Integration In Practice (or Still a Prospect) Richard Hunt CBE Chairman

Plenty of Joint Working London Ambulance Service NHS Trust 2

Consultation Enabling Closer Working between the Emergency Services “provide opportunities for stronger local leadership to drive greater collaboration and more efficient and effective emergency services” London Ambulance Service NHS Trust 3

Overview of London Ambulance Service Busiest Ambulance Service in the UK and only London-wide NHS Trust. Handled 1.9 million emergency calls from across London Attended over 1 million incidents Covers all of London, population of 8.9m = 32 CCG’s, 41 NHS trusts, across 86 sites. London Ambulance Service NHS Trust 4

Current collaboration with other emergency services A Joint response unit (JRU) in 12 boroughs – working together with the Metropolitan Police Service (MPS) to provide a more efficient service in areas of high demand. Working closely with the London Fire Brigade (LFB) on joint training exercises and teaching fire fighters advanced first aid skills as well as sharing office space. Working together at events and incidents to protect and treat Londoners. Mobile communications - This project will provide a new communications system for the emergency services. London Ambulance Service NHS Trust 5

Current collaboration with other emergency services The Joint Emergency Services Interoperability Programme (JESIP) Working closely with the City of London Police and automatically alerting them to cardiac arrest calls. Co-responding - We are currently piloting co-responding in 3 London boroughs with MPS and will be piloting co-responding with LFB soon. Joint campaigns – delivered a campaign with other emergency services over the festive period aimed at reducing the number of alcohol related calls over winter. London Ambulance Service NHS Trust 6

Joint Response Unit London Ambulance Service NHS Trust 7 Fast response LAS vehicle with a lone paramedic that responds solely to police requests for LAS attendance (except RED1 calls). Piloted in Hackney in Successfully rolled out in 12 boroughs.

Focus on… Joint Response Unit JRU is able to discharge the patient on-scene and cancel LAS ambulances. This results in a higher number of available LAS ambulances for other calls. 79.3% calls ambulance not required or alternative transport used. London Ambulance Service NHS Trust 8 Aim of providing on-scene triage, assessment and treatment of patients.

Co-responding Currently piloting a co-responding scheme with Metropolitan Police Service in 3 boroughs – Croydon, Enfield and Ealing. Aim of improving health outcomes for Londoners – MPS co-responding to probable cardiac arrests. 110 additional defibrillators in London as a result of the pilot. Ends in May 2016 and will be evaluated. London Ambulance Service NHS Trust 9

Eat, Drink and Be Safe Campaign with Mayor of London, LFB and MPS. Aimed to reduce alcohol related calls over the festive period. London Ambulance Service NHS Trust 10 Included posters in tubes across London, targeted social media advertising, launch at city all and stakeholder engagement.

Opportunities for the future ‘Making London the safest Global City’ (Joint discussions) The government launched a consultation in late 2015 on ‘enabling closer working between emergency services’. They are currently considering the responses and will publish a response. We are currently working closely with MPS and LFB to explore the potential for collaboration in the future. The project aims to make London the safest global city. London Ambulance Service NHS Trust 11

What may the ‘Safest Global City’ look like? The highest Cardiac arrest survival rates in the world Best in the world Seattle =65% London = 32%) Lowest levels of Crime and Disorder The lowest incidences of fires in dwellings, fire injuries and fire deaths Develop Collaboration & Prevention as the heart of everything we do London Ambulance Service NHS Trust 12

Potential areas of collaboration Control Rooms  Potential for working together more closely in the future.  Number of considerations, such as training, clinical triage system. Prevention activities  Effective demand management tool for the Fire Brigade.  Potential to improve health outcomes for Londoners  Fit with wider health and social care work. London Ambulance Service NHS Trust 13

Potential areas of collaboration Examples from elsewhere  Greater Manchester  Surrey and Sussex  East Midlands  South West Response activities  We already work with the MPS to provide a joint response service in 13 boroughs.  Potential to expand this further  Possible co-responding pilots. Back office and support functions  Potential for closer working. Could include procurement, such as the mobile communications project, joint campaigns, sharing services and co- locating – our Information Management and Technology team are based at LFB’s HQ. London Ambulance Service NHS Trust 14

Challenges Funding and Governance Some legacy issues Fit with NHS [governance] arrangements Funding for collaboration – LAS is funded by 32 GP Clinical Commissioning Groups. Urgent and Emergency Care developments  part of/Involvement in wider NHS. London Ambulance Service NHS Trust 15

Conclusion Currently working with other emergency services in a range of ways. Joint working can provide opportunities and help to make London safer. There are a number of opportunities for the future, which we’re currently exploring. London Ambulance Service NHS Trust 16 Perhaps now is the time to make real progress

London Ambulance Service NHS Trust 17