular to:-

·           Taking a system leadership role in respect of unscheduled care, with support from Welsh Government;

·           Advanced Paramedic Practitioners (APPs) are able to treat patients, without the need for hospital care;

·           Investment in services to support patients who have fallen, or patients who have dementia or mental health;

·           Improved ‘hear to treat’ rates;

·           Continue to work with health boards on referral pathways for a number of conditions, which allows the service to refer to community based services with clinical decision made by a SICAT GP;

·           Increasing the number of staff on shifts during the winter period;

·           Demand and capacity review has addressed roster efficiency.

However, the service is continuing to look at longer term, sustainable solutions to address complex issues.

The Operations Manager further reported that the Welsh Ambulance Service Trust has been working in partnership with the local authority and he referred specifically to the Anglesey Night Owls Services scheme which responded to 115 patients due to ‘falls within the home’ with only 11 patients having to be admitted to hospital.  He noted that there was a scheme, funded by Welsh Government’, with the Fire & Rescue Service assisting the ‘Falls in the Home’ scheme to support the Ambulance Service when the service is under high demand.  However, Welsh Government has ceased the funding towards the ‘Falls in the Home’ scheme but ongoing negotiations are taking place to reinvest in the scheme. 

The Operations Manager referred to the work with the third sector and specifically to the St John’s Ambulance Service in respect of ‘Falls’ response service.  However, the St John’s Ambulance Service are limited with only been able to provide additional resources during peak periods at the weekends across North Wales due to their own capacity issues; negotiations are still ongoing with the St John’s Ambulance Service as to them been able to increase their capacity issues.  The main examples of working in partnership with the County Council was reported as follows:-

·      Support was afforded to the Welsh Ambulance Team during negotiations regarding the proposed Wylfa Newydd project to mitigate the pressure on the service during construction and thereafter;

·      Night Owls scheme – meetings held bi-monthly with the local authority and the Welsh Ambulance Service to discuss opportunities to improve community resilience.  Training is afforded to local authority staff in first aid course to respond to ‘red’ calls and to be able to use community  defibrillators;

·      The work of the Safety Advisory Group and the Local Resilience Forum is paramount to inform the Ambulance Service on activities held on the Island to ensure that if an incident occurs the Ambulance Service can response efficiently to such incidents.  The adverse weather conditions has tested these plans recently with the closure of the Britannia Bridge.

He further said that Welsh Ambulance Service within its Integrated Medium Term Plan for 2021/23 commissioned an Independent Review to address the fall in response time and it has identified that there is a requirement for an additional 537 front-line staff by 2024/25; workforce planning is currently been undertaken to deliver the recommendations within the review.  He noted that there has been challenges in recruiting staff within the rural areas of North Wales and the Ambulance Service is addressing the issue by affording recruitment sessions. 

The Committee considered the information presented and made the following points:-

·      Reference was made to the requirement to increase the number of ambulance staff and appoint additional front line staff by March 2021.  Questions were raised whether it will be a challenge to recruit staff as with other medical professions.  The Operations Manager responded that the Welsh Ambulance Service Trust has made a commitment to increase its workforce with an additional 131 extra staff across the North Wales area by March 2021. A significant proportion of those staff will be Emergency Response Technicians which can be recruited and trained internally by the Ambulance Service.  The recruitment of Paramedics will be more challenging as they will have to be trained through the college systems.  Further questions were raised that whilst the increase of staff within the Ambulance Service is welcomed there is a backlog when patients are transferred to Ysbyty Gwynedd with Ambulance Service staff having to wait for patient to be transferred to the medical staff.  The Operations Manager responded that negotiations are undertaken with the Health Board to have a more efficient transfer process in delivering patients to hospital; the Ambulance Service is trying to treat patients within the home environment and to afford services within the Community;

·      Questions was raised whether the Ambulance Service is robust enough in Anglesey and North Wales to be able to cope with a potential of a serious outbreak of Coronavirus.  The Operations Manager responded that all the Ambulance Service staff have been trained appropriately in the use of protective equipment and deep cleaning processes in place should such an outbreak of Coronavirus occur;

·      Reference was made to the potential traffic congestion issues travelling to the Port of Holyhead on the A55 as a result of Brexit.  Questions were raised as to the potential effect on the Ambulance Service.  The Operations Manager responded that it can be an issue when there are traffic issues on the A55 and delay to the response times can occur;

·      Reference was made to the ‘Falls in the Home’ scheme and the work of the Night Owls team to be able to help people when a fall happens within the home environment.  A Member of the Committee suggested that a leaflet would be advantages to give guidance to people when falls happen at home.  The Operations Manager said that the Ambulance Service attends Community Engagement Events to share the awareness of services provided.  He said that the ‘Galw Gofal’ scheme from the 1^st March, 2020 will be able to transfer calls through the call-line system to the Ambulance Service;

·      Reference was made to the success of the Night Owls service which is provided by the Isle of Anglesey County Council in order to respond to individuals who fall.  Questions were raised as to what other partner projects are in place between the Ambulance Service and the County Council. The Operations Manager responded that to improve the response to ‘red’ call out incidents, especially within rural areas’, discussion have been undertaken with the local authority to use ‘smart phone’ provisions to enable Beach Wardens during the Summer months to be enable have access to Community Defibrillators to attend the scene of accidents that might occur in rural communities.   

The Chair thanked the representatives from the Welsh Ambulance Service Trust for attending the meeting.

It was RESOLVED that the Partnership and Scrutiny Committee receives annual reports on the work of the Welsh Ambulance Service Trust.

ACTION: As noted above.