Agenda item

To consider and comment on the West Midlands Ambulance Service (WMAS) Winter Plan for 2021/22.

The Board received a presentation from West Midlands Ambulance Service on its Winter Plan 2021/22 and the process of developing the Plan each year.

The planning process began in April of each year with a lessons-learned exercise looking back on the previous winter. The first draft of the Plan was normally presented to the Trust’s Board in July.  The Plan was a living document and was managed through the command team, which included the Chief Executive of the Trust. 

The Plan was based around three key objectives:-

1)            Protect the critical infrastructure of the 999 service.

2)            Maximise frontline resources.

3)            Save as many lives as possible.

All services had been maintained during the pandemic and effective strategies had been implemented for infection control, including 24 hour staff testing and track and trace.  93% of staff had been vaccinated against Covid-19.

Some of the strategies for maximising the efficient use of resourceswere outlined, including managing the 100% increase in 111 calls.  Community First Responders were deployed to respond to some 999 calls.  They were able to provide life-saving treatment to patients until an ambulance arrived.  Call handlers were able to determine whether an ambulance was required by discussion with the caller.  This allowed the service to reduce the number of ambulances being dispatched at any one time and redirect the staff so that the most experienced paramedics were deployed to the most critical cases.  Call handlers were also able to refer patients to other services electronically during calls, which minimised handover waiting times and allowed patients to be directed to the most appropriate service.  All WM Ambulance Service staff were trained physicians, and this included clinical directors, which meant they could be deployed operationally when required.

Despite these challenges the service’s performance on 999 calls was the best in the country. 

A director was on duty 12 hours a day, 7days a week to direct operations. The ambulance fleet was composed of approximately 1,000 vehicles, around half of which were designed for 999 response and other half were patient transport service (PTS) vehicles.

There were around 7,500 staff working for WM Ambulance Service. During the worst period of the pandemic almost 1000 members of staff were off work due to sickness, which created a considerable operational challenge. This currently stood at 480 people.

Handover of patients to hospital remained a key challenge for the service, however, Sandwell and West Birmingham Hospitals Trust was one of the best performing trusts in the region for this.

The following was noted in response to comments and questions:

·      Achieving the net zero emissions target by 2030 was going to be a great challenge for the ambulance fleet. The changes required a big capital investment and it depended on whether the market could respond in time to produce suitable vehicles for an ambulance service that could also be affordable for the public sector.

·      Some GPs were referring patients to 111 services which created additional demand on services however this was difficult to resolve as it was well known that GP practices were operating beyond capacity and demand was growing. Nationally 19% more appointments were now being offered than before the pandemic, but the primary care workforce had reduced by 15,000 over the same period.

·      The provision of nebulisers in primary care was linked to the type of General Medical Services (GMS) contract in place at the practice, as most CCGs commissioned only the basic services due to cost.

·      Operating 999 and 111 services as part of the same organisation brought tangible benefits. All staff at West Midlands Ambulance Service were trained to deal with both 999 and 11 calls, which contributed to the service being fastest in the country to respond to 999 calls.