Agenda item

The Committee considered a report of East Midlands Ambulance Service (EMAS) which gave an overview of their work. A copy of the report, marked ‘Agenda Item 9’, is filed with these minutes.

The Committee welcomed to the meeting for this item Susannah Ashton, Divisional Director, EMAS, Leicester, Leicestershire and Rutland.

Arising from discussions the following points were noted:

(i)           One of the advantages of EMAS being a regional organisation rather than solely for Leicestershire was that in periods of high demand in Leicestershire resources could be taken from elsewhere in the region to help out.

(ii)         At times EMAS would take a patient picked up in Leicestershire across the border to a hospital in the West Midlands as it was closer, however EMAS would not pick patients up in the West Midlands.

(iii)        Ambulances could take longer to reach patients in rural areas. The software used by EMAS gave advice on the best routes to take to avoid roadworks or other blockages. Although there were ambulance stations in rural areas this did not mean an ambulance would be at the station ready to go when a call came in for a rural area. The ambulance could be on a job in another area.

(iv)       The table in the report demonstrated that the category 2 response times had lengthened significantly in December 2023 and again in December 2024. This was thought to be due to an increase in demand around that time of the year rather than being due to staff being on holiday. Reassurance was given that staffing levels did not fluctuate during the year and were kept consistent.

(v)         In response to concerns raised, members were reassured that whilst patients were waiting for an ambulance or paramedic the control room would keep in touch with them. The number of call takers and clinicians available to provide the Hear and Treat service had been increased. NHS England had set a target of 20% of ambulance calls being managed by the Heart and Treat service; the latest figure for EMAS was 24%.

(vi)       In response to a question about how ambulance handover times at the Emergency Department in Leicester compared with other areas of the country, it was explained that it varied. The National Standard was a 15 minute handover time but as this was not always realistic, in 2025 ICBs had been asked to aim for a 30 minute handover time. It was agreed that the exact comparison data would be provided to members after the meeting.

(vii)      Members queried what percentage of people called for an ambulance when they did not need one and could have received treatment via another method. Some patients that were dealt with by EMAS had called 111 and some had called 999. Patients did not always call the correct number for their medical issue, but either way they would receive the same service because the same pathway system was used. Members indicated that they might wish to scrutinise these issues further at a future meeting.

(viii)    Concerns were also raised that the call operators were allocating ambulances to calls when the patient could have been conveyed to hospital via other means. Members queried how good the call handlers were at triaging patients and deciding what treatment and assistance they required. In response it was explained that the accuracy was variable and it could be challenging for the call takers to make the right assessment as most patients did not have the medical training to describe their symptoms accurately. However, calls could be re-categorised very easily once EMAS had seen a patient face to face. Reassurance was given that the calls were reviewed and audited and further guidance was issued to call operators when necessary. It was not possible for EMAS to change the questions asked by call operators as the questions were set nationally. It was agreed that data regarding the accuracy of the triage process would be provided after the meeting.

(ix)       It was explained that 39% of patients dealt with by EMAS were conveyed to hospital and the remaining 61% were conveyed to an alternative place of care. Members asked to receive further information regarding these statistics. 

(x)         In response to a query, it was explained that there were enough training places for paramedics. Locally Nottingham Trent University and Northampton University ran the courses. However, the problem was that there were not enough vacancies for newly qualified paramedics.

(xi)       West Leicestershire had been named as one of 43 areas in England which would benefit from improved Neighbourhood Health Services as part of a government scheme. A decision had been made locally that this work would focus on respiratory issues and EMAS was linked in with this work. EMAS was also involved in other community schemes such as work taking place in Hinckley and Bosworth district to identify and address mould in homes.

RESOLVED:

(a)        That the overview of the work of EMAS be noted:

(b)        That officers be requested to provide regional comparison of ambulance handover times, data regarding the accuracy of the triage process and the percentage of calls to EMAS where the patient could have received appropriate treatment elsewhere.