Agenda item

Kevin Brown, Assistant Director Operations for South London and Keith Miller, Ambulance Operations Manager at Waterloo.

Evidence is being taken to inform the ongoing review: Access to Health Services in Southwark.

8.1  The chair invited representatives from the London Ambulance Service (LAS) to introduce themselves; Kevin Brown, Assistant Director Operations for South London and Keith Miller, Ambulance Operations Manager at Waterloo.

8.2  The LAS representatives referred to the report circulated and gave a brief overview of the service. They explained that calls have been increasing by about 3 %, year on year. LAS have a business target for 75% of category A call outs to be met within 8 minutes, and 95% in 19 minutes. In Southwark 76% of category A calls outs were met in November.

8.3  The chair invited questions and a member asked  LAC about the different categories and the response times and the Director explained that Category A is reserved for the most serious critical life threatening incidents; there are also categories C1, C2, C3 & C4 . The service has a fast responder pathfinder which is about safely leaving people at home.

8.4  LAS were then asked about the calls out for older people, particularly given the evidence that there is an increase in acutely unwell older people arriving at A & E.  LAS responded that demand is going up across the board by between 3-5%, and the service is seeing a greater number of older people. Members asked why; but LAS did not feel able to explain the reasons of the increase in the  number of older people, but they did comment that the festive season added to the rise in the number of younger people seen. A member asked if this was linked to drug and alcohol and commented that she had spent time on a shift with an ambulance crew and observed that this was a huge pressure. LAS reported it was a pressure and  that previously the service was funded for an additional service in Soho over the festive period, but not this year.

8.5  A member asked about the general rise in demand. LAS commented it was difficult to know why; around half of patients are not being taken to A & E.  Sometimes people are dialing 999 because they don't know what to do and don't know how to access help and support; and this could be related to increased social isolation and lack of community and family support.  There is also a cultural change, whereas people used to ensure their drunk friends got home safely - now people get abandoned by their companions. LAS also added that unfortunately 999 campaigns to increase appropriate use actually increase demand, rather than decrease.  There is a centrally based communication team which goes out schools to promote awareness of the service.

8.6  A member commented that theses are cash strapped times, and suggested that the service might ask patients to make a financial contribution to their care, for example if they needed to receive rehydration treatment for alcohol poisoning. LAS responded that the NHS guiding principle is that care is free at the point of access. A member asked if institutions could be asked to pay.

8.7  LAS were then asked about reports of ambulances queuing at hospitals. They explained that LAS monitor ambulance queue times; there is a system to look at timings. There are also new penalties for handover breaches. For example the chief executive has to be involved and a serious incident declared if there are serious delays. LAS have a new flow business tool to manage the system,  which is improving performance.

8.8  A member asked if there had been an increase in category A calls out and LAS said that these are up by 20%, but the service does not know why. A member suggested this might be caused by drug and alcohol abuse, however LAS representatives said these incidents are not showing an increase, and most incidents on the increase are coding ‘unknown’. LAS said it would be possible to analyze this trend, and that they are able to provide data at a postcode level for Southwark & Lambeth.   

8.1  A member asked about the modernization and collaboration improvement process and the Director said that LAS has to become more efficient given increased demand and constrained resources. The service is now sending cars and motorbikes out to incidents  and there have been changes to shift times and annual leave to increase capacity. He reported that there is a shift of demand towards later activity in afternoons,  and even the middle of the night , -  the service is adapting capacity to meet this need. LAS are also working with firefighters, who are able to respond to cardiac arrests.