South East Coast Ambulance Service NHS Trust
NHS / Health Body
Action Taken
South East Coast Ambulance Service NHS Trust is recruiting additional crew members and purchasing new and second-hand ambulances. They have provided enhanced training to Support Call Takers, introduced a new Patient Welfare Procedure, and changed the procedure for standing down ambulances. (AI summary)
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Dear Madam write to respond to the Regulation 28 Report you issued on 25 June 2018 following the inquest into the death of Margaret Stemp. was very sorry to hear of Mrs Stemp's death, and that we were not able to provide the response that we aspire to when her sister called for help on Christmas
2017. would Iike to address in turn each of the areas of concern that you have raised: 1 . There were insufficient resources_to_deal with _the_high number of_calls on the dayin question The Christmas period, and specifically Christmas is one of the busiest and most challenging times of the year for the ambulance service. We anticipate increased demand and roster increased resources to try to meet that anticipated demand. On Christmas 2017, the level of demand was even greater than we had anticipated and for which we had resourced_ At times of highest demand, priority is given to patients in an immediately life threatening position. In order to avoid this situation recurring in future periods of very high demand, we have taken the following action:
a. We are aiming to recruit an additional 300 ambulance crew members, sO we have more resources that we can call upon for times of maximum demand_ b We are purchasing approximately 100 new ambulances over the course of the next three years, again to increase our resource base. As an immediate measure, we have Chairman: Graham Colbert (Interim) Chief Executive: Daren Mochrie QAM Your Service, jour call Day Day, Day will
purchased 30 second hand ambulances so far this year; to help us to deal with anticipated winter pressures We are, together with our commissioners , carrying out "Demand and Capacity Revlew' which will enable both parties to determine: the resources needed to meet the demand on our service, to cope with increased pressure throughout the acute healthcare system, including "out of hours provision, and how those resources will be provided. d_ We have planned review of our forecasting model, with the objective of better anticipating what resources will be needed for any hour of any making provision for system pressures_ 2 ThePolice_had to_be_used to provide_the necessary welfare support to Mrs Stemp and her sister am grateful to the Police for their assistance on this occasion, however fully accept that the welfare of patients is SECAmb's responsibility, not that of the Police. Since this incident; we have put in place new procedures to ensure the welfare of patients who have fallen and to whom we are not able to respond in timely manner: attach a copy of our Emergency Operations Centre clinical summary (and relevant attachments) setting out our new procedure to safeguard the welfare of patients who have fallen, while are awaiting an ambulance_ 3 The_call takers_did_not_seem _to_appreciate_the_worsening_condition_of_these_two ladies during the time_they were seeking assistance As a result of this incident; all Support Call Takers have received, and new SCT's will receive on induction, enhanced training with an emphasis on how to recognise worsening of patient's condition and what action to take on recognising that fact: We have introduced a new Patient Welfare Procedure, which involves SCT's working more closely with our new Clinical Navigators, who are clinicians who oversee the clinical queuelwaiting calls and help manage them more efficiently from clinical perspective. In addition, system of audit of SCTs' work is to be introduced, to bring them in line with the quality assurance system in place for our 999 call takers. This project is at the planning stage, as we will need additional resources to carry out the audits and we are defining the criteria for the audit tool which will set out the audit elements and scoring: 4_ There_was no clinical oversight of_the decision to stand the ambulance down As a result of this incident; the procedure for standing down an ambulance has now been changed. Support Call Taker can no longer stand down an ambulance_ A two-step verification process has been introduced whereby must refer the case to a Dispatch Team Leader or Clinician (Clinical Navigator) for the ambulance to be stood down: trust that this letter reassures you that we have taken seriously the issues arising from Mrs Stemp's incident on 25 December 2017 and that we have put measures in place to ensure that the situation will not recur. day, they they very
2017. would Iike to address in turn each of the areas of concern that you have raised: 1 . There were insufficient resources_to_deal with _the_high number of_calls on the dayin question The Christmas period, and specifically Christmas is one of the busiest and most challenging times of the year for the ambulance service. We anticipate increased demand and roster increased resources to try to meet that anticipated demand. On Christmas 2017, the level of demand was even greater than we had anticipated and for which we had resourced_ At times of highest demand, priority is given to patients in an immediately life threatening position. In order to avoid this situation recurring in future periods of very high demand, we have taken the following action:
a. We are aiming to recruit an additional 300 ambulance crew members, sO we have more resources that we can call upon for times of maximum demand_ b We are purchasing approximately 100 new ambulances over the course of the next three years, again to increase our resource base. As an immediate measure, we have Chairman: Graham Colbert (Interim) Chief Executive: Daren Mochrie QAM Your Service, jour call Day Day, Day will
purchased 30 second hand ambulances so far this year; to help us to deal with anticipated winter pressures We are, together with our commissioners , carrying out "Demand and Capacity Revlew' which will enable both parties to determine: the resources needed to meet the demand on our service, to cope with increased pressure throughout the acute healthcare system, including "out of hours provision, and how those resources will be provided. d_ We have planned review of our forecasting model, with the objective of better anticipating what resources will be needed for any hour of any making provision for system pressures_ 2 ThePolice_had to_be_used to provide_the necessary welfare support to Mrs Stemp and her sister am grateful to the Police for their assistance on this occasion, however fully accept that the welfare of patients is SECAmb's responsibility, not that of the Police. Since this incident; we have put in place new procedures to ensure the welfare of patients who have fallen and to whom we are not able to respond in timely manner: attach a copy of our Emergency Operations Centre clinical summary (and relevant attachments) setting out our new procedure to safeguard the welfare of patients who have fallen, while are awaiting an ambulance_ 3 The_call takers_did_not_seem _to_appreciate_the_worsening_condition_of_these_two ladies during the time_they were seeking assistance As a result of this incident; all Support Call Takers have received, and new SCT's will receive on induction, enhanced training with an emphasis on how to recognise worsening of patient's condition and what action to take on recognising that fact: We have introduced a new Patient Welfare Procedure, which involves SCT's working more closely with our new Clinical Navigators, who are clinicians who oversee the clinical queuelwaiting calls and help manage them more efficiently from clinical perspective. In addition, system of audit of SCTs' work is to be introduced, to bring them in line with the quality assurance system in place for our 999 call takers. This project is at the planning stage, as we will need additional resources to carry out the audits and we are defining the criteria for the audit tool which will set out the audit elements and scoring: 4_ There_was no clinical oversight of_the decision to stand the ambulance down As a result of this incident; the procedure for standing down an ambulance has now been changed. Support Call Taker can no longer stand down an ambulance_ A two-step verification process has been introduced whereby must refer the case to a Dispatch Team Leader or Clinician (Clinical Navigator) for the ambulance to be stood down: trust that this letter reassures you that we have taken seriously the issues arising from Mrs Stemp's incident on 25 December 2017 and that we have put measures in place to ensure that the situation will not recur. day, they they very