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							               Steve Edwards
       Clinical Governance manager
West Midlands Ambulance Service NHS Trust
                        NHS TRUSTs

                           Statutory
                        Bodies – formed   Accountable to
      Managerially      Under NHS and      Secretary of
      Independent         Community          State for
                           Care Act,          Health
                             1990


                          Own Board
                          of Directors


5 executive directors     CHAIRMAN        5 non-executive directors
                          Management Structure
                              CHIEF EXECUTIVE
                                Barry Johns

  CORPORATE         DIRECTOR OF              DIRECTOR OF           MEDICAL          DIRECTOR
DEVELOPOMENT         PERSONEL                OPERATIONS/           DIRECTOR         OF FINANCE
   DIRECTOR                                  DEPUTY CHIEF
                      Jean Howell                                                    Rob Hinton
                                              EXECUTIVE           Iain Robertson-
  Paul Harris*                                  Bob Seaward             Steel
                    Human Resources                                                 Financing and
                                                                                     Accounting
Communications      Payroll Services         Emergency and        Education and
                                            Urgent Operations                        Purchasing
   Bureau                                                          Professional
                                            Emergency Control     Development
   Capacity
                                                                                     DIRECTOR
  Management                                 Patient Transport      Clinical        NHS DIRECT
                                                   Services        Governance
 Public Relations                                                                   Steve Elvin*
                                                   Estates
     Quality                                                                         NHS Direct
                                            Vehicle Engineering    IT DIRECTOR
Risk Management                                                   Barry Thurston*


                             *Denotes associate director            Information
                                                                    Technology
                                                                  Communications
                           County Air      Patient
           Emergency       Ambulance      Transport
             And              X3          Services
            Urgent
                                                      NHS
Shropshire
                                                      Direct
Ambulance
 Service               West Midlands
                        Ambulance
                       EMS SYSTEMS
                          Service
                                                 Training
 Information
 Technology
    (software
     Systems)
                                           Capacity
                             Transport    Management
                  First
                                For
                Response
                            Transplants
Population
                  5,700            Budget           People
 Served
                Square              £52.5           (staff)
   3.3
               Kilometres          million          1,600
 million


                        
       Emergency      NHS Direct          PTS
         Calls          Calls            Patients
        405,000        400,000           600,000




                               Rapid
Paramedic
              Motorcycles     Response          Helicopters
  Units
                  12            Cars                 3
   180
                                 40
          Standards and Quality
•   DOH, response standards
•   Minimum equipment levels
•   Training levels (IHCD)560



•   J R C A L C (Treatment protocols)
•   ISO                 Aqua Pro QA (AMPDS)
•   CHI                 NCAA
•   MDA                 Health & Safety Executive
•   CNST                NICE
•   NHSLA               UK Resuscitation council
•   NPSA                Caldicott
•   NSFs                Etc
          Standards and Quality
•   Medical steering group
•   Executive Consultant Medical Director
•   All Run sheets checked
•   Clinical Governance committee
•   Risk analysis meetings
•   Review of all cardiac arrests
•   Blameless culture/Whistle blower hot line
         EMERGENCY 999 or 112




Command and                 Advanced
Control System             Technology


Advanced Medical
    Emergency                      Digital
    Priority
      First Aid
      Nurse                    Calling Line
        Satellite              Predictive
                                   Time
                              RealMapping
    Dispatch
       Advice                    Identity
     Advisors
       Tracking           ‘Hot Spotting’
                                Analysis
                            System Status
                             Management
          Performance Standards




 Category A                     Doctors’ cases
 80% Target
   75% in                          95% in
By March 2003    Category B/C
  8 minutes                      15 minutes
                    95% in
                  14 minutes
Department of Health Performance




      Category A 75% in 8 Minutes




       80% in 8 Minutes
         PARAMEDIC RESPONSE
               State Registered Paramedic
              Emergency Medical Technician



State Registered Paramedic




                 Paramedic or Technician




  Two State Registered Paramedics
                    Plus
• Specialised immediate care doctors are
  available to paramedics for,
• Patient trapped.
• Or major emergency.
                            Area Covered
Charitably   Three Aircraft32,000 square
 Funded       Operation      kilometers

      Population    Used mainly
      7.8 million    for trauma
                    (needs to change)
         State Registered Paramedic


•   Endo tracheal Intubation
•   I V Infusion
•   Defibrillation
•   Transthoracic pacing
•   Drug therapy
•   Needle Thoracentesis
•   Cricothyroidotomy
•   Opiate analgesia
      999 calls
                  Cardiac
                  RTAs
                  Respiratory
                  Self Harm
                  Abdominal
                  Others
                   14%
                                5%

                                     11%




62%                                  3%
                                5%
          Department of Health




•   Coronary Heart Disease
•   Strokes
•   Diabetes
•   Elderly People
•   Paediatrics (pending)
            Coronary heart disease
• Biggest single killer in UK
   One quarter of all deaths      Cost to industry
         Under 65              £3.8 billion in sick pay
• Chain of Survival




• Early defibrillation
    Plus public access defibrillation
•   New Street train station
•   Airport
•   International train station
•   Wolverhampton train station
•   Saddlers shopping centre
•   Mander shopping centre
•   Merry hill shopping centre
•   Snow Hill train station
•   Coventry train station
•   Coventry shopping centre
•   Total 53 AEDs
            INTRODUCTION
                  OF
 PATIENT     12 LEAD ECG   PRE-HOSPITAL
TELEMETRY                  THROMBOLYSIS
 Return of     TARGET
Spontaneous      20%
 Circulation
    14%         Continuous
               Improvement
ANY QUESTIONS
   PLEASE ?