Cheshire Overview

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Cheshire Overview Scrutiny Committee

• Activity and Performance Report

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Overall Activity

• Total demand for emergency ambulances has
  continued to increase in the following PCT areas
  throughout 2007/08 and 2008/09 to date
• Central and East Cheshire PCT
• Western Cheshire PCT
• 999 activity for 2007/08 compared to 2006/07 for
  Cheshire as a whole rose by 6.11. This trend in
  increased activity has continued during the first
  quarter of 2008/09.

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Category A Activity

• In addition to the increases in activity, NWAS
  has also experienced changes in the case mix of
  emergency and urgent demand. Effectively, this
  has seen an increase in the proportion of overall
  demand which has been categorized as potentially
  immediately life-threatening (Category A).
• Category A demand increased for Cheshire as a
  whole by 18.29 in 2007/08 compared to 2006/07.

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Category A Activity

• Increases in Category A demand by PCT area in
  2007/08 was
• 17.78 in Central and Eastern Cheshire
• 19.22 in Western Cheshire

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Response Time measurement

• In April 2008 changes were introduced to the way
  in which emergency response times are measured by
  ambulance services in England. From that date,
  responses are measured from the point at which a
  999 call is presented to the ambulance service
  telephone switch. This replaced the previous
  position which saw such responses measured from
  the point at which the ambulance service had
  ascertained the location of an emergency and the
  type of incident.

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Response Time measurement

• Whilst the methodology for calculation has
  changed, response time standards for ambulance
  services have remained the same
• Category A emergency Calls 75 within 8 minutes
• 95 within 19 minutes
• Category B emergency calls 95 within 19 minutes
• Category C emergency calls 95 within 60 minutes

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Response Time measurement

• Commissioning arrangements for NWAS require
  emergency response time performance to be met
  over the NWAS operating area as a whole, and also
  within each constituent previous legacy Trust
  area. In 2007/08 the Cheshire and Merseyside area
  (previously MRAS) achieved a response time
  performance level of 75.47 for Category A
  emergency calls.

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Response Time measurement

• Emergency Response time performance in Cheshire
  as a whole, and in each of the PCT areas has
  shown improvement since April 2006.

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Response Time measurement

• Against a backdrop of increased demand and the
  introduction of a more challenging approach to
  response time measurement, response time
  performance has improved across Cheshire. This
  has resulted in more patients receiving an
  ambulance service response within 8 minutes in
  2008/09.

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Improvement Plans

• Supported by increased investment by
  commissioners for 2008/09, NWAS plans to continue
  to make further improvements in response time
  performance in Cheshire through
• Increased levels of Rapid Response Vehicles (RRV)
  and High Dependency Service (HDS) deployment
• Introduction of Response / Conveyance model
• Improvements in Emergency Control Centre call
  answering and dispatch performance
• Introduction of additional Community First
  Responder schemes

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Improvement Plans

• In the last quarter of 2007/8, through rota
  redesign, additional RRVs were deployed in
  Congleton, Crewe/Nantwich and Wilmslow
• From 1 April 2008, additional investment has
  resulted in additional RRV resources in Wilmslow
  and Crewe/Nantwich
• As of 1/6/08, additional resources have been
  invested in RRVs across Crewe/Nantwich, Wilmslow
  and Sandbach
• High Dependency Service resources are due to be
  deployed 24/7 throughout Cheshire