Agenda item

The Chairman welcomed representatives from East Midlands Ambulance Service (EMAS) who gave councillors a presentation on their ‘Being the Best’ programme:

• Andrew Spice – Commercial Director
• Greg Cox – Service Delivery Manager – Lincolnshire
• Steve Illingworth – Operational Support Manager – Lincolnshire

Mr Spice provided a contextual overview of the service EMAS provided; it covered the whole of the East Midlands region and received approximately three-quarters of a million calls annually. Approximately 600,000 calls required the service to send staff out, either in a fast response vehicle, motorbike or double-crewed ambulance. The number of calls was increasing each year by approximately 5% to 7%.

The ‘Being the Best’ programme comprised a package of changes in respect of asset management, service provision, deployment and staff management. The consultation document on which the presentation was based, constituted an estate strategy which comprised changes aimed at making the most of clinical staff and improving performance against key targets.

Representatives reported that the service did receive some complaints, the majority of which were in respect of response times rather than the quality of care given. EMAS had a number of performance indicators it was required to meet including two key indicators relating to response times: A8 (reach 75% of all life-threatening calls in 8 minutes or less) and A19 (get an ambulance to transport a patient to hospital, on scene within 95% of all cases within 19 minutes). In September 2012 neither target was achieved in Lincolnshire (73.89% and 88% respectively); cumulative performance between April 2012 and September 2012 also fell below target levels (74.88 and 89.53% respectively). Below these performance indicators were a number of targets that measured the quality of service.

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. Local knowledge was helping inform the exact location of the CAPs.

The model proposed by EMAS had been successfully introduced by West Midlands Ambulance Service and the South Coast Ambulance Service who were two of the best performing services in the country.

The Council was advised that proposals would be formally submitted to the EMAS board in January 2013 and changes would be implemented over a five year period beginning at April 2013. Mr Spice informed Councillors that there would be no change to the level of cover provided within the district and investment would be made to the fleet. He added that the proposed changes were not designed to cut costs but drive improvements to services.

Several Members referred to a number of different consultation events that had been held within the district at which strong feelings were expressed by local residents, and the meeting of the Scrutiny Committee on 27 November 2012, at which a presentation was given. A number of examples were also given of instances where EMAS had failed to meet its targets in respect of response times. Mr Spice stated that these examples supported the need for change and improvements to service.

A small number of Councillors referred to a petition that had received 12,336 signatures over 23 days. The Chief Executive clarified that the petition was not undertaken on the Council’s behalf and it was presented to EMAS representatives outside the meeting.

Concern was expressed by a number of Councillors that there was no plan to create an ambulance hub in Grantham and that the hub from which services from the district would start was in Sleaford. They suggested that the planned growth within the district supported the case for a hub in Grantham. They also highlighted the good transport links with easy access to the A1 and the south of the district. When asked whether EMAS had ever considered positioning a hub in Grantham, Mr Spice responded that all possible options had been considered, which would have included a hub in Grantham. In response to a question, Mr Spice denied that there had been recruitment for a hub in Sleaford. One Member added that as part of consultation, concerns were expressed about engaging with blind and partially-sighted residents in the county; representatives stated they would follow this up after the meeting.

Debate ensued about the potential impact of changes on EMAS staff with specific reference to increased journey time between home and work and travelling between hubs and CAPs at the beginning and end of shifts. EMAS representatives advised that staff would be able to arrive at the hub, and after a quick check of their vehicle, leave the station in a very short-time. Work was also underway to stagger shifts to ensure that no area would be left without cover because of changeover. Consultation was also underway with staff in respect of shift lengths; any changes would need to strike a balance between staff preference, clinical need and staff safety.

Some Members suggested that EMAS providing a hub in Grantham would help support the sustainability of Grantham hospital and ensure it was protected from the further loss of services.

The consensus of Councillors was that services for the residents of South Kesteven should be of the highest quality and available within the times set out within the performance standards while taking account of the planned growth within the district.

Staff from EMAS were thanked for attending the meeting and giving their presentation.