2. Steve Edwards Clinical Governance manager West Midlands Ambulance Service NHS Trust

4. NHS TRUSTs Managerially Independent Statutory Bodies – formed Under NHS and Community Care Act, 1990 Accountable to Secretary of State for Health Own Board of Directors CHAIRMAN 5 executive directors5 non-executive directors

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

6. West Midlands Ambulance Service EMS SYSTEMS Emergency And Urgent County Air Ambulance X3 Patient Transport Services NHS Direct Training Capacity Management Transport For Transplants First Response Information Technology (software Systems) Shropshire Ambulance Service

8. Population Served 3.3 million 5,700 Square Kilometres Budget £52.5 million People (staff) 1,600  Emergency Calls 405,000  NHS Direct Calls 400,000 PTS Patients 600,000 Paramedic Units 180 Motorcycles 12 Rapid Response Cars 40 Helicopters 3

9. Standards and Quality DOH, response standards Minimum equipment levels Training levels (IHCD) 560 J R C A L C (Treatment protocols) I S O Aqua Pro QA (AMPDS) CHI NCAA MDA Health & Safety Executive CNST NICE NHSLA UK Resuscitation council NPSA Caldicott NSFs Etc

10. 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

11. EMERGENCY 999 or 112 Command and Control System Advanced Medical Priority Dispatch Emergency Nurse Advisors First Aid Advice Satellite Tracking Advanced Technology Digital Mapping Calling Line Identity Predictive Analysis Real Time System Status Management ‘Hot Spotting’

12. Performance Standards Category A 75% in 8 minutes 80% Target By March 2003 Category B/C 95% in 14 minutes Doctors’ cases 95% in 15 minutes

13. Department of Health Performance Category A 75% in 8 Minutes 80% in 8 Minutes

14. PARAMEDIC RESPONSE State Registered Paramedic Emergency Medical Technician State Registered Paramedic Two State Registered Paramedics Paramedic or Technician

15. Plus Specialised immediate care doctors are available to paramedics for, Patient trapped. Or major emergency.

16. Charitably Funded Three Aircraft Operation Area Covered 32,000 square kilometers Population 7.8 million Used mainly for trauma (needs to change)

17. State Registered Paramedic Endo tracheal Intubation I V Infusion Defibrillation Transthoracic pacing Drug therapy Needle Thoracentesis Cricothyroidotomy Opiate analgesia

18. 999 calls

19. Department of Health Coronary Heart Disease Strokes Diabetes Elderly People Paediatrics (pending)

20. Coronary heart disease Biggest single killer in UK Chain of Survival Early defibrillation One quarter of all deaths Under 65 Cost to industry £3.8 billion in sick pay

21. 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

22. INTRODUCTION OF 12 LEAD ECG PATIENT TELEMETRY PRE-HOSPITAL THROMBOLYSIS

23. Return of Spontaneous Circulation 14% TARGET 20% Continuous Improvement

24. ANY QUESTIONS PLEASE ?