From Ben Gummer MP Parliamentary Under Secretary of State for Care Quality Department of Health Richmond House 79 Whitehall London SWIA 2NS POCS 938155 Tel: 020 7210 4850 Mr J. Pollard Senior Coroner 30 JUL 2015 Coroner' s Court Mount Tabor Street Stockport SKI 3AG Kec Asllcs k Thank you for letter of 29th 2015 following the inquest into the death of Elizabeth Lester: I was very sorry to hear of Ms Lester'$ death and wish to extend my sincere condolences to her family. Your concerns in this case are levelled at the clinical call handling system used by the call handlers at the North West Ambulance Service (NWAS) to determine the category of ambulance response time which should be allocated to emergency calls. You consider that a vital question related to chest is excluded from the scripted questions used when the patient has breathing difficulties. As a result of this, the call handler initially failed to ask a question in determining Ms Lester's condition and significant delay was caused in prioritising her transport to hospital. You raise the following concerns: You believe there is an omission in the questions that are included on the breathing difficulties card. You ask for this to be rectified with the addition of a question about chest You have been told that the local ambulance service cannot alter the wording themselves as it must be done by the software suppliers [understand that the call system used by NWAS is the Advanced Medical Priority Dispatch System (AMPDS) developed by the Priority Dispatch Corporation, an independent body. AMPDS is an international call handling system which is used by some; but not all NHS ambulance services in England: The other used by providers is NHS Pathways. It is open to ambulance trusts to choose which of these two systems to use: May ` your pain key pain. system

Users of AMPDS must contact Priority Dispatch directly if they feel that an element of the system needs to be reviewed and changed. I understand NWAS has responded to your report suggesting that you write directly to the AMPDS contact at Priority Dispatch UK asking for the changes that you have recommended to be considered I would support this [am SOrry that the Departmeht cannot be of further help in implementing the changes you suggestyHoweNer; I hope that you find this reply helpful and [ am grateful to you for biingingfthe circumstances of Ms Lester'$ death to my attention. Il~~ BEN GUMMER any