NORTH EAST AMBULANCE SERVICE NHS TRUST
PROGRESS REPORT ON THE DEVELOPMENT OF RUSSELL HOUSE – CONTACT CENTRE / EMERGENCY PLANNING DEPARTMENT / HART and A&E STATION
Background and Overview of the NEAS Operational Responsibilities
The North East Ambulance Service NHS Trust (NEAS) covers the areas of Accident and Emergency, Patient Transport Services, Emergency Planning and Resilience, Operational Support and Service Improvement. NEAS covers an operational area of some 3,230 square miles and provides assistance to a population of around 2.65 million.
1.0 Accident & Emergency Performance – 2008/09
NEAS has exceeded the government’s response targets for reaching 75% of all life threatening emergency calls (Category A) within eight minutes:
1.1 Cat A – Life threatening
Trust performance for 2008-09 was 75.69%, this is based upon the new Call Connect methodology of measurement (introduced - April 2008). Response target for (Category A) within 19 minutes was achieved at 99.0%. In 2008-2009 our A&E crews dealt with a total of 90,818 life-threatening Cat A emergency incidents which was a 14% increase on last year’s figure. This equates to approximately 7,568 incidents per month.
1.2 Cat B – Serious but not life-threatening
NEAS also achieved the government’s target of responding to 95% of all serious but not life threatening calls (Category B) within 19 minutes. The performance for 2008-09 was 95.57%. NEAS responded to 158,504 Category B incidents which equates to approximately 13,209 per month.
Note: These excellent performance standards have again been achieved through the hard work, skill, dedication and knowledge of the Contact Centre staff and the front line operational staff, Voluntary Agency Staff (St John Ambulance and Red Cross), First Responders and numerous other support staff.
1.3 Non Transportation Rate
The Trust treats patients ‘on scene’ (See and Treat) and has reduced its transportation rate to hospital Accident and Emergency Departments by approximately 13% over recent years. This reduction in transportation rate equates to around 30,000 fewer attendances at the hospital emergency departments.
1.4 Teesside Performance Post Transfer of Dispatch to Bernicia House
The responsibility for dispatching ambulances to emergencies originating in the Teesside Division was transferred from Ladgate Lane to Bernicia House on the 18th May 2009. Since that time, operational performance on Teesside has been the subject of intense management scrutiny by NEAS staff. The following tables highlight the levels of performance achieved for the months immediately following the transfer, all appear to demonstrate good levels of operational performance:
Number of Category A incidents / June08 09 / July
08 09 / Aug
08 09 / Sept
08 09 / Oct
08 09
Teesside Division / 1627 / 1913 / 1716 / 2014 / 1703 / 1714 / 1630 / 1885 / 1707 / 2094
Number of Category A incidents / June
08 09 / July
08 09 / Aug
08 09 / Sept
08 09 / Oct
08 09
Stockton TPCT / 480 / 558 / 497 / 563 / 474 / 478 / 452 / 568 / 533 / 620
Number of Category A incidents / June
08 09 / July
08 09 / Aug
08 09 / Sept
08 09 / Oct
08 09
Hartlepool PCT / 235 / 321 / 240 / 322 / 286 / 287 / 285 / 305 / 252 / 342
Number of Category A incidents / June
08 09 / July
08 09 / Aug
08 09 / Sept
08 09 / Oct
08 09
Middlesbrough PCT / 512 / 564 / 557 / 652 / 533 / 551 / 521 / 544 / 529 / 598
Number of Category A incidents / June
08 09 / July
08 09 / Aug
08 09 / Sept
08 09 / Oct
08 09
Redcar & Cleveland PCT / 400 / 470 / 422 / 477 / 410 / 398 / 372 / 468 / 393 / 534
2.0 Patient Safety
There have been a number of steps taken to ensure patient safety is not compromised prior and following the relocation of the A&E control function from Ladgate Lane to Bernicia House, Newcastle upon Tyne.
2.1 Prior to the move, the Assistant Control Manager collated an in depth information referral document for all control staff at Bernicia House, Newcastle. Content of the document was sought from TEES control staff based at Ladgate Lane and also those based at Newcastle. As a result an action plan was devised with individual responsibility assigned to key personnel with each action being closed out on completion. The intention of the document was to ensure no aspect of TEES operational and control operating procedures was missed and patient safety was maintained at all times. For example the document ensured area maps, emergency planning/COMAH sites, hospitals etc were supplied.
2.2 The TEES desk in Bernicia House, Newcastle has been staffed solely with dedicated dispatch staff and furthermore has been managed by a Duty Manager and the assistant Control Manager TEES who has monitored overall performance of the desk following the relocation. There have been no reported incidents regarding patient safety within control although the speed at which former Ladgate Lane staff have been inputting addresses has been subject to re-training and overseen by the clinical supervisor.
2.3 Operational management was (and continues to be) consulted throughout the process, seeking their views on how best to secure a seamless transition. It was vital operational crews were kept reliably informed of all aspects of the relocation. With the exception of one complaint from an operational crew member, the feedback from crews within the division has been extremely positive.
2.4 Four Duty Managers and One Dispatch Officer relocated to Bernicia House, Newcastle from TEES and without exception all have found the move to be a huge benefit to the delivery of patient care.These members of staff have emphasised how the Integrated Communications Control System (ICCS) and the Command and Control (CAD) system at Bernicia House has greatly improved the speed of dispatch of ambulance on Teesside.
3.0 Resilience
3.1 Second Contact Centre (Russell House)
The implementation of the second contact centre is a result of a review to ensure that NEAS complies with its statutory responsibilities under the Civil Contingencies Act.
During 2006/07 the Department of Health commissioned a review of contact centre resilience and recommended that all ambulance services had two fully functioning A&E control centres to ensure no significant disruption to services in the event of one being disabled for any reason. The second contact centre at Monkton, Hebburn,in South Tyneside, will be a mirror image of the existing contact centre at Ambulance HQ, Bernicia House in Newburn Riverside, near Newcastle. (see floor plan attached).
The contact centre site covers 550 sq meters and will be ready for operations in December 2009. A further plan to bring the centre into operation will be phased in with 999 call takers moving from Ladgate Lane and Bernicia House to the new centre in Hebburn. Once the second centre is fully operational, the site at Ladgate Lane will be decommissioned. This work is expected to be completed by March 2010.
3.2. Emergency Planning (Teesside considerations)
NEAS’s Emergency Planning Department (EPD) has responsibility for emergency preparedness throughout the whole of the operational area. EPD officers are based in Newcastle and Middlesbrough. The Newcastle site will relocate to Monkton when the centre is completed.
The Middlesbrough site is based at the joint services Emergency Planning Unit based at Middlesbrough Fire Station. This unit has emergency planning representatives from NEAS, Cleveland Police, Cleveland Fire & Rescue Service and each of the unitary authorities within Teesside. The NEAS representative on Teesside participates in the planning, running and post exercise debriefs of approximately 20 planned exercises per year, including six at the British Energy Site in Hartlepool. He is fully involved in multi agency training with the other emergency services and authorities ensuring NEAS representation at all times. He is also an active member of the emergency planning groups from each of the local acute hospitals, emergency planning forums including the Strategic Local Resilience Forum in the absence of his line manager.
A number of specialist courses have now been completed in the Cleveland area and these have been well received by operational staff. The courses are the Major Incident Medical Management Courses that prepare frontline staff to deal with the early command and control requirements of the NEAS. The course has had representatives from Cleveland Police and Fire Services on it to improve the multi agency understanding of our role at a major incident.
When the Monkton site comes on line, there is no intention of withdrawing this officer from the Cleveland area as it is crucial to the management of risk within the area. He is supported by another EP officer and line manager when required.
3.2.3 Pandemic Influenza (Swine Flu)/ Winter Pressures
Pandemic flu preparation for the NEAS is a regional priority in which the ambulance service is liaising with acute trusts, Primary Care Trusts and Strategic Health Authority to ensure a whole systems approach.
The first wave of pandemic flu in the summer of 2009 affected the North East Ambulance Service with a significant increase in demand on services at a time when staff were also absent from work with sickness. This affected call centre operations against our national target to answer 95% of 999 calls within five seconds. The trust usually answers these calls within target in 98% of all cases, but the affects of swine flu saw this call answer rate drop to 96%.This is still above the national standards at a time when demand was up and we were suffering absences of staff. The important thing to note is that we got through it.
Percentage of calls answered within 5 seconds of connection to the contact centre:
Apr-09 / May-09 / June-09 / Jul-09 / Aug-09<5 / 97.8% / 96.1% / 96.4% / 96.2% / 98.3%
Number of calls:
Apr-09 / May-09 / June-09 / Jul-09 / Aug-09Calls / 24,822 / 26,611 / 25,675 / 28,830 / 25,927
From a national perspective, all ambulance trusts have experienced significant increase in activity as a result of swine flu over the summer. We have tested our resilience plans at both a national and regional level to ensure that NEAS is prepared to maintain our core activity in the event of a sudden increase of the pandemic over the winter.