South Central Ambulance NHS FT

1. South Central Ambulance ServiceHampshire DivisionNeil CookHead of Operations East HampshireMarch 2012

2. Formed in July 2006 Covering 4 counties Over 3,500 square miles 400,000 Emergency Calls per year 2,300 staff 1,200 clinical road staff 200 call centre staff South Central Ambulance NHS FT

3. History / Background of Division Hampshire Division • 15 ambulance stations across Hampshire • Plus network of social / serviced standby points • 560 WTE • Paramedic (inc Emergency Care Practitioners) • Technicians • Emergency Care Assistants • 590 Registered Community / co responders • circa 60 schemes • 250 Registers static AED sites • 42 Clinical Support Desk Nurses

4. Two Ambulance Stations Gosport and Fareham Each provides 4 Fully equipped ambulances at the height of the day and 2 night vehicles 2 x 24hr Rapid Response Vehicles Dynamic deployment – mobile service Fareham and Gosport Peninsula

5. A response that is:- Fast Clinically effective Personal and reassuring What our patients want

6. Strategy for High Quality Care Aims Provide the best standards of care Provide the right care by the right person at the right time To get the correct balance between highly specialist care where it is needed and more local care, where appropriate Play our role in encouraging healthier communities and individuals Move to clinically-led, patient focused organisation with a motivated professional workforce

7. Red Calls – immediately life threatening Require 8 minute response first resource on scene (75%), 19 minute first patient carrying vehicle on scene (95%) Amber Calls require an ambulance resource within 20 mins (95%) Green calls – these vary and have 4 categories ranging from ‘call back’, to attendance in 60 mins. Call Prioritisation

8. Clinical Quality Performance Clinical Performance measured in 5 areas against best practice evidence based guidelines: Stroke Asthma STEMI (heart attacks) Hypoglycaemia (diabetic emergency) Cardiac Arrest Each area has sub components for measurement e.g. for stroke Blood glucose measured Blood pressure measured FAST test performed

9. The Four Step Approach Step One: Call handling / assessment Entry point, integrated unscheduled care, clinical support for dispatching, sending an appropriate response Step Two: Hear and treat/refer Clinical advice and referral to appropriate care pathways Step Three: See treat and refer When physical assessment identified from the call, timely provision of appropriately skilled and equipped staff provide treatment and refer Step Four: See treat and convey Safely and comfortably convey patients to appropriate treatment centres, including specialist centres

10. Performance: Demand for SE by category by month 2010-2012

11. Performance: Demand for Fareham & Gosport by category by month 2010-2012

12. Performance: Performance for SE by category by month 2010-2012

13. Performance for Fareham & Gosport by category by month 2010-2012

14. National League Table for Non Conveyance YTD

15. Demand continually rising Economic pressure on all public services Historically, we have not always worked seamlessly Pre and post 999 call initiatives The Current Environment

16. Our Role: To proactively support PCT’s in their demand management goals To work in joint teams to implement safe and cost effective change programmes To use our South Central wide information streams to inform and advise PCT’s Whole Systems Care

17. Utilising patient and premises intelligence will enable SCAS and partners to: Work upstream to prevent a call Work downstream to prevent repeat calls Develop care plans to guide callers to the appropriate and more beneficial response Manage calls from premises such as the night economy, care homes, sports facilities and so forth Whole Systems Care

18. Upstream: Pre 999 • Training for premises needs • Night economy - Pubs, clubs, bars • Service user rules • Staff engagement • Premises partnership management • Night response service (falls) • Legislation utilisation • Inappropriate calls • Community engagement • Evidencing gaps in provision • Evidencing demand • Health promotion • Frequent callers • Patient needs assessment • Premises needs assessment

19. Downstream: Post 999 • Falls response service • Mental health crisis intervention • End of life care protocols on CAD • Community equipment services • Alternative care pathways • SCAS WSC Locality Manager • Patient care plans on CAD • Auto patient referral • GP triage • Patient risk registers • Premises risk registers • Patient care plans on CAD • GP urgent assessment tool • Night response service (falls) • Virtual ward information on CAD • Patient needs assessment • Premises needs assessment

20. Mobile Service, not static Ambulance, Rapid Response Vehicles, Standby locations, serviced and unserviced Community Responders Static AED Staff Responder Groups Operational delivery

21. Restructure of the Operational and Clinical Directorates New team working Rosters across the area Team Leader and Clinical Mentor Review the Options for a New Ambulance Resource Centre for the South East Sector Engagement with stakeholders Fareham and the South East Hants area

22. Thank you Any questions? Questions