Minutes:
A presentation was given by Tracy Pidgeon, Ambulance Operations Manager for A&E Operations Bromley, Beckenham and Forest Hill and David Gibson-Stark, Duty Station Officer at Bromley Ambulance Station. A copy of information handed to Committee Members and Co-opted Members is at Appendix B.
In addition to information in the handout, a number of comments were made by the Ambulance representatives including those summarised below.
In discussion it was indicated that Bromley Town Centre to Kings College Hospital could take some 25 minutes on an emergency “blue light” journey.
Referring to the Urgent Care Network of which all LAS services were a part, the Director of Public Health indicated that work was ongoing with LAS services on alternative pathways outside of A&E e.g. taking patients to Urgent Treatment Centres. It was necessary for people to be taken to the right place.
In further discussion, it was confirmed to Councillor Catherine Rideout that a triage could be undertaken by telephone and if appropriate urgent assistance provided by motor cycle with ambulance backup.
In response to a question from Councillor Fookes, it was indicated that highest demand was at the weekend, peaking from Thursday to Friday. In response to a further question, it was indicated to Councillor Fookes that an independent analysis of demand is undertaken and a prediction made of where calls for an ambulance are most likely to be made. The location of ambulances would then be fixed according to the predicted demand. If a crew was unavailable, the next nearest crew is sent out. Depending on the location, this could be a crew from a neighbouring A&E Operations area such as Greenwich.
Concerning hoax calls, it was explained that some might dial the emergency number out of panic and others might dial the number through lack of education.
Councillor Ruth Bennett felt that the cardiac survival rate was impressive; she suggested that it showed that specialist service in hospital is the way forward.
In response to a question from Councillor Catherine Rideout, it was explained that out of hours demand has always been rising; some call 999 as it is easiest. There was a need for “vomit buses” in places such as Waterloo or Soho in central London. Croydon also has such a bus. But the ambulance service was not called out so much for such incidents in Bromley.
Concerning use of an air ambulance, it was explained that if a serious trauma is identified then an air ambulance can be despatched. A car is also available at night.
Traffic calming measures such as road humps caused a problem for the ambulance service and some damage; a number of ambulance vehicles were not set up to go straight over road humps. The ambulance service had a policy on traffic calming.
Councillor Jefferys enquired of the percentage of cases where an assessment made by an ambulance crew did not result in going to hospital. It was indicated to Members that this information was not conveyed and so it was difficult to provide an accurate response.
A further question was asked about any policy to indicate where ambulances should be sited. It was explained that historic data was looked at every three to six months. Cars were sited at locations where places could be reached quickly – they were not sited at ambulance stations as it would take longer to respond.
Angela Harris enquired whether the ambulance service was content about responding to calls involving falls. It was indicated that crews were happy to respond to such calls and check those suffering a fall. Every fall was reported and details referred on to GP services.
Angela Harris also enquired whether there was any problem where people did not want to be admitted. It was explained that there were sometimes difficulties with mental health patients. Sometimes there could also be confusion with calls and people not expecting an ambulance crew.
A question was also asked on whether assaults on ambulance staff continued to be a problem. It was confirmed that this was continuing on a fairly regular basis either verbally or physically. Police would also attend if shouting was heard during the telephone call. The London Ambulance Service had stab vests. Crews also carried out risk assessments. Training helped e.g. with breakaway techniques. It was open for the service to write to individuals where there were serious concerns – there were some addresses that ambulance crews would not attend without police assistance.
In conclusion the Chairman thanked the LAS representatives and commended the number of cases attended. The Chairman also commended LAS performance in the borough associated with a return of spontaneous circulation following heart attack. However, the Chairman remained concerned that the emergency 999 number was viewed by some to be a short cut to services. She suggested that the matter could perhaps be looked at by commissioners and the effectiveness of the new non emergency number considered. She suggested that the matter be looked at by the Sub-Committee at a later date.