Agenda item

Mr Allen Brown, Camden and Islington Group Manager, London Ambulance Service (LAS) gave a presentation to the Committee. It was highlighted that the purpose of the LAS was to provide outstanding care for all their patients; be a first-class employer; provide the best value to taxpayers and to work with partners to optimise healthcare and emergency service provision. LAS were the only London wide healthcare provider and were one of the busiest ambulance services in the world with approximately ten thousand employees and volunteers serving a population of 8.99 million people. During the current year the service had received 2.2 million 999 calls and 2.2 million 111 calls, seeing a million patients, with an average response time of six minutes and fifty seconds. On busier days the service received a 999 call every six seconds and a 111 call every three seconds. They had recruited over one thousand new staff members and ranked number one amongst NHS employers for apprenticeships.

The LAS faced several challenges including high demand for the service. This required closer partnership working on more community pathways; the introduction of a new patient flow system to ensure patients were taken to the nearest hospital that could provide the quickest care and a clinical hub, where clinicians could give telephone assessments.

There had been improvements made to benefit staff and patients including a new purpose-built control room and two education centres; new technology including a simulation room; revamped logistics and supply units and a new computer aided dispatch system. Their key priorities were the health and wellbeing of teams including improving the work culture and staff morale; the launch of a recruitment drive; work to reduce violence and aggression towards staff and investment into green, lower emission and electric vehicles.

On their performance, it was highlighted that they were on target for responding to category one serious emergencies and category three calls. Category two was a challenge with a target of eighteen minutes and a response time of approximately twenty minutes to over an hour. It was explained that it was a challenging time for the whole NHS and they were working with partners to help manage their flow; were offering financial incentives for staff to cover shifts, had looked at a range of alternative care pathways and aimed to put out twenty – thirty additional ambulances a day.

Councillor Russell asked whether the summer heat resulted in an increase in ambulance callouts and whether they were looking at this being a long-term risk caused by the changing climate and, whether paramedics could be using e-bikes. It was explained that the heat caused spikes in demand and the weather would dictate whether extra ambulances were put out. They were looking at e-bikes however there were some complications. They would provide the committee with a written response on this.

Councillor Jeapes asked what caused delays at hospitals and whether there was a problem caused by patients waiting to be admitted; whether the service was impacted by Islington becoming a low traffic neighbourhood and whether there were people being considered in category two when they should be considered in category one. It was explained that hospital delays were an issue that caused the loss of a lot of ambulance hours. A Hospital Liaison Officer would attend the hospital if the flow became an issue. Figures for this could be provided to the Committee. Being a low traffic neighbourhood did present challenges but there was no evidence it led to an increase in injury or death. Cases on the border of category one and two would be picked up by the clinical hub who would review those cases.

Councillor Craig asked about a new scheme that looked at offloading patients to a receiving centre, what was being done to improve the category two response times and whether the transition to urgent care plans had worked. It was explained that although the scheme had been successful it would be challenging to implement in other areas, due to the lack of space at hospitals and the use of tents. To help with the category two response times they were looking at doing a recruitment drive; had introduced assistant ambulance practitioners; aimed to put out 20-30 extra ambulances a day; introduced a patient flow team; took patients to hospitals with more space and worked with hospitals on a rapid release system for emergencies. The introduction of urgent care plans had helped ambulance crews to make more informed decisions with patients.

Councillor Zammit asked whether councillors could be doing more to encourage careers in the ambulance service. It was explained that it would be good to attend schools to educate children on the ambulances work and to help encourage black and minority ethnic (BME) applicants.

Councillor Croft asked whether there was data on mental health emergencies and if there had been an increase in callouts. It was explained that there had been an increase in mental health issues, and it had also become the highest sickness indicator for staff. A car had been introduced to attend mental health crisis; suits were hard to find, and mental health nurses were present in the control rooms. There were figures available that could be circulated to the Committee.

The Chair asked whether a lack of carers had led to more calls to LAS by older people and what could be done if you cannot answer some of the questions asked when you call an ambulance for assistance. It was explained that it would be better to have more carers but there was no direct evidence related to whether a 999 call could have been more effectively dealt with by others. The questions were part of the triage system bought in, were tried and tested, and if questions were taken out and someone died it would be the responsibility of the service.

The Chair asked the Committee whether the Council should facilitate an event for children and young people who wanted information on how to get into the ambulance service or wider health and care jobs such as the mental health service or domiciliary care.

RESOLVED:

To look into facilitating a health and care careers day for children and young people.