Agenda item

Dan Smith, Area Consultant Paramedic, North west Ambulance Service will be in attendance to discuss the interaction between the Ambulance Trust and mental health services/service users.

Members of the Joint Health Overview and Scrutiny Committee considered a verbal presentation from Dan Smith Area Consultant Paramedic – Northwest Ambulance Service.  The presentation contained the following information:

•       Northwest ambulance service covers the North West footprint;33 Clinical Commissioning Groups, 1,420 GP practices, 29 Acute Trusts

•       1.3 million 999 calls per year

•       81% of red calls are answered within 8 minutes and 95% within 19 minutes

•       63% of patients arriving at A&E by ambulance in Greater Manchester end up in a hospital bed.

The Area Consultant Paramedic reported that the ambulance service has changed.  Paramedics now work differently; a paramedic pathfinder scheme has been introduced as well as community care pathway and community paramedics.

The Area Consultant Paramedic reported that paramedics now provide an enhanced treatment role.  Paramedics will often safely manage more patients at the scene, treat them at home or refer them to a community based service. 

The Area Consultant Paramedic reported that in 2014/15, 30% of the calls they responded to the patients was either left at home or with an alternative care package.  In 2015/16 that figure had risen to 42%.  Of the 500,000 calls responded to in the same period, 10% were defined as life threatening.

In response to a Member’s question with regards to the paramedic pathfinder scheme; the Area Consultant Paramedic reported that the scheme allows the paramedic to assess the patient and if required arrange to review the patient again after a period of two hours. 

The Area Consultant Paramedic reported that a number of calls are received from healthcare professionals, a large proportion of calls are received in the same period, causing peaks in demand.  The Ambulance Trust is working with other healthcare professionals to educate them in respect of this issue.

In respect of mental health, the Area Consultant Paramedic reported that in all areas there has been an increase in the percentage of 999 activity coded as suicide, self harm, overdose or mental health.  The Paramedic reported that any incident of overdose/self harm or acute mental illness would automatically be transferred to A&E.  Paramedics do also have powers with regards to the Mental Health Act or Mental Capacity Act when there is an immediate threat to life.  Paramedics will liaise with GPs and mental health services in respect of the most suitable place for a patient.

In response to a Member’s question, the Area Consultant Paramedic reported that the Ambulance service would classify a patient as a frequent caller, if they called the service four times in twenty eight days or twice in seven days.  The Ambulance service will work with patients categorised as frequent callers and assess what support is available must appropriate to their needs.

The Area Consultant Paramedic reported that the Greater Manchester Fire Service, Community Risk Intervention Team has been established to extend support to other emergency services.  The team will respond to NWAS low-priority calls including; falls in the home and instances where they can help people to stay in their own homes rather than go into hospital.

In response to concerns expressed in relation to the provision by Pennine Care of Crisis Home Treatment Teams; the Area Consultant Paramedic reported that the service is operating well, there have been no problems recently when accessing the service.  For paramedics there is a great deal of risks in treating a patient with a mental health condition.  Paramedics will discuss the crisis team to receive assurance and information in relation to a particular patient’s mental health condition.

In response to issues identified above, Northwest ambulance service is in the process of recruiting a mental health practioner based at their call centre.

The Area Consultant Paramedic reported that there is a blue light user group with representation from all the emergency services that meets regularly to review cases.

Members expressed concern about cases Ambulances being used to transport patients to different areas of the country.  The Area Consultant reported that depending on availability it may be necessary to source an alternative mode of transport to transfer the patient.

It was agreed:

1.   That Dan Smith, Area Consultant Paramedic be thanked for his attendance.

That the figures in relation to the number of ambulance journeys made to transfer mental health patients to out of Borough placements be provided to the Joint Health Overview and Scrutiny Officer and circulated to members of the committee