Agenda item

The Panel was provided with a report and brief presentation that updated them on the new Hub and Spoke model of the Yorkshire Ambulance Service NHS Trust.  The report and presentation covered the following areas;

·             The new hub and spoke model.

·             What future impact/benefits the new model will have.

·             Information on handovers of patients from ambulances to emergency departments.

The Panel requested that the presentation be circulated to Panel Members following the meeting.

There was a discussion held and the following issues were raised;

New Hub and Spoke Model – A Member commented that the new model looked workable and practical.  It was noted that response times were good and with further investment into the new Hub and Spoke model, there would be additional staffing and vehicles.

Recruitment and Staffing – Members were advised that the challenge when recruiting staff, was being reliant on individuals being educated to degree level through the University.  Members were assured that this was being addressed by developing an internal programme to upskill staff already recruited into positions within the service.  It was recognised that recruiting staff was therefore a challenge and efforts were being made to attract people into ambulance assistant roles through to paramedic and specialist paramedic and finally advanced practitioners. It was explained that 192 paramedics were required across Yorkshire and the Humber, in order to reach the desired level of staffing.

Members were advised that, at present, the use of prescribing  paramedics was in its infancy.  It was explained that there was a great deal of work taking place to broaden the scope of the role to ensure that patients were in the right place at the right time and receiving appropriate care.

It was noted that the Yorkshire Ambulance Service had previously worked with the armed forces (Catterick Garrison) although acknowledged that the skill set of military medics was slightly different between the roles (although the level of care was still there). 

Resources - Members were informed that resources were often despatched outside of the area when work was dynamically deployed.  It was explained that the new operating model and investment made, would enable the service to have the right level of resource in the right place with better planning, in particular, with more specialised types of care for patients suffering from conditions such as stroke and heart attacks.

Use of Ambulances - It was clarified that there could be up to 10 ambulances waiting outside Doncaster Royal Infirmary (DRI) although not all were necessarily Doncaster-based ambulances.  It was explained that some ambulance were from other areas which was unavoidable (with up to 16 ambulances during the day).  It was recognised that this figure had increased over the last 12 months, with 3 additional ambulances compared to a year ago. 

Hyper Acute Stroke - In terms of Hyper Acute Stroke, it was explained that there were pathways that provided direct access into specific hospital services.  It was explained that access was in the right areas and the direct line facility in place was good.

Hospital Turnaround at DRI – Members expressed deep concerns in the information presented which included:

·         Conveyance Demand

·         Average Turnaround

·         % handovers under 15 minutes

As part of the discussion, it was recognised that similar issues were being faced nationally, and that Doncaster Royal Infirmary (DRI) was not alone in this.  It was explained how delays were a symptom of a wider system issue that could potentially work more effectively.  It was added that a greater understanding of that system was needed and specific challenges were being faced by DRI.  It was hoped that more could be done to identify and influence a more effective way of working with system partners to resolve those issues faced.  It was commented that some hospitals were able to deal with this issue better than others.

Members agreed to write a letter of concern to Jackie Pederson, Chief Officer of the Doncaster Clinical Commissioning Group in her capacity as co-chair of the Accident and Emergency Delivery Board.

RESOLVED that the Panel;

      i.        Note the report; and

    ii.        Send a letter expressing their concern Hospital Turnaround at Doncaster Royal Infirmary (DRI)  to Jackie Pederson, Chief Officer of the Doncaster Clinical Commissioning Group in her capacity as Co-Chair of the Doncaster and Bassetlaw Accident and Emergency Delivery Board