Agenda item

West Midlands Ambulance Service has invited the Committee to consider and comment upon its annual Quality Account.

A copy of the WMAS draft Quality Account for 2021-22 had been circulated and the Committee was invited to submit questions and comments.  Pippa Wall took members through the document, which was accompanied by a presentation of the key areas:

• Update on 2021/22 priorities for:
  • Cardiac arrest management
  • Maternity care
  • Reduction in the volume of patient harm incidents
  • Learning from patient feedback
• Priorities for 2022/23 for:
  • Integrated urgent and emergency care clinical governance
  • Maternity
  • Mental health
  • Utilisation of alternative pathways including urgent community response
• Taking action on last year’s comments
• The recent engagement exercise on the draft quality account

The following points were raised, with responses provided as indicated:

• The report made reference to the Commonwealth Games and the 400 frontline staff being deployed to work on the games. There were strong concerns that ‘business as usual’ would not be maintained. Data was sought on what proportion of WMAS staff this involved.  Pippa Wall gave an undertaking to provide this information including  why 400 staff were required and what the expected impact would be, together with the cover arrangements. It did sound a significant number and she outlined the reasons for this, including the scale of events, multiple locations and the length of cover needed each day. WMAS would be challenged if it didn’t provide resources. The Chair also asked who was funding the service to the Commonwealth Games. A formal response would be provided.
• A series of questions and points were submitted about the incomplete nature of the QA document, with a number of examples quoted. The member felt it would have been better to defer this item until the full report was available. 
• Reference to the accompanying presentation. Earlier in the meeting there was discussion about the serious challenges in providing a responsive service for patients, which had not been included in the presentation. WMAS had attended the Committee in November to provide a performance update and at that time described the situation as a crisis. Again, the report made no reference to this, focussing on other areas, such as safeguarding and body cameras. For the public the key issue was a responsive service.
• Pippa Wall responded reminding of the statutory nature of this report which had to be approved and published by June. There was a duty to seek comments from a range of stakeholders and a number of timing constraints with availability of information, such things as avoiding council elections and the requirements for sign-off before publication. The Chair added that this was a draft report. She agreed with the points made about the key issue for patients being a responsive service and questioned the value of producing such QA reports instead of addressing the current service challenges. Pippa Wall confirmed that large sections of the report were mandated. Most people would be concerned about response times, whilst others had raised staff wellbeing and safety.

• Chris Bain noted that all service providers were required to produce these QA documents and he questioned what added value they provided. He clarified some wording in the document which should refer to people who were ‘seldom heard’ rather than ‘hard to reach’. This would be updated. He welcomed the forward objective around mental health, but less so the link to the NHS plan. This should not become an objective but may be a means to achieving objectives and should be distinguished. The point was noted. Finally, the objective of tackling inequalities was raised. This may mean different things to different people.
• Councillor Bell noted that none of the targets included any data. This should state the current and target performance to enable measurement.  From the previous session she referred to the low chance of a patient surviving a cardiac arrest. Even if the target was to improve survival chances by just 1% it would give some reassurance.  There was ongoing work on ambulance services which would be discussed by the Health and Wellbeing Board (HWBB) with a view to formulating an action plan for improvement. It was a systemic issue which needed joint work to address it.
• A comment that the comparison of the WMAS performance being better than many other areas was sightly irritating. Councillors were concerned about services for Warwickshire patients.
• Further information was provided about the first responders who were volunteers and the urgent community response, which was a national directive. Further clarification would be provided after the meeting.
• The Chair commented that there was a need to involve the key personnel of all organisations, to agree a strategy and direction of travel, to address the reported concerns and focussing on manageable areas at one time. A need to focus collectively on patient outcomes was the critical aspect. She spoke about survival rates which were lower than those in other European countries and feared that this would worsen further. There was an opportunity to shape things for the future through a joint discussion. It was hoped that this would be progressed by the HWBB.

In closing the debate, the Chair thanked Pippa Wall for her attendance for both items.

Resolved

That the Committee notes the WMAS draft Quality Account for 2021-22 and responds as outlined above.