Performance August - October 2015 & Operational Pressures Performance Figures for August 2015 –October 2015 are as follows: Red 1 (8 minutes) – 77.30% against a target of 75% Red 2 (8 minutes) – 74.20% against a target of 75% A 19 (19 minutes) – 94.58% again a target of 95% The Trust prepares well in advance for the winter period and puts in place robust plans to deal with the challenges the winter season can bring – adverse weather, rise in life threatening calls and the festive season. However, the traditional ‘quieter’ periods in the summer have not been as apparent as in previous years, as calls have continued to rise month on month. Over the last few weeks the Trust has responded to a significant increase in life threatening incidents with events such as “Halloween” being the cause of major spikes in 999 demand. The health system has experienced real pressures in recent weeks a symptom of which is an increase in the time it take the NWAS Ambulances crews to hand over their patient at the hospital. NWAS’ year to date figures show that the Trust is dealing with around a 25 per cent increase in ‘Red’ calls – these are those who have a life-threatening or potentially life-threatening conditions and have a national eight minute response target, and this is a huge challenge for the organisation. Following a strategic management review of the current operating pressures being placed on the Trust, NWAS has escalated to Resource Escalation Action Plan (REAP) Level 4 from Tuesday 3 November to enable the organisation to respond to and address the operational challenges it is currently facing. The REAP Level system is in operation at all times. It enables the Trust to ensure that its service can be maintained when challenges occur, such as increased activity, significant loss of staff, buildings and resources, or pressures within the wider NHS. In general it will operate at lower levels when the service is operating within normal parameters and will escalate when pressures occur. The REAP is designed to increase operational resource in line with demand in order to assist the service in coping with periods of high pressure and maintain the quality of patient care. It is widely acknowledged that there is a distinct shortage of Paramedics in the UK, NWAS has been challenged by this also but the Trust has been able to develop methods to develop its own staff to gain the Paramedic qualification. Filling all vacancies has been one of NWAS’ priorities during 2015 and since April 2015, XX road staff and XX call centre staff have been appointed. As well as the above, and in order to free up more resources to attend life-threatening emergencies, the Trust has made a concerted effort to improve its triaging of 999 calls. Improvements made to the organisation’s clinical structure has meant more people can be either treated at home, omitting the need for an ambulance journey to hospital, or be directed to a more appropriate healthcare service such as a walk-in or GP led centre. 18 additional ambulances staffed 16 hours each day, 7 days each and 19 rapid response vehicles again staffed 16 hours each day and 7 days each week are progressively becoming operational throughout the region, and contracts have been established with voluntary aid society groups such as St John Ambulance to provide additional support during periods of high activity.