Agenda item

Representatives from East Midlands Ambulance Service will talk about their ‘Being the Best’ consultation.

The Chairman welcomed three representatives from East Midlands Ambulance Service (EMAS) to the meeting:

• Jon Sargent – Director of Finance
• Lynn Rutland – Service Delivery Manager
• Greg Cox – Operational Support Manager, Lincolnshire

Mr Sargent gave a presentation on EMAS’ ‘Being the Best’ consultation. The programme comprised a package of changes in respect of asset management, service provision, deployment and staff management. The document, which constituted an estate strategy comprised changes aimed to make the most of clinical staff and improve performance against key targets.

As part of the consultation, EMAS was talking to patients, the public and stakeholders. Key proposals included replacing 66 ambulance stations with 13 hubs/super stations and introducing 118 Community Ambulance Posts (CAPs). Five hubs were planned for Lincolnshire. The hubs would be the start and end point of the working day, providing a base for vehicle maintenance and the clinical cleaning, stocking and preparing of ambulances; these activities currently carried out by ambulance crews would be undertaken by dedicated staff. There would also be an educational facility, which would replace regional facilities, so that staff could be trained locally. Management/supervisory staff would also be available at hubs to brief and debrief teams as appropriate.

CAPs would replace standby points (points at which ambulances park in laybys, car parks, etc.) All CAPs would include a building which provided facilities for crews to rest. These would either be shared facilities with other local stakeholders, or when this option was not available, modular buildings. The location for CAPs was based on modelling work that identified the best places from which to respond to help EMAS provide a better service.

Councillors were reassured that the number of ambulances and the level of cover would stay the same. Throughout the strategy period, EMAS was working to reduce the age of the fleet from ten years to five years.

Deployment systems were also under review so that callouts received a proportional response appropriate to the incident. This would mean sending the most skilled paramedics to the most serious incidents. Shift patterns would also be staggered so that not all ambulances were off the road for changeover simultaneously.

The model proposed by EMAS had been successfully introduced by West Midlands Ambulance Service who reported good results, and the South Coast Ambulance Service. The model was also used internationally.

So that the feedback of local people could be fully incorporated within detailed proposals, Mr Sargent explained that the consultation was on the broad principles only. When local views had been fed in, more detailed plans would be developed. Consultation had taken a variety of formats which included public meetings, general meetings, media releases, EMAS’ website, social networking sites, free phone and free post. Consultation with staff was also underway.

Mr Sargent advised the Committee that EMAS hoped that all changes could be achieved from within existing resources.

The Committee was advised that proposals would be formally submitted to the EMAS board in January 2013 and changes would be implemented between April 2013 and April 2018. Mr Sargent summarised that by making the changes, EMAS aimed to ensure patients received the right clinical care, response times were improved, the Trust would be the best it could be providing a modern service fit for the future with increased support for staff.

Members of the Committee were invited to ask questions. A summary of discussion is provided below:

• Citing a document produced by Unison one Councillor questioned whether it was correct in stating the future plan was the existing plan. The ‘Being the Best’ programme was not the same as existing arrangements; no current station was big enough to turn into a hub. It was noted that some existing ambulance stations could be turned into community ambulance points.
• The map included in the presentation which showed proposed hubs and CAPs in relation to key road networks did not include the A1. Councillors highlighted the importance of quick access to the A1. CAPs were planned for Stamford and Grantham which would provide this access.
• Ambulances with the most highly trained paramedic staff would be deployed on the same basis as present. Units would go to the nearest call and despatch would be based on priority need.
• While travelling to and from hubs increased the mileage at the start and end of shifts, the number of miles travelled during the day should reduce because of the strategic location of CAPs.
• Local maintenance should ensure that a lower percentage of the ambulance fleet is off the road than under the current provision of two regional garages.
• Rural police stations were suggested as possible CAPs.
• As hubs needed to be eco-friendly, councillors suggested including solar panels and rain reservoirs in designs. It was suggested that the Trust might be able to access grant funding to provide these.
• One councillor and former paramedic commended the proposals and in response to concerns about sufficient cover in the event of a major accident stated that all resources would redeploy to ensure sufficient cover across the whole area.
• Existing arrangements provided for staff to choose whether they were available for call during meal breaks. Negotiations were underway in respect of ongoing arrangements.
• Councillors noted that initial consultation was based on broader principles and computer modelling and were pleased that the input of local stakeholders received through the consultation would define the detail of proposals.
• The location of CAPs was based on modelling. Councillors were assured that decisions would not be based on the re-sale value of the land on which current ambulance stations were sited.
• The full range of hub staff may not be available 24 hours a day however there would be sufficient coverage to allow round the clock operation, which was as efficient for crews as possible.
• EMAS was funded for each journey undertaken; pricing was subject to national rules but based on local prices. EMAS was working with commissioners to try and identify ways in which funding could be increased, particularly in Lincolnshire.
• East Midlands Ambulance Service was running a programme to train people as paramedics. In response to a councillor’s question, officers explained that when former army medics applied and their skills matched, they were appointed as paramedics.
• Councillors expressed concern that in the construction of hubs, improvements to the fleet should remain a top priority. EMAS officers reassured the Committee that continued improvements were planned to the fleet with an annual capital spend of approximately £5m (£4m on ambulances and £1m on IT equipment within ambulances and for despatch purposes). All of the vehicles that the Trust was buying were capable of carrying bariatric patients.
• Concern was expressed about the proposal to locate a CAP in Morton and not Bourne. Councillors highlighted the benefit of using Bourne, noting particularly that it was a growing town with a higher volume of people. They hoped this local knowledge would be used to inform the final location of the CAP. It was also suggested that Grantham would be a more suitable location for a hub than Sleaford.
• The Eastern region was exploring adopting the same model of operation. Both Trusts were liaising with other Ambulance Trusts in the UK, including neighbouring Trusts.

The Chairman thanked the representatives from EMAS for attending the meeting and answering the Committee’s questions.

The meeting was adjourned between 11:43 and 11:55