DARTMOUTH PUBLIC MEETING Friday 1 March 2019 SOME FACTS :SWASFT - - PowerPoint PPT Presentation

DARTMOUTH PUBLIC MEETING Friday 1 March 2019

SOME FACTS :SWASFT

• 20% of the English landmass
• The most rural ambulance service in the UK
• Cornwall and the Isles of Scilly, to Worcester

border in the North to Hampshire border in the East

• 10,000 square miles
• 2 HART bases, 96 ambulance stations, 6 air

ambulance bases and 2 999 Clinical Control Rooms

• 5.3 million residents and 17.5 million visitors
• 1,000,000 incidents per annum
• +4,500 staff and over 5,200 volunteers

Communications

• D Harper (DCC) held meetings with Dartmouth

Healthcare Action Group (DAHAG) Chairman M Mills in response to SWAST activity & demand

• Data shared with DAHAG
• Facilitated Clinical Hub Visit pre Christmas for

Mike Mills, KMcS, DH and James Wenman to gain understanding of SWASFT core business

• Planned attendance at DAHAG meeting

deferred on 16 January 2019 due to Organisational Research for Health (ORH) report due at the end of January 2019

National Context

Category Headline Description Sub Description Average Response Target 90th Percentile Response Target 1 Life Threatening A time critical life- threatening event requiring immediate intervention or resuscitation 7 minutes 15 minutes 2 Emergency Potentially serious conditions that may require rapid assessment and urgent on-scene intervention and/or urgent transport 18 minutes 40 minutes 3 Urgent An urgent problem (not immediately life threatening) that needs treatment to relieve suffering and transport or assessment and management at the scene with referral where needed within a clinically appropriate timeframe 1 hour 2 hours 4 Less - urgent Problems that are less urgent but require assessment and possibly transport within a clinically appropriate timeframe None 3 hours

• Focus on all patients – performance monitored against the mean
• Focus on the 90th centile for all categories of call
• New national standards for ambulance services in England confirmed Autumn 2018
• Replaced previous targets including Red 1
• This is called the national “ARP Programme”
• New categories of call and changes in response times (see table below)

Our Contract

• A&E / 999 Contract
• 10 CCGs
• 1 Co-ordinating Commissioner Dorset
• Contracted and funded to deliver performance

at a whole Trust level, not by CCG or locality

• Negotiating now for the next 2 years – 2019/20

+ 2020/21

New County Structure

• New operations structure was established from

June 2018

• Moved from 3 Divisions in SWASFT to 8 Counties
• Dartmouth is within the South & West Devon

County which includes Plymouth and Torbay hospitals

• The County Management Team is a County

Commander, a Deputy and a Business Manager

County Map of the South West

Current Performance – Trust

SWASFT Response Times RAG Rated Against ORH Modelled Performance This is the performance deemed as ‘deliverable’ within existing

• resources. This shows that the Trust is delivering against all with the

exception of the Cat 3 90th centile (circa 15 minutes outside target). Category 1 calls are the most life threatening calls with a national target

• f 7 minutes which SWASFT is delivering consistently

ORH Model Q1 2018/19 Q2 2018/19 Q3 2018/19 Q4 2018/19 To Date Latest Week w/c 18/2/2019 Cat 1 (Mean) – life threatening 0:07:19 0:08:11 0:07:01 0:06:56 00:07:10 0:06:40 Cat 1 (90th) 0:15:49 0:15:23 0:12:58 0:12:33 00:12:40 0:11:48 Cat 2 (Mean) 0:44:38 0:24:55 0:27:18 0:27:32 00:29:58 0:28:01 Cat 2 (90th) 2:06:11 0:52:05 0:57:50 0:57:59 01:02:34 0:58:39 Cat 3 Mean 1:37:33 1:05:29 1:14:38 1:11:51 01:17:43 01:11:36 Cat 3 (90th) 2:32:22 2:33:32 2:54:08 2:45:57 2:58:13 2:47:04 Cat 4 (90th) – lower acuity 3:52:40 5:16:36 6:04:50 4:13:53 03:45:13 03:12:52

Recent Activity

A&E Incident Numbers - 8 Week Trend (Dark Red = Highest Activity in area over the last 8 weeks, Dark Green = Lowest) 31/12/2018 07/01/2019 14/01/2019 21/01/2019 28/01/2019 04/02/2019 11/02/2019 18/02/2019 Cornwall 2,037 1,911 1,889 1,901 1,876 1,984 1,873 1,992 S&W Devon 2,513 2,405 2,478 2,591 2,415 2,549 2,309 2,372 N&E Devon 1,901 1,714 1,773 1,799 1,890 1,828 1,768 1,743 Somerset 1,779 1,780 1,828 1,853 1,775 1,850 1,846 1,816 Dorset 2,853 2,753 2,720 2,725 2,735 2,758 2,656 2,616 BNSSG 3,109 2,976 3,052 3,278 3,220 3,195 3,121 3,058 Gloucestershire 2,066 1,918 1,883 1,981 1,961 2,037 1,912 1,855 Wiltshire 2,537 2,510 2,572 2,636 2,660 2,670 2,641 2,570 Total 18,830 18,009 18,226 18,816 18,583 18,914 18,169 18,072 A&E Incident Numbers Last Week vs Equivalent Week Last Year and vs Contract) Mon Tue Wed Thu Fri Sat Sun Total 2018/19 2,539 2,550 2,438 2,563 2,509 2,737 2,735 18,071 2017/18 2,714 2,476 2,457 2,458 2,582 2,646 2,600 17,933 Contract 2,621 2,459 2,421 2,428 2,471 2,695 2,660 17,755 Variance to 2017/18

• 6.4%

3.0%

• 0.8%

4.3%

• 2.8%

3.4% 5.2% 0.8% Variance to Contract

• 3.1%

3.7% 0.7% 5.6% 1.5% 1.6% 2.8% 1.8%

Current Performance South & West Devon County

Q1 2018/19 Q2 2018/19 Q3 2018/19 Q4 2018/19 To Date 27/02/19 Cat 1 (Mean) 0:07:47 0:06:40 0:06:39 0:06:46 Cat 1 (90th) 0:14:06 0:11:14 0:11:24 0:11:31 Cat 2 (Mean) 0:22:06 0:24:43 0:24:54 0:27:49 Cat 2 (90th) 0:45:51 0:51:59 0:51:43 0:58:18 Cat 3 Mean 1:09:42 1:16:06 1:10:56 1:17:27 Cat 3 (90th) 2:40:56 2:50:46 2:44:23 2:55:01 Cat 4 (90th) 5:54:57 6:11:52 4:14:38 3:24:27

Incidents in TQ Postcode Area

Ambulance Incidents in TQ Post Code Area by Month

Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19

TQ1

619 726 730 643 696 632 677 704 715 692 674 703 669 771 725 623 696 651 662 662 686 627 602 625 654 702 702

TQ2

696 750 649 637 702 664 707 721 740 716 762 762 709 806 800 645 779 682 731 759 804 754 661 775 783 765 714

TQ3

484 558 622 484 464 462 517 470 499 471 483 495 491 536 523 485 563 483 531 485 510 461 491 477 525 551 582

TQ4

401 415 425 355 362 422 385 450 444 412 409 433 396 470 398 377 468 400 429 429 434 392 373 366 366 428 438

TQ5

339 372 326 300 307 331 347 358 352 316 346 346 292 384 377 347 374 364 374 367 322 354 370 331 333 373 355

TQ6

135 152 135 100 123 127 129 111 115 152 156 146 122 117 103 113 121 113 138 120 107 136 111 97 98 110 121

TQ7

266 264 214 228 234 222 255 267 235 246 210 232 213 279 253 195 248 268 240 219 259 264 202 233 237 229 260

TQ8

24 14 26 26 16 18 24 33 32 38 32 25 30 27 27 27 16 24 30 35 31 36 26 20 27 20 24

TQ9

271 302 231 255 243 271 215 221 281 241 259 252 260 302 261 225 238 240 271 257 279 243 258 236 257 274 262

TQ10

49 52 44 49 53 54 41 35 41 39 33 40 59 59 53 48 64 50 49 58 39 51 42 33 61 49 58

TQ11

63 47 53 44 50 50 61 59 47 43 65 43 49 68 60 56 65 52 63 57 51 55 59 35 62 67 59

TQ12

885 928 937 761 826 840 884 848 815 852 882 958 874 996 936 850 933 949 858 881 913 864 878 927 895 954 1,020

TQ13

260 327 274 263 252 266 291 306 281 277 274 251 315 339 279 243 288 244 332 274 298 286 281 283 271 340 312

TQ14

318 352 376 281 302 292 352 300 320 331 299 343 337 324 343 291 375 334 323 355 359 333 312 310 297 305 332

Total

4,810 5,259 5,042 4,426 4,630 4,651 4,885 4,883 4,917 4,826 4,884 5,029 4,816 5,478 5,138 4,525 5,228 4,854 5,031 4,958 5,092 4,856 4,666 4,748 4,866 5,167 5,239 30 31 31 28 31 30 31 30 31 31 30 31 30 31 31 28 31 30 31 30 31 31 30 31 30 31 31 Nov-16 Dec-16 Jan-17 Feb-17 Mar-17 Apr-17 May-17 Jun-17 Jul-17 Aug-17 Sep-17 Oct-17 Nov-17 Dec-17 Jan-18 Feb-18 Mar-18 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 Average Number of Incidents per Day in TQ6 Post Code Area 4.5 4.9 4.4 3.6 4.0 4.2 4.2 3.7 3.7 4.9 5.2 4.7 4.1 3.8 3.3 4.0 3.9 3.8 4.5 4.0 3.5 4.4 3.7 3.1 3.3 3.5 3.9 0.0 1.0 2.0 3.0 4.0 5.0 6.0

Average Number of Incidents per Day in TQ6 Post Code Area

The Whole of South & West Devon County 24/7 Available Resources

Days (commencing before 0930hrs) Late’s (commencing between 0930hrs - 1700hrs) Nights (commencing after 1700hrs) Resource Double Crewed Ambulance Pathways Support Vehicle Rapid Response car Double Crewed Ambulance Pathways Support Vehicle Rapid Response car Double Crewed Ambulance Pathways Support Vehicle Rapid Response car Mon 22 1 6 9 2 2 16 6 Tue 22 1 6 9 2 2 16 6 Wed 22 1 6 9 1 2 16 6 Thu 22 1 6 9 1 2 16 6 Fri 22 1 6 9 2 2 17 7 Sat 22 1 6 9 1 2 17 7 Sun 22 1 6 9 1 2 16 6

Hospital Handover Delays

Hospital Handover Delays in Excess of 15 Minutes Handover Delays vs NHSE Trajectory Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 1079:17:39 1073:14:20 985:24:12 1122:47:09 1224:30:58 1260:22:57 1272:56:28 1261:10:04 1363:45:32 1607:02:08 1332:36:54 1436:21:05 1034:08:54 1103:29:20 1467:38:32 1175:51:37 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 86:17:42 85:58:01 93:37:22 75:26:02 69:42:59 104:08:10 138:34:25 105:09:56 62:30:11 177:45:07 146:28:48 124:12:34 75:38:53 93:25:57 106:24:48 114:49:49 Apr-18 May-18 Jun-18 Jul-18 Aug-18 Sep-18 Oct-18 Nov-18 Dec-18 Jan-19 147:40:05 113:13:05 107:05:57 148:36:17 139:20:37 157:35:25 136:45:56 125:33:51 129:26:08 146:24:47 134:37:30 165:40:50 113:49:55 145:45:25 181:51:41 146:48:31 All Acute Hospitals NHSE Trajectory Torbay Hospital NHSE Trajectory Derriford Hospital NHSE Trajectory

0:00:00 24:00:00 48:00:00 72:00:00 96:00:00 120:00:00 144:00:00 168:00:00 192:00:00

Torbay Hospital - Time Lost to Handover Delays in Excess of 15 Mins vs NHSE Trajectory

0:00:00 24:00:00 48:00:00 72:00:00 96:00:00 120:00:00 144:00:00 168:00:00 192:00:00

Derriford Hospital - Time Lost to Handover Delays in Excess

• f 15 Mins vs NHSE Trajectory

Final Comments & Questions

• Community First Responder Group – Your Assistance Please
• Dartmouth Group currently has 2 Community First

Responders

• Recent recruitment campaign NHS Jobs local media 21/12/18

– 21/01/19 gained one additional volunteer, training set 9 March 2019

• Further recruitment drives are planned, no cap on numbers of

volunteers to achieve 24/7 cover

• Dartmouth has three public access defibrillators, every

second counts in the chain of survival in cardiac arrest.

• The importance of early intervention – the chain of survival
• For every 1 minute that CPR is delayed Life Expectancy reduces

by 10%.... If CPR is delayed by 5 minutes there is a 50% chance

• f non survival (British Resus Council)