Agenda item

Update report from YAS on service delivery, challenges and recent developments. 

Members considered a report from Yorkshire Ambulance Service (YAS), which updated the committee on current performance and provided information on challenges currently facing the service.  YAS saw high levels of operational demand continue, but also performed more strongly in some areas.  Patient handovers continued to be well above the national 15-minute target.

Members sought further information on the report:

a)    Had alternative arrangements for servicing and maintaining ambulances been considered, to obviate the need for lengthy round trips to Harrogate to carry out maintenance?

Alternative sites had been considered, and further investment in Bridlington is planned to expand it as a vehicle servicing point.  Currently the site was being assessed to determine its suitability for expansion and additional vehicle technicians being based on site.

b)    How effective was the stroke service being provided at York?  When the service was discontinued at Scarborough it was intended that patients could be taken to York and transferred to Hull for CT scans and further treatment.  Was this process functioning effectively, without undue delays from transfers and handovers?

The closure of the stroke unit at Scarborough was necessary because the need was only sporadic, leaving specialist crews idle for long periods.  The closure allowed for ambulances to be dynamically moved to areas of anticipated demand.

c)    Were there ever times when, due to transfers and maintenance, there were no available ambulances?

A handover escalation policy was in place to quickly free up resources at times when ambulances were critically short.  A process to rapidly release patients in hospitals to release community resources had been implemented earlier this year and was now in use at such times.

d)    What information was available for transfers across into areas covered by North East Ambulance Service?  In areas such as Great Ayton and Richmond, patients were often transferred to James Cook or Darlington Memorial Hospital.  Concern was expressed around the perceived reliance on the Yorkshire Air Ambulance to facilitate patient transfer.

The information in the report only covered transfers within YAS’ area, but members would be provided with the requested information separately through the Democratic Services Officers.  The Yorkshire Air Ambulance formed a part of the critical care strategy for major trauma.

e)    How did YAS performance on Hear and Treat compare with national guidelines, and were there currently any delays with community See and Treat?

Currently YAS Hear and Treat rates stood at 14.6%, against 16% nationally.  The two control rooms, in York and Wakefield, administered the dispatch of resources and the remote clinical triage hubs.  The target for See Treat Refer was 51%, which YAS were moving towards.  North Yorkshire saw a higher proportion of See Treat Refer than anywhere else.

f)     How many crewed ambulances are there on the road, compared to last year?

Staffing ambulances was currently made difficult by significant recruitment challenges.  North Yorkshire was an attractive place to work and an international recruitment campaign had been undertaken to attract recruits from Australia and New Zealand.  Paramedics from Teeside University remained a key source of new staff.

g)    Could YAS account for the significant gap between the initial estimated cost of the new Scarborough ambulance station of £7 million, and its current projected cost of £21 million?  Had opportunities for additional funding been sought to meet this shortfall?

Discussions were underway to explore co-locating diagnostic services at the new station, but significant capital funding challenges remained.  It was agreed to seek a detailed explanation for the rising costs which would be fed back to members.

h)    Members had heard anecdotal evidence that there were sufficient crews to cover the Craven and Skipton areas, but insufficient vehicles for them to operate.

Skipton, Settle, and Ingleton were all covered by West Yorkshire Ambulance Service, and vehicles were proactively backfilled based on anticipated demand, rather than reacting to events and needing to travel long distances in response to a call.  Community First Response Teams had a role to play, particularly in remote and rural areas.

i)      Was there a policy which prohibited paramedics from administering fentanyl as a painkiller in critical trauma cases?  This was in response to reporting in the case of the death of Harry Dunn in Northamptonshire in 2019.

That case occurred in the East Midlands so was subject to different guidelines than applied in North Yorkshire, but morphine was available to YAS crews which was sufficient, and additional critical care assets could be dispatched in urgent cases.

Members thanked YAS for their attendance and the report, but identified some gaps in data.  While there was sufficient detail on issues in Scarborough, members felt that other areas were not adequately covered in the report, and there was a lack of information on the impact on residents rather than the performance of specific hospitals.  As well as requesting follow up communication, members asked that for this to be included in future reports.

Resolved:

That the report be noted.