Scottish Ambulance Service Presentation to Islands Connection Group. 20th October 2016 Andy Brady Area Service Manager Agenda • Service overview • Local issues • Service developments • Open forum Operating Divisions North Service Divided into 5 Divisions East Central 4300 staff 3 Ambulance Control Centres: - Edinburgh (East) West - Cardonald (West) Central South East - Inverness (North) South West Scheduled Care co-located at ACC’s Service Overview – A&E • Respond to 999 calls • Accident & Emergency Incidents 2015/2016 – 629,000 (approx) nationally (approx 12,000 per week) – 14,000 (approx) in Argyll & Bute (approx 270 per week) • Responding to more emergency calls than ever before • Responding faster than ever before Service Overview • Respond in a number of different ways • Crews are more skilled than ever before • Transport patients to hospital but also see and treat/hear and treat. • Paramedic Response Units • Specialist Paramedic Practitioners • First Responders – 121 schemes – 1000 volunteers • Emergency Medical Retrieval Service (EMRS) • SAS Air Fleet 2 x Helicopters 3 x Fixed wing planes • Coastguard Search and Rescue, Life Boats and Land Support. • Clinical Advisors • Special & Operations Response Team (SORT) Service Overview - PTS • Patient Transport Service – 125,000 journeys per month • Finite resources means prioritisation: – Patients with a medical need – Needing assistance – Cannot use Public Transport – Mobility restrictions • Challenges around alternative transport options • Patient transport review Overview 999 call processing • Every time our call takers receive a 999 call, they question the caller in detail about the nature of the emergency to ensure we respond quickly in the most appropriate way. Using sophisticated world-class software, call takers categorise calls into three types. • Category A are classed as life threatening and as the most serious calls are always prioritised above any other type of call. • Calls which are serious, but not life threatening, are prioritised as Category B and may sometimes receive a slightly slower response as life threatening calls are prioritised ahead of them • Calls which are neither serious or life threatening are graded as Category C and in many cases do not require the skills of an emergency ambulance crew. Many of these calls are referred to the most appropriate agency, such as NHS 24. • Our call takers often give life saving medical advice over the phone while the ambulance is on its way and our highly skilled crews are trained to deal with a wide range of medical emergencies • The Scottish Government sets targets for us to reach patients within certain timescales. The targets are: – 75% of Category A calls in eight minutes ; – 95 % of category B calls in 19 minutes, depending on population density. – 91% of urgent calls within the specified time from clinician Argyll & Bute Argyll & Bute 2,480 square miles 23 inhabited islands 143 staff total 123.5 A&E 19.5 PTS staff 48 vehicles 89,800 residents Approx Island Locations • There are 23 Islands covered in Argyll by the SAS. Settlement (1) Proposed Remote Population Drive time to settlement Response time from closest Comment & Rural (3) of 10,000 (4) SAS location (if different) classification (2) Isle of Colonsay Island Community 123 145 mins Island Class Vehicle + volunteers Isle of Jura Island Community 212 240 mins GP & Volunteers + Island Class Vehicle Isle of Coll Island Community 217 180 mins Island Class Vehicle + GP Isle of Mull Island Community 3127 80 mins <8mins 1 x AEU (on-call) Community AED’s Isle of Tiree Island Community 725 240 mins Contractor & GP Isle of Islay Island Community 3441 200 mins <8mins 1 x AEU (on-call) Community AED’s Isle of Bute Island Community 6894 60 mins <8mins 1 x AEU (on-call) Police first responder Isle of Danna Island Community 5 No Ferry Isle of Davaar Island Community 2 No Ferry Isle of Easdale Island Community 58 40 mins Isle of Erraid Island Community 8 100 mins Isle of Gigha Island Community 110 120 mins Island Class Vehicle + Contractor Isle of Gometra Island Community 5 90 mins Isle of Inchtavannach Island Community 3 70 mins Isle of Innischonan Island Community 1 No Ferry Isle of Iona Island Community 125 100 mins Isle of Kerrera Island Community 42 6 mins Isle of Lismore Island Community 146 25 mins Island Class Vehicle + Volunteer Isle of Luing Island Community 212 40 mins Island Class Vehicle + Volunteer Isle of Lunga Island Community 7 30 mins Isle of Oronsay Island Community 5 140 mins Isle of Sanda Island Community 1 No Ferry Isle of Seil Accessible Rural 560 20 mins Road Bridge to Mainland Isle of Shuna Island Community 1 35 mins Isle of Ulva Island Community 16 80 mins Community First Responders Scheme Name\Operating Area Call Sign Number of active members Ardfern ARDFRU 20 Croabh Haven CRHFRU 2 Garelochhead GLHFRU 6 Isle of Luing LUIFRU 11 Lochgoilhead LOCGFRU 7 Ross of Mull ROMFRU 5 Iona IONFRU 1 Dervaig DERFRU 2 Tobermoray TOBFRU 5 Ulva Ferry Not yet Active Island & Argyll Resources Location Establishment Numbers Skill Mix Arrochar 5 3 Paramedics 2Technicians Inverary 5 3 Paramedics 2 Technicians Helensburgh 16 1 Paramedic Team Leader 1 Technician Team Leader 7 Paramedics 4 Technicians 1ACA Dunoon 31 2 Paramedic Team Leader 6 Paramedics 12 Technicians 7 Driver 2’s 4 ACA’s Rothesay 13 1 Technician Team Leader 3 Paramedics 6 Technicians 4 ACA’s Lochgilphead 15.5 5 Paramedics 8 Technicians 2.5 ACA’s Tarbert 5 1 Paramedic Team Leader 1 Paramedics 3 Technician Campbeltown 18 1 Paramedic Team Leader 9 Paramedics 3 Technicians 5 ACA’s Islay 6 1 Paramedic Team Leader 1 Paramedic 2 Technicians 2 Driver 2’s Oban 23 1 Technician Team Leader 8 Paramedics 11 Technicians 3 ACA’s Mull 5 2 Paramedic 1 Technicians 2 Driver 2’s Engagement • The SAS engage with HSCP through Locality Planning Groups and Health Board Liaison meetings. There is also community engagement through community cafes and numerous sub groups • Improving stakeholder involvement and communication is part of the SAS’s strategic aims • Open and honest communications • Working in partnership with staff • www.scottishambulance.com Service Developments • Remote & Rural working initiatives • Extended training for Paramedics • Paramedic Practitioner role • Community First Responder • Defibrillator programme 540 A&E 414 PTS • Developing alternative pathways • New model of clinical working • Integrated health care working • Introducing a new communication systems Challenges • Ever increasing demand • Centralisation of Medical Services • Increased Inter-Hospital Transfers • H&S, on-call working, meal breaks, fatigue • Integrated transport solutions • Island cover and recruitment and retention. • Financial Questions and Open Forum .