Stockton-on-Tees Borough Council

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Adult Services and Health Select Committee Minutes

Tuesday, 11th February, 2014
4.00 p.m.
Ground Floor Committee Room, Town Hall, High Street, Stockton on Tees TS18 1AU
Please note: all Minutes are subject to approval at the next Meeting

Attendance Details

Cllr Mohammed Javed(Chairman), Cllr Kevin Faulks(Vice-Chairman), Cllr Evaline Cunningham, Cllr Ray McCall, Cllr Mrs Sylvia Walmsley, Cllr Norma Wilburn, Cllr Mrs Mary Womphrey.
Sean McEneany (CESC) Mark Cotton, Paul Liversidge, Tom Howard(NEAS), Sean White(Cleveland Police), Peter Mennear and Kirsty Wannop(LDS).
In Attendance:
Member of the Public
Apologies for absence:
Cllr Elliot Kennedy and Deborah Miller
Item Description Decision
The minutes of the meeting held on 26th November 2013 were signed by the Chair as a correct record.
AGREED the information be noted and information requested be provided.
AGRRED that:
1. Information on progress on joint working between NEAS and Cleveland Police be reported back to the Committee in 6 months.
2. The information be noted.
AGREED the information be noted.
AGREED for the review to report to Cabinet and NHS bodies in May.


Cllr Mohammed Javed declared a disclosable pecuniary interest as he was employed by Tees, Esk and Wear Valleys NHS Foundation Trust. Cllr Javed had been granted a dispensation in this regard.

Cllr Ray McCall declared a personal interest as he was an Associate Hospital Manager and Governor for Tees, Esk and Wear Valleys NHS Foundation Trust.
The minutes of the meeting held on 26th November 2013 were signed by the Chair as a correct record.
Members were provided with an update on the Progress of recommendation form the EIT Review of Mental Health. The Committee were provided with update on the following:
- The 6 service users at Ware Street had now been moved appropriately into other services including independent living.
- It was queried who was responsible for funding the two asylum seekers who had been in Ware Street prior to closure. This information would be provided
- Day service users from Norton Road had temporarily relocated to Ware street prior to its closure . 32 users had been offered alternative services and 23 had successfully engaged in community bridge building. Out of those who did not wish to receive an ongoing service, some had engaged with voluntary provision and others will continue to receive contact from SBC to monitor their situation.
- There had been staff meetings in relation to the closure of services before commencing the consultation period.
- There was an anticipated closure date of Ware Street of 28th February 2014 that was very achievable.
- Members queried what opportunities had been made available for the volunteers in Norton Road. It was noted that they had been offered opportunities in alternative services.
The Committee considered information from representatives from Cleveland Police and North East Ambulance Service (NEAS).

The main information from Cleveland Police included:-
- The Police force were concerned with the rising demand on urgent and emergency care and agreed largely with the conclusions of the work that had been undertaken by Middlesbrough Council surrounding Cleveland Police and North East Ambulance Service.
- The Police had noticed there seemed to be more people attending A&E and more ambulances parked up outside waiting , and that this had been particularly noticeable since December 2012. ACC White stated that this was beginning to impact upon the police’s operational relationship with the ambulance service.
- In the Tees area, there was an average of around 400 police/NEAS interactions a month
- The Police attended many different situations that required an ambulance present i.e. assaults, people injured in the street and collisions yet were sometimes finding it difficult to get an ambulance present.

It was stated that sometimes the police may be called to provide support to NEAS crews on potentially dangerous jobs and this was not always deemed to have been necessary. NEAS stated that they would only request Police presence at nuisance properties where it was needed. Mr White outlined that there was on average over 200 requests for the police to attend per month.

It was reported that the police had on several occasions transported patients to the hospital themselves. NEAS stated that this would not be advised and was not their policy or instruction to their staff. Mr White had a range of case examples that he would provide to the ambulance service for review.

The police and ambulance service had been undertaking structured dialogue since 2013, and some work had been undertaken to provide guidance to police officers when requesting ambulance support, however the police believed that issues were ongoing.

The main information from NEAS included:-
- Information and statistics regarding the 111 service including time taken to answer calls, volume of calls, outcome from calls and patient information on services they would have used if they hadn't used the 111 service.
- A&E monthly incidents, performance and national benchmarking for NEAS.
- Average ‘time to treat’ red incidents compared to other ambulance services.
- Response to GP urgent calls in Hartlepool and Stockton CCG area.
- Details of the A&E Review of vehicles available within the south division and what it meant for Stockton, following the redistribution of ambulance and urgent care resources across the region in order to maintain performance.
- Details of a support leaflet with information for Police when requesting an ambulance and how NEAS would respond, and responses times to calls made by police forces. The majority of calls requested by the police were in non-life threatening cases.

The region’s NHS111 service was performing well compared to many other NHS111 services.

The ambulance service was commissioned to respond to 75% of red (the most urgent) calls within 8minutes and 95% of these calls within 19mins, which are national standards. As of November 2013 the Trust was the best performing Trust in England in respect to these targets, and it had the lowest unit costs.

Commissioners have provided funding for c. 376000 calls for 2013-14, however the service was forecasting 390,000 calls for the period. The difference was being met with non-recurrent funding used to pay for external providers including St John’s Ambulance and the Red Cross. Overall demand had doubled in the previous ten years.

It was heard that the day before the meeting alone there was 1100 calls and ambulances in waiting areas at hospitals.

The winter period of 2012-13 had seen greater demands across the NHS and this had led to reduced performance in the emergency care system, including longer handover times of patients from ambulances to A and E which meant that crews were delayed being able to respond to new incidents. This was dependent on hospital capacity to admit new patients.

-It was recognised that a whole system approach was needed to deal with pressures on A and E. Each CCG had developed urgent care groups to address issues. Some work had also been done with GPs to understand how there could be better responses to GP urgent calls.

At the time of the meeting, handover delays were apparent in County Durham and Darlington Trust but the position on Teesside was greatly improved on the previous year.

During periods of extreme pressure locally, ambulances may be requested from elsewhere in the region; however these would always transport patients to the most suitable local hospital for their needs.

Members raised the following points/comments/questions:-
- Members noted that if the national target was 75% of calls were responded to within the target time that would mean 25% of people who did not get responded to within the target time.
- It was noted that callers to NHS111 would receive a 999 response if this was assessed as being needed during the call, and there would be no delay.

Members queried the numbers of people who NEAS ‘see and treat’ without transporting them to hospital. Other Trusts had higher numbers and this reflected the varying skills base (eg. enhanced level paramedics) and may be an area for further development. Other developments in ambulance care on a national basis included the need to recognise ambulances as providing skilled mobile care in the community, and finding more ways to deal with the increase in the urgent care caseload..

Representatives from NEAS agreed to review the information provided by the police and report back to the Committee.
The Committee requested an update from NEAS and the police on their operational relationship at a future meeting within six months.
The Committee received an update regarding the Tees Valley Joint Health Scrutiny Committee and its work. Members were provided with the minutes of the meeting of 28th October 2013 and 9th December 2013.
The Committee agreed to move the GP and urgent care review final report’s consideration at Cabinet to May 2014 due to the complexity of the review and evidence that was still being received.
The Chair had nothing to update.

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