Issue - meetings

1.1.        The Committee considered a report by the Assistant Chief Executive providing an update on a number of developments in relation to SECAmb’s services. 

1.2.        HOSC asked a number of questions in relation to these developments.

Patient triage and patient safety

1.3.        HOSC raised concerns about the safety of SECAmb’s ‘hear and treat’ and ‘see and treat' policies; the effect on patient safety of the use of non-paramedic staff on ambulances; and the reasons for a disparity between the number of incidents recorded by SECAmb and NHS England.

1.4.        Geraint Davies said that neither SECAmb nor any other ambulance trust in the country has an all paramedic workforce. There is a skill mix in the organisation comprising paramedics, technicians, and emergency care support workers.

1.5.        Geraint Davies said it was a challenge for SECAmb to ensure that when a call comes into the organisation it is triaged properly. The hear and treat policy involves putting clinicians into control rooms so that calls can be reviewed by clinical staff. This ensures that calls are triaged correctly and responded to in the most appropriate way. The see and treat policy involves ensuring that the right crew with the right skill mix is present for the clinical need of the patients, maximising the opportunity to provide the necessary care in situ and reducing the need to convey to other services. The triage system used by SECAmb is a national system that is quite risk averse. As part of the ambulance triage programme, SECAmb is working with partner organisations to understand how to adapt the triage system to effectively manage patients in a manner that is as safe as possible.

1.6.        Mr Davies added that nationally the Ambulance Response Programme had been set up to look at how best to ensure ambulance trusts hear and treat and see and treat effectively – there are five ambulance trusts involved in the pilot and if successful it will be rolled out across England in the autumn. The programme should allow ambulance trusts more time to triage patients up front and then re-categorise calls.

1.7.        Geraint Davies said that when a ‘Serious Incident’ (including a death related to an incident) occurs, SECAmb investigates it, learns lessons, and changes its pathways accordingly.

SECAmb culture

1.8.        HOSC asked about the bullying culture and staff morale issues identified by the Care Quality Commission (CQC) in a letter to SECAmb following its recent inspection and what the senior management team would be doing to address these concerns.

1.9.        Geraint Davies said that he would remain as Acting Chief Executive until a new Chief Executive was recruited, which was estimated to be in 4-6 months – he said he would not apply for that role himself. He said that his remit as Acting Chief Executive would be to: stabilise the organisation; ensure that there are plans in place to address the recommendations of the external review into the red 3 triage pilot; and plans to deliver performance improvements over the next few  ...  view the full minutes text for item 7