East Midlands Ambulance Service still not hitting targets

Not enough ambulances are getting to emergency calls to enable the''service to hit minimum Government targets
Not enough ambulances are getting to emergency calls to enable the''service to hit minimum Government targets

East Midlands Ambulance Service (EMAS) has consistently failed to meet the minimum Government targets over a number of years, and with the winter months almost upon us, figures presented this week show that they are still failing.

At least 75 per cent of the most serious calls must be attended with a fully equipped ambulance vehicle able to transport the patient within eight minutes, and 95 per cent of less serious calls attended within 19 minutes.

The 75 per cent target applies to calls that are categorised as “time critial” such as cardiac arrest, chest pains, unconscious.

For those types of calls the service needs to have a response on scene within eight minutes. That response can be a fast response car, double Crewed Ambulance or community first responder.

Although the EMAS hit all targets in April, it has failed to hit the minimum 75 per cent target since then, and only hit the 95 per cent target once.

The failures were reported to members of the Nene Clinical Commissiong Group in a joint report by the director of nursing and quality Peter Boylan and director of contracting and procurement Kathryn Moody.

The concerns are so serious that the report says: “Poor urgent response time performance noted for three consecutive days in September raising concerns that patient safety may have been compromised with the trust during this time.”

The report says that a high level investigation has been launched by EMAS.

The recovery plan highlighted in the report says: “EMAS continues to implement their ‘Better Patient Care’ programme – an on-going programme of improvement with the potential of further investment for 2014-15 based on EMAS delivering their agreed contract performance standards in this year’s contract.

“EMAS have committed to funding wider transformation plans to improve non conveyance rates and robust data provision.

“The commissioner will seek assurance that the improvement programme is on track to deliver in 2014-15.”

Blanche Lentz, EMAS General manager for Northamptonshire said: “Our improvement plan ‘Better Patient Care’ was launched in late 2013 and since then we’ve seen steady improvements in our response times. We are not complacent and know there is a lot more work to do, but we are moving in the right direction.

“It’s also important to recognise that we are close to hitting the standard, for example, if the clock was stopped at eight minutes and 37 seconds we would reach our 75 per cent target for the most serious emergencies.

“We will continue to work hard to make further performance improvements over coming months.

“We launched the high level investigation referred to in the report so we could identify any factors that may have had a negative impact on September’s performance.

“Although the investigation is on-going we know that there were significant handover delays at A&E departments and this does affect our ability to respond to the emergency calls we receive whilecrews are tied-up at hospital.

“We are working closely with hospital colleagues to reduce patient handover times and have recently introduced the role of Hospital Ambulance Liaison Officer (HALO) at Northampton General Hospital. This person monitors handover times and keeps a close watch in ‘live time’ and takes action when problems seem likely to arise. “The role has been supported by EMAS, the CCG and Northampton General Hospital.”

NHS 11 service fails to hit targets too

Health officials in the county are closely monitoring the NHS 111 service after a number of failures to hit key targets over the past six months.

The Northamptonshire NHS 111 service is delivered by Derbyshire Health United (DHU). The standard is for at least 95 per cent of calls received to be answered within 60 seconds.

However, a joint report to members of the Nene Clinical Commissiong Group by the director of nursing and quality Peter Boylan and director of contracting and procurement Kathryn Moody shows that the call handlers have failed to hit that target all summer.

Initial indications suggest they will also have failed to hit it in September.

The report says: “NHS 111 in Northamptonshire continues to be closely managed to ensure a robust and responsive service is delivered.

“The service has showed some improved performance with regards the proportion of calls answered in 60 seconds with validated performance of 94.8 per cent in August.

“Unvalidated data for September shows performance of 94 per cent.”

The average time for a call back by a nurse adviser, where required, has improved to 32.39 minutes for the first part of quarter two from 43.52 minutes in quarter one. However, the minimum target is less than 15 minutes.

DHU have produced an improvement plan to get back on track.

The report to the Nene Clinical Commissiong Group, which oversees health services across the north of the county, except Corby, states: “The Commissioners continue to monitor the recovery action plan against provider performance.

“There has been some improvement noted so far in quarter two.

“The CCG has also raised these issues with the provider at the local joint contract and quality review meeting and governance review.

“A quality visit has been undertaken to the service. The quality of call handling and provision of nurse advice was reviewed and found to be of good standard.

“DHU provides a quarterly quality report detailing complaints and serious incidents at which any adverse impact of delays in call back are discussed. The CCG clinical lead also meets with the provider monthly and chairs a call review for any calls which may have been of concern along with a number of calls picked at random.”

The commissioning group in Northamptonshire is sent copies of staff rotas three times a week and conference calls take place with commissioners and the provider twice weekly to discuss staffing and issues of concern.

The chief executive of DHU, Stephen Bateman, said: “All of our patients can be assured that action is being taken to uplift performance.

“We continue to work closely with Nene Clinical Commissioning Group, our commissioners. In preparation of increased demand an additional 16 nurse advisers and around 50 call handlers are being recruited by DHU to support the service over the winter period.  

“DHU and commissioners constantly monitor performance and strive for improvement in order to achieve the required key performance indicators to ensure that patients receive the highest level of service.”