Decision details

To receive a lessons learnt report from the London Ambulance Service on queues from the Royal Free and Barnet and Chase Farm.

The Chairman introduced the report which provided the Committee with an update from the London Ambulance Service NHS Trust covering the following:

·         The staffing position and delivery of performance of the Trust.

·         An overview of activities taken to improve response times through better staffing levels.

·         Staffing matters.

·         How the Trust is modernising to improve the care delivered to patients.

·         How the Trust is educating people to use appropriate care pathways

The Chairman invited Paul Gates, the Deputy Director of Operations at the London Ambulance Service NHS Foundation Trust to the table.

Mr. Gates advised the Committee that in Barnet the Trust had seen a 7% increase in the number of category A (most seriously ill and injured) calls responded to, when comparing the period 1^st April to 26^th September of both 2013 and 2014.  The number of calls from 1 April to 26 September 2014 was 8129, an increase from 7602 for the same period in 2013. The Committee noted that the delivery of the Category A target of 75% within 8 minutes was a significant challenge for the service in Barnet and the Trust as a whole.

The Committee noted that North Central London had had 21 members of staff leave within the period April to September 2014 and that of those 21, 19 were Paramedics. The Committee noted that the attrition rate had improved significantly from the same period last year when 56 staff had left.

Mr. Gates advised the Committee that London was one of the busiest Ambulance Areas, with the utilisation rate of London at 80 – 95% compared to that nationally of 60-65%.

Responding to a question from a Member, Mr. Gates advised the Committee that the term “Category A” referred to the most dangerously affected patients and could include for example cardiac arrest or difficult breathing. 

A Member questioned if the number of staff leaving the Trust was to do with pay and questioned if the Trust had lobbied the Government on the matter.  Mr. Gates advised that pay was certainly an issue.    

A Member questioned if the Trust had looked overseas to recruit.  Mr. Gates advised that whilst there was a shortage of graduates in the UK, there was a surplus in Australia and New Zealand and that the Trust was looking to make links with universities in those countries.  Denmark was also mentioned as a country which had similar training to the UK and was therefore a compatible recruiting area. 

Responding to a question from a Member, Mr. Gates advised that care homes were the biggest user of ambulances. 

A Member questioned if there were still issues around keeping ambulances well equipped.  Mr. Gates advised that the Trust had a fleet plan and that there would be new ambulances.

The Chairman noted that the North Central London Joint Health Overview and Scrutiny Committee had been advised that, as well as the elderly, a large number of people aged between 29 – 35 years were using ambulances and, when questioned why this was, Mr. Gates advised that a large proportion of these cases were alcohol related.

The Chairmen questioned how the London Ambulance Service found accessibility to A&E once they had arrived at a hospital and noted that she had heard reports that ambulances had to ring a bell and wait for up to 20 minutes to be let in at the Royal Free.

Mr. Gates advised that he had not been made aware of a 20 minute wait at the Royal Free and noted that the time taken for an ambulance to unload would be determined by the volume on the day.  Mr. Gates also commented on the importance of ensuring that the patient went to the correct department for their care.

A Member requested to be provided with the figures on the use of private versus locum ambulances in Barnet.

RESOVLED that:-

1)    The Committee note the report

2)    The Committee request to be provided with figures showing the use of private versus locum ambulances in Barnet.