Rural Ambulance Monitoring Meeting

Wednesday 14th March 2012 13:00 – 15:00 Old Forge Surgery, Middleton in Teesdale

Attendance: Berenice Groves NHS County Durham and Darlington Jane Dickson Practice Manager – Middleton-in-Teesdale Douglas McDougal NEAS NHS Trust Lynn Corrigan NEAS NHS Trust Andrew Bell NEAS NHS Trust Nigel Mitchell Community Paramedic/ Team Leader Vicky Watson Practice Manager – Weardale Practice Craig Hay Community Paramedic/ Team Leader Joy Urwin Community Rep - Weardale Tony Cooke Community Rep – Teesdale Jean Hetherington Community Rep - Weardale Margaret Dent Community Rep - Teesdale

Apologies: Tom Howard NEAS NHS Trust Stephen Gwillym Overview and Scrutiny DCC Feisal Jassat Overview and Scrutiny DCC Dr Luxmoore GP – Middleton-in-Teesdale

1. Apologies As above

2. Update from previous meeting

Community Hospitals – BG is meeting with Julie Walton, Modern Matron at Weardale Community Hospital on 03.04.12 regarding referrals to UC. BG will update at next meeting.

Meal Breaks – the section from contract meeting was forward to TH to ensure smooth implementation.

Breach reports – BG highlighted that the information supplied with breach reports was not sufficient, Ray Burns was reviewing this with TH, however in his absence it was requested that Lynn Corrigan address for next meeting. JU requested specifically if meal breaks and snarl-ups be included. NEAS are currently undergoing a control room configuration and breach reports will be looked at during this exercise. DMcD to report back.

1 Emails – The issue of practices not receiving emails from the EPRF remains outstanding. Also some emails were being sent to the wrong practices. DMcD to follow up asap and feed back to JD.

OSC – It was noted that although representatives had conveyed apologies for their lack of attendance they were still unable to be present at this meeting.

3 Data Review

At the last meeting the group agreed that all queries were being responded to adequately.

MD reported a big improvement in the data being received but queried the reason for a considerable increase in Cat A Breaches. DMcD confirmed that this is due to an increase in call volume.

JU had forwarded queries regarding to TH but to date has not received a reply. LC to investigate/JU to forward the queries. BG requested that all queries were copoied to her to ensure as a PCT we could chase responses.

In total, 10 breaches were reported, 6 unexplained.

A staff handover period is currently underway at NEAS which has resulted in some delays responding to queries. As previously agreed, more comprehensive reports will be provided and sickness codes will be included to help Community Reps identify if this is the reason for ambulances not responding.

4 Breach Information Update

Removed from agenda.

5 Update on Rural Ambulance Project

CH provided an update from Weardale. GP’s have been using the service a lot more; Quality Outcomes Framework (QOF) targets, outcomes are being supported using this resource. Confidence is certainly building in the service and more calls are being made. Regular visits are made to patients and as a result of this calls to GP’s have reduced. Paramedics are also keeping patient records so other crews are able to follow the patient’s care. Concern was raised about visits incurring additional fuel costs, this requires monitoring.

DMcD provided a report that more community calls are being made and positive feedback has been received from GP Practices. It was noted that Barnard Castle crews are out on response calls more so not available as

2 much for community work. BG confirmed that data is identifying low non- elective admissions and UC attendances from this localit.

CH expressed concern that problems are being encountered getting GP’s to make out of hours visits. BG stressed that all incidents of this nature MUST be fed back to her to be addressed and they are important use as supporting information in terms of commissioning.

DMcD took a telephone call from an MP in Cumbria asking for information on the service to take back to his constituency as we are seen as having best practice.

A discussion took place concerning the possibility of obtaining some positive publicity out of the success of the home visiting; good news stories, case studies, etc. It was suggested that an article be written covering the community work being done by paramedic to assist in raising awareness and gaining acceptance. BG and CH to work on this.

JC to get copies of any previous press articles.

DMcD asked the group for ideas of how quality can be measured with regard to patient satisfaction, relationships with health professionals, etc. Group members to feed back at next meeting. He also requested that the group work together with a view to planning for next winter.

Home visits are currently recorded on EPRF initially then transferred to SystmOne by a practice nurse. As paramedics have access to SystmOne it was suggested visits could be recorded directly by paramedics. DMcD confirmed that a job number couldn’t be produced by this method and that visits couldn’t be recorded retrospectively as they would then be recorded as an incident. CH and DMcD to look into this in liaison with practices.

6 Weardale Base Options Appraisal

DMcD updated that an option appraisal was being worked on to look at the cost of upgrade to St John’s Chapel and the cost of sharing facilities with Durham & Darlington Fire Service. Estates are carrying out a survey of the St John’s Chapel site which will identify any structural recommendations. DMcD to follow up.

7 District Referrals to Richardson and Weardale Community Hospitals

Covered in previous agenda items (BG to meet with Julie Walton and feed back to the group)

3 8 Future of the Group

The Terms of Reference of the Rural Ambulance Monitoring Group meeting state that all reports are written/delivered jointly. Positive feedback was received at the last meeting that the group was working well together and feedback from Dr Luxmoore confirmed this.

BG expressed concerns about a presentation delivered to the OSC on 09.03.12. A meeting took place between BG, DMcD and the Community Reps prior to the OSC Meeting to define the presentation. However, it was felt that the presentation delivered by the Community Reps was perceived as negative and disjointed.

BG questioned the effectiveness of the group and her role as chair.

A lengthy discussion ensued. The Community Reps felt that they had reported positive progress during the presentation, but also have duty to raise their concerns. BG agreed that Community Reps do a very good job and she is aware of their concerns and does not dispute them. The issue is that the majority of the presentation was negative and one of the case studies used as an example had not even been reviewed by the group and consequently painted a negative picture not reinforced by facts. It is also important that the group maintains a unified approach and communicating the positive issues is vital in securing funding.

NEAS Representatives felt that there was very little evidence to support the issues raised.

Group members agreed that it was important that the group continue and that BG continues to chair. JD expressed her disappointment that this situation had arisen and felt that there is value in continuing with the group.

It was agreed for the Terms of Reference and purpose of the group to be reviewed at the next meeting.

4 9 A.O.B.

The question of maintaining achievements with the implementation of CCG’s was raised. Contract agreement 1012/13 – achieve 71% Cat A performance for County Durham with the aim of achieving 75% by march 2013. An allocation of the contract funds has been identified to support this improvement with a further allocation supporting see & treat/hear & Treat Mode 1.

NEAS have been asked to provide detail on what resource and funding would be required to achieve 75% by the new CCG.

Work has already commenced on next year’s funding.

Next meeting Time Date Venue Chair 13:00 – 15:00 16th May 2012 Old Forge Berenice Surgery Groves Apologies: Contact for the meeting: Jayne Clement – 0191 374 4264 – [email protected]