Agenda item

To consider a report of the Head of Scrutiny and Member Development providing information on the plans for Yorkshire Ambulance Service NHS Trust to become a Foundation Trust and seeking the Board’s views on this

(report attached)

  Further to minute 29 of the Scrutiny Board (Health and Wellbeing and Adult Social Care) meeting of 28^th October 2011 where the Board considered proposals by Leeds Teaching Hospitals NHS Trust and Leeds Community Healthcare NHS Trust to become Foundation Trusts, the Board considered a report setting out proposals by Yorkshire Ambulance Service (YAS) NHS Trust to become a Foundation Trust.

Attending for this item and representing Yorkshire Ambulance Service (YAS) were Mr. John McSorley and Mr. James Webb (Locality Managers (Leeds).

Members were informed that YAS was aiming to become a Foundation Trust by the end of 2012 and presenting the proposals to the Board was part of the consultation and engagement process being carried out.  The closing date for comments was stated as 4^th December 2011.

Members noted that YAS covered an extensive area, with Mr McSorley stating this was approximately 6,000 square miles with a population of 5 million.

The benefits of Foundation Trust status were explained as being:

• independence from Government control;
• less bureaucracy; and,
• greater financial flexibility.

YAS hoped the proposals would enable more lives to be saved and better training and equipment to be provided.

The importance of guiding people to the most appropriate care pathways was emphasised, as not all cases required an ambulance and emergency care; the possibility of a system of telephone triage was being considered to direct people appropriately and YAS was in the process of submitting a bid to provide the new 111 service for non-urgent medical care.

YAS was looking to improve the treatment for trauma patients, through better training and more specialised equipment.

In terms of governance arrangements, it was proposed that there would be a Council of 24 Governors made up of:

• 13 public governors elected from the four constituencies of East Yorkshire (2), South Yorkshire (3), North Yorkshire (2) and West Yorkshire (6);
• 7 appointed governors - including two representatives from Local Authorities across the region;
• 4 staff representatives (with staff of all levels eligible to sit as Governors in a mix of front-line and support staff).

The Board commented on the report and the presentation.  The key areas of discussion were:

·  the proposed governance arrangements; the intention to have only two representatives from Local Authorities; how these would be determined; how these representatives could begin to properly represent the extensive geographic area, which included urban and rural areas, together with the wide-ranging communities, groups and associated needs in the proposed four constituency areas of Yorkshire;

·  whether YAS was looking to tailor its services to reflect each area/community or whether a standard service would be provided across all areas;

·  budgets and resources, how these would be allocated across such a large geographic area and whether some areas would receive larger amounts;

·  how any budget deficit would be managed once the Trust was independent from Government control;

·  whether as a Foundation Trust, YAS would be able to set salary levels for all staff and pay Governors (beyond expenses for travel and subsistence); 

·  whether the organisation considered itself ready for Foundation Trust status, given areas of poor performance previously reported;

·  how YAS would work with other services, e.g. the Air Ambulance and Mountain Rescue and how such services would be represented in the governance arrangements of the Foundation Trust;

·  the importance of ensuring the governors were truly representative of the areas and communities within YAS’s boundaries, with some concerns being raised about the possibility of this being achieved;

·  that further information was needed on the arrangements for the election of Public Governors;

·  emergencies in neighbouring areas; how the financial arrangements would work if YAS needed to attend a major incident outside of its area and whether there would be reciprocal arrangements;

·  the possibility of changing the make-up of the constituencies which might address some of the concerns raised.

The Chair thanked Mr McSorley and Mr Webb for their attendance; the

information provided and Mr McSorley’s offer to take specific issues back to the organisation for further information.

The Board considered how to proceed.

RESOLVED –   

i)  That, pending further consideration of the issues raised, a holding response be submitted on behalf of the Board, setting out the initial concerns raised around the proposals for YAS NHS Trust to become a Foundation Trust;

ii)  That the report be resubmitted to the December meeting with senior Executives from YAS invited to attend to address the Board’s concerns in more detail.