I attended the Ambulance Trust Board Meeting at Ambulance Headquarters, Bransford on Thursday 31^st October 2002.

The Acting Chief Officer, Mrs. Tamar Thompson, gave a report and stated the newly refurbished Kidderminster Ambulance Station would be formerly opened on the 6^th December 2002 and Dr. Richard Taylor had agreed to carry out the Official Opening.

The Ambulance Trust Board were given a verbal update on the Fire Fighters dispute by Mr. Steve McGuiness and the Board were informed that a thorough review of all buildings and staff procedures were currently underway in light of a possible fire strike.

Mr. McGuiness stated that the biggest troubled area for the Ambulance Service was that of entrapment. He stated that Paramedics would need to make clinical decisions that would not normally be expected. He stated that all fire engines in the County had extraction equipment fitted as a matter of course, and that the Government had put on stand-by crews from the Royal Air Force (RAF) who would be based in Redditch, Kidderminster, Herefordshire and Worcester areas, to assist the Paramedics when they are attending a blue light call.

It needs to be noted that in the County of Herefordshire and Worcestershire over the last 12 months, there have only been 290 road traffic accidents that were attended by the Hereford and Worcester Fire Brigade.

Mr. McGuiness presented the Board with a paper entitled "Operational Service Delivery" which breaks down the average ambulance activity district by district.

The Board were presented with a paper headed "Health and Safety Report " which eluded to the incidents for the period July through to August 2002. It was noted that 15 incidents were reported, 4 of which referred to staff that were assaulted (verbally or physically) and 1 involving a manual handling injury.

The Board endorsed the paper that was presented by Mr. Brian Chambers headed "Medicines Policy" for the Herefordshire and Worcestershire Ambulance Service (NHS Trust). The paper eludes to the fact that the Chief Executive of the Trust has overall responsibility for the safe and secure handling of medicines, although the Director of Clinical Services is responsible for the day to day safe and secure handling of medicines in the Trusts use.

The Trust Board was presented with a paper by Mr. Brian Chambers, the Director of Clinical Services in relationship to the recent audit of service for the Coronary Heart Disease (CHD). The paper was endorsed by the Trust.

Mrs. Linda Millinchamp, the Director of Finance and Commercial Affairs, presented the Trust with a financial appraisal, and the Trusts accounts up to 30^th September 2002, which showed a net under-spend of £15,000. The Trust Board endorsed the current financial position, and noted the fact that they are still on course to break even at the end of this financial year.

It was noted by the Trust Board that for the period September 2002 that 8 written appreciations had been received and 7 official complaints. The majority of the complaints related to transportation.

Finally, before the Trust Board went into closed session Mr. Steve McGuiness presented a paper called "Guidelines for the Admission to Minor Injuries Unit (MIU) following 999 calls. The guidelines have been written around the Department of Health document (Reforming Emergency Care) which sets out some very challenging standards. In order for he NHS to meet these standards, there needs to be changes in the way services are provided.

When they were first established it was agreed Minor Injuries Units (MIUs) would not accept patients by the Ambulance Service, however, if they are to support A & E. Departments to achieve standards such as the standard set by the Department - that nobody should wait more than 4 hours in an A. & E. Department, then the type of patients that MIUs are prepared to take needs to change.

The guidelines in the paper detail the type of patient/conditions that can be transferred by ambulance to Minor Injuries Units for treatment. The Ambulance Trust Board endorsed the paper and stated that data regarding the appropriateness of patients being brought to the MIU by ambulance, would be recorded and monitored every 3 months by a lead Nurse in each Department and a representative of the Ambulance Trust.

Should any member of the CHC require to read a copy of the guidelines there is a copy in the office freely available.