SlideShare a Scribd company logo
1 of 11
Emergency Ambulance Access
Improvement Project
Presentation Overview
โ€ข Red 1 & 2 Targets
โ€ข Current Performance (Red 1 & 2)
โ€ข Current Performance (Turn around Time)
โ€ข Improvement project - Examples
โ€ข Questions
Red One & Two Performance Targets
Red 1
(Respiratory / cardiac
arrest)
Response in 8 minutes Response in 8 minutes
Red 2
(All other life threatening
emergencies.)
Current Performance
Standard Measure Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 YTD
75.00% RED1(8mins) 51.20% 69.10% 64.60% 68.90% 67.90% 75.00% 69.23% 49.09% 69.70% 65.10%
CallVolume 41 55 49 46 53 44 52 55 66 461
75.00% RED2(8mins) 61.90% 63.90% 68.60% 62.40% 63.10% 61.80% 61.50% 59.58% 65.40% 63.10%
CallVolume 734 682 809 784 743 805 892 881 954 7,284
95.00% ALLRED(19mins) 92.00% 94.60% 96.10% 92.30% 93.80% 93.00% 94.40% 91.97% 94.10% 93.60%
CallVolume 775 737 858 830 796 849 944 936 1,020 7,745
Current Performance
Handover: Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16
Average TurnaroundTimes:
Note1 MDGH 27:36 26:33 26:09 25:11 25:55 25:45 25:39 26:33 26:51 27:20
Cheshire &Merseyside 31:05 28:42 27:43 27:08 26:42 28:46 30:04 30:37 32:45 37:17
NWAS 29:49 27:40 27:15 27:13 27:25 28:50 29:52 30:48 31:45 35:09
MDGHClinicalHandoverbyTimeband:
0m-15m% 79.97% 78.24% 82.49% 80.55% 83.26% 86.34% 78.98% 77.23% 82.02% 78.34%
15m-30m% 17.94% 18.87% 15.88% 17.72% 15.32% 12.25% 19.13% 20.48% 16.74% 19.80%
30m-45m% 1.95% 2.20% 0.98% 1.59% 1.28% 1.27% 1.65% 2.17% 1.01% 1.73%
45m-60m% 0.00% 0.69% 0.16% 0.14% 0.14% 0.14% 0.12% 0.00% 0.11% 0.12%
60m-75m% 0.14% 0.00% 0.16% 0.00% 0.00% 0.00% 0.00% 0.12% 0.00% 0.00%
>75m% 0.00% 0.00% 0.16% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00% 0.00%
Note1 MDGHbetterthanbothCheshire-Merseyside&NWASOverall
July
2015
Deep
Dive
Event
1st
Group
Meeting
Aug
2015
Dec
2015
Oct
2015
Jan
2015
Feb
2015
Nov
2015
Sept
2015
3rd
Group
Meeting
2nd
Group
Meeting
4th
Group
Meeting
5th
Group
Meeting
Inter-trust
transfers
Meeting
Heart
Failure
Team
Meeting
Transfer
Type
Mapping
event
Patient Campaign
GP Locality
Presentation
Additional
Vehicles in
place
Red 1 - Improvement in Sept 15 only Data not available
Emergency Ambulance
Improvement Project
Overview
Example One:
Building Capacity
Example Two:
Hospital Transfers
-
Clinical Need
STEMI
- POST
TREATMENT
Non STEMI
Stable condition
Type Of
Ambulance
Trolley or Chair?
Unstable STEMI
In A&E Requires
urgent Primary
Urgent Care
Service
Chair
Multi occupancy
opportunities?
Yes/No?
Yes (Multi
Ocuupancy)
A&EDeptCCUorWardDept
Not Applicable. Return journey not required. Patient admitted to
UHNS and discharged from UHNS. Length of Stay up to 3 days.
Inter Trust Transfer Mapping - Return
Yes (Multi
Ocuupancy)
UrgentCare
Service
Chair/Trolley
Example Four:
1st Responder Recruitment
Chest pains and cardiac arrests
in East Cheshire (Jan 15 โ€“Jan 16).
Any questions?
Julia Curtis, Service Delivery Manager (Quality)
julia.curtis2@nhs.net

More Related Content

Viewers also liked

JULIANA_BACCHUS_RESUME 2015
JULIANA_BACCHUS_RESUME 2015JULIANA_BACCHUS_RESUME 2015
JULIANA_BACCHUS_RESUME 2015
Juliana Bacchus
ย 
Mujeeb Ahmed Sharief
Mujeeb Ahmed ShariefMujeeb Ahmed Sharief
Mujeeb Ahmed Sharief
Mujeeb Sharief
ย 
Mujeeb Ahmed Sharief
Mujeeb Ahmed ShariefMujeeb Ahmed Sharief
Mujeeb Ahmed Sharief
Mujeeb Sharief
ย 

Viewers also liked (12)

JULIANA_BACCHUS_RESUME 2015
JULIANA_BACCHUS_RESUME 2015JULIANA_BACCHUS_RESUME 2015
JULIANA_BACCHUS_RESUME 2015
ย 
Deepdive presentation GBAF20 primary care
Deepdive presentation GBAF20 primary careDeepdive presentation GBAF20 primary care
Deepdive presentation GBAF20 primary care
ย 
AR205: FCPX @ McPherson College โ€“ Keyboard Shortcuts #1
AR205: FCPX @ McPherson College โ€“ Keyboard Shortcuts #1AR205: FCPX @ McPherson College โ€“ Keyboard Shortcuts #1
AR205: FCPX @ McPherson College โ€“ Keyboard Shortcuts #1
ย 
Apuntes
ApuntesApuntes
Apuntes
ย 
Manuel atelier iveco 4 x4 - vรฉhicule de 1998 - PDF
Manuel atelier iveco 4 x4 - vรฉhicule de 1998 - PDFManuel atelier iveco 4 x4 - vรฉhicule de 1998 - PDF
Manuel atelier iveco 4 x4 - vรฉhicule de 1998 - PDF
ย 
Mujeeb Ahmed Sharief
Mujeeb Ahmed ShariefMujeeb Ahmed Sharief
Mujeeb Ahmed Sharief
ย 
About GPA 2015
About GPA 2015About GPA 2015
About GPA 2015
ย 
FAQ 2016
FAQ 2016FAQ 2016
FAQ 2016
ย 
Mujeeb Ahmed Sharief
Mujeeb Ahmed ShariefMujeeb Ahmed Sharief
Mujeeb Ahmed Sharief
ย 
Incentive Assignment
Incentive AssignmentIncentive Assignment
Incentive Assignment
ย 
Tema 4 sociales
Tema 4 socialesTema 4 sociales
Tema 4 sociales
ย 
Eight tips for bird watchers
Eight tips for bird watchers Eight tips for bird watchers
Eight tips for bird watchers
ย 

Similar to Emergency Ambulance Access Improvement Project

Presentation Stage Graphe de Connectivitรฉ du Cerveau 2014 (FR)
Presentation Stage Graphe de Connectivitรฉ du Cerveau 2014 (FR)Presentation Stage Graphe de Connectivitรฉ du Cerveau 2014 (FR)
Presentation Stage Graphe de Connectivitรฉ du Cerveau 2014 (FR)
Romain Chion
ย 
AssumptionsAssumptions that can be changed for the caseAs the ins.docx
AssumptionsAssumptions that can be changed for the caseAs the ins.docxAssumptionsAssumptions that can be changed for the caseAs the ins.docx
AssumptionsAssumptions that can be changed for the caseAs the ins.docx
rock73
ย 
A&E London Hospital Statistics 4 hour waiting times 4.7.13
A&E London Hospital Statistics 4 hour waiting times 4.7.13A&E London Hospital Statistics 4 hour waiting times 4.7.13
A&E London Hospital Statistics 4 hour waiting times 4.7.13
CityHallLabour
ย 
Intelligent Real-time Water Level Forecast Models for Pumping Stations
Intelligent Real-time Water Level Forecast Models for Pumping StationsIntelligent Real-time Water Level Forecast Models for Pumping Stations
Intelligent Real-time Water Level Forecast Models for Pumping Stations
Yingray Lu
ย 
Combined Pat Presentation Oct - Copy
Combined Pat Presentation  Oct  - CopyCombined Pat Presentation  Oct  - Copy
Combined Pat Presentation Oct - Copy
John Osborne
ย 
capwappresentgsdfgsdfgsdfgsdfgsdfgsdfgsdfg.ppt
capwappresentgsdfgsdfgsdfgsdfgsdfgsdfgsdfg.pptcapwappresentgsdfgsdfgsdfgsdfgsdfgsdfgsdfg.ppt
capwappresentgsdfgsdfgsdfgsdfgsdfgsdfgsdfg.ppt
akhoanguyeneng
ย 
Comparative results of the 3 rd questionnaire
Comparative results of the 3 rd questionnaireComparative results of the 3 rd questionnaire
Comparative results of the 3 rd questionnaire
Haris Evaggelou
ย 
Comparative results of the 3 rd questionnaire
Comparative results of the 3 rd questionnaireComparative results of the 3 rd questionnaire
Comparative results of the 3 rd questionnaire
eftihia67
ย 

Similar to Emergency Ambulance Access Improvement Project (20)

Modellistica di dispersione a Torino durante il lockdown
Modellistica di dispersione a Torino durante il lockdownModellistica di dispersione a Torino durante il lockdown
Modellistica di dispersione a Torino durante il lockdown
ย 
Presentation Stage Graphe de Connectivitรฉ du Cerveau 2014 (FR)
Presentation Stage Graphe de Connectivitรฉ du Cerveau 2014 (FR)Presentation Stage Graphe de Connectivitรฉ du Cerveau 2014 (FR)
Presentation Stage Graphe de Connectivitรฉ du Cerveau 2014 (FR)
ย 
Emergency Laparotomy Collaborative: West of England
Emergency Laparotomy Collaborative: West of EnglandEmergency Laparotomy Collaborative: West of England
Emergency Laparotomy Collaborative: West of England
ย 
Tapping into the value on a transport corridor
Tapping into the value on a transport corridorTapping into the value on a transport corridor
Tapping into the value on a transport corridor
ย 
AssumptionsAssumptions that can be changed for the caseAs the ins.docx
AssumptionsAssumptions that can be changed for the caseAs the ins.docxAssumptionsAssumptions that can be changed for the caseAs the ins.docx
AssumptionsAssumptions that can be changed for the caseAs the ins.docx
ย 
A&E London Hospital Statistics 4 hour waiting times 4.7.13
A&E London Hospital Statistics 4 hour waiting times 4.7.13A&E London Hospital Statistics 4 hour waiting times 4.7.13
A&E London Hospital Statistics 4 hour waiting times 4.7.13
ย 
Presentation Correlation and Volatility Eurex
Presentation Correlation and Volatility EurexPresentation Correlation and Volatility Eurex
Presentation Correlation and Volatility Eurex
ย 
20 x 60_econo
20 x 60_econo20 x 60_econo
20 x 60_econo
ย 
Intelligent Real-time Water Level Forecast Models for Pumping Stations
Intelligent Real-time Water Level Forecast Models for Pumping StationsIntelligent Real-time Water Level Forecast Models for Pumping Stations
Intelligent Real-time Water Level Forecast Models for Pumping Stations
ย 
Elective Care Conference: demand and capacity in cancer services
Elective Care Conference: demand and capacity in cancer servicesElective Care Conference: demand and capacity in cancer services
Elective Care Conference: demand and capacity in cancer services
ย 
Healthcare Service Improvement
Healthcare Service ImprovementHealthcare Service Improvement
Healthcare Service Improvement
ย 
Excel/VBA model for nurse scheduling in outpatient wards
Excel/VBA model for nurse scheduling in outpatient wardsExcel/VBA model for nurse scheduling in outpatient wards
Excel/VBA model for nurse scheduling in outpatient wards
ย 
Cob 20080715 1
Cob 20080715 1Cob 20080715 1
Cob 20080715 1
ย 
Combined Pat Presentation Oct - Copy
Combined Pat Presentation  Oct  - CopyCombined Pat Presentation  Oct  - Copy
Combined Pat Presentation Oct - Copy
ย 
capwappresentgsdfgsdfgsdfgsdfgsdfgsdfgsdfg.ppt
capwappresentgsdfgsdfgsdfgsdfgsdfgsdfgsdfg.pptcapwappresentgsdfgsdfgsdfgsdfgsdfgsdfgsdfg.ppt
capwappresentgsdfgsdfgsdfgsdfgsdfgsdfgsdfg.ppt
ย 
Determination of Elemental Impurities โ€“ Challenges of a Screening Method
Determination of Elemental Impurities โ€“ Challenges of a Screening MethodDetermination of Elemental Impurities โ€“ Challenges of a Screening Method
Determination of Elemental Impurities โ€“ Challenges of a Screening Method
ย 
Chromatography: Meeting the Challenges of EU regulations with up-to-date Conf...
Chromatography: Meeting the Challenges of EU regulations with up-to-date Conf...Chromatography: Meeting the Challenges of EU regulations with up-to-date Conf...
Chromatography: Meeting the Challenges of EU regulations with up-to-date Conf...
ย 
Comparative results of the 3 rd questionnaire
Comparative results of the 3 rd questionnaireComparative results of the 3 rd questionnaire
Comparative results of the 3 rd questionnaire
ย 
Comparative results of the 3 rd questionnaire
Comparative results of the 3 rd questionnaireComparative results of the 3 rd questionnaire
Comparative results of the 3 rd questionnaire
ย 
2 x 4_econo
2 x 4_econo2 x 4_econo
2 x 4_econo
ย 

More from Matthew Cunningham

More from Matthew Cunningham (20)

GBAF250 Deepdive presentation Mental Health Services Capacity - Increasing ac...
GBAF250 Deepdive presentation Mental Health Services Capacity - Increasing ac...GBAF250 Deepdive presentation Mental Health Services Capacity - Increasing ac...
GBAF250 Deepdive presentation Mental Health Services Capacity - Increasing ac...
ย 
Consultation on MH Service Redesign - Eastern Cheshire, South Cheshire & Vale...
Consultation on MH Service Redesign - Eastern Cheshire, South Cheshire & Vale...Consultation on MH Service Redesign - Eastern Cheshire, South Cheshire & Vale...
Consultation on MH Service Redesign - Eastern Cheshire, South Cheshire & Vale...
ย 
GBAF246 Primary Care Delegation Risk July 2017
GBAF246 Primary Care Delegation Risk July 2017GBAF246 Primary Care Delegation Risk July 2017
GBAF246 Primary Care Delegation Risk July 2017
ย 
2016-17 Annual Communications and Engagement Update
2016-17 Annual Communications and Engagement Update2016-17 Annual Communications and Engagement Update
2016-17 Annual Communications and Engagement Update
ย 
GBAF15 - Elective, Diagnostic and Outpatient Access to Services
GBAF15 - Elective, Diagnostic and Outpatient Access to Services GBAF15 - Elective, Diagnostic and Outpatient Access to Services
GBAF15 - Elective, Diagnostic and Outpatient Access to Services
ย 
GBAF242 ECT Underlying Financial Position
GBAF242 ECT Underlying Financial PositionGBAF242 ECT Underlying Financial Position
GBAF242 ECT Underlying Financial Position
ย 
Caring Together deep dive risk240
Caring Together deep dive risk240Caring Together deep dive risk240
Caring Together deep dive risk240
ย 
Annual safeguarding presentation
Annual safeguarding presentation Annual safeguarding presentation
Annual safeguarding presentation
ย 
Draft Financial Plan 2017-18 and 2018-19
Draft Financial Plan 2017-18 and 2018-19Draft Financial Plan 2017-18 and 2018-19
Draft Financial Plan 2017-18 and 2018-19
ย 
Nursing home dietetics service update
Nursing home dietetics service update Nursing home dietetics service update
Nursing home dietetics service update
ย 
Quality Premiums - Deep dive GBAF03
Quality Premiums - Deep dive GBAF03Quality Premiums - Deep dive GBAF03
Quality Premiums - Deep dive GBAF03
ย 
Commissioning intentions 2017-19
Commissioning intentions 2017-19Commissioning intentions 2017-19
Commissioning intentions 2017-19
ย 
Physical activity and mental whealth 07 oct16
Physical activity and mental whealth 07 oct16Physical activity and mental whealth 07 oct16
Physical activity and mental whealth 07 oct16
ย 
Cheshire Fire and Rescue Service Safe and Well presentation
Cheshire Fire and Rescue Service Safe and Well presentationCheshire Fire and Rescue Service Safe and Well presentation
Cheshire Fire and Rescue Service Safe and Well presentation
ย 
NHS Eastern Cheshire CCG Deepdive presentation GBAF17
NHS Eastern Cheshire CCG Deepdive presentation GBAF17 NHS Eastern Cheshire CCG Deepdive presentation GBAF17
NHS Eastern Cheshire CCG Deepdive presentation GBAF17
ย 
Draft Financial recovery plan for NHS Eastern Cheshire CCG
Draft Financial recovery plan for NHS Eastern Cheshire CCGDraft Financial recovery plan for NHS Eastern Cheshire CCG
Draft Financial recovery plan for NHS Eastern Cheshire CCG
ย 
Financial recovery plan for NHS Eastern Cheshire CCG
Financial recovery plan for NHS Eastern Cheshire CCGFinancial recovery plan for NHS Eastern Cheshire CCG
Financial recovery plan for NHS Eastern Cheshire CCG
ย 
QIPP Presentation April2016
QIPP Presentation April2016QIPP Presentation April2016
QIPP Presentation April2016
ย 
Communications and engagement presentation governing body - april 2016 final1
Communications and engagement presentation   governing body - april 2016 final1Communications and engagement presentation   governing body - april 2016 final1
Communications and engagement presentation governing body - april 2016 final1
ย 
2.2.1 stroke services deep dive - 1
2.2.1   stroke services deep dive - 12.2.1   stroke services deep dive - 1
2.2.1 stroke services deep dive - 1
ย 

Recently uploaded

Sambalpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetSambalpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 
palanpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
palanpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meetpalanpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
palanpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near MeVIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
mriyagarg453
ย 
Independent Call Girls Hyderabad ๐Ÿ’‹ 9352988975 ๐Ÿ’‹ Genuine WhatsApp Number for R...
Independent Call Girls Hyderabad ๐Ÿ’‹ 9352988975 ๐Ÿ’‹ Genuine WhatsApp Number for R...Independent Call Girls Hyderabad ๐Ÿ’‹ 9352988975 ๐Ÿ’‹ Genuine WhatsApp Number for R...
Independent Call Girls Hyderabad ๐Ÿ’‹ 9352988975 ๐Ÿ’‹ Genuine WhatsApp Number for R...
Ahmedabad Call Girls
ย 
๐Ÿ’š Punjabi Call Girls In Chandigarh ๐Ÿ’ฏLucky ๐Ÿ”8868886958๐Ÿ”Call Girl In Chandigarh
๐Ÿ’š Punjabi Call Girls In Chandigarh ๐Ÿ’ฏLucky ๐Ÿ”8868886958๐Ÿ”Call Girl In Chandigarh๐Ÿ’š Punjabi Call Girls In Chandigarh ๐Ÿ’ฏLucky ๐Ÿ”8868886958๐Ÿ”Call Girl In Chandigarh
๐Ÿ’š Punjabi Call Girls In Chandigarh ๐Ÿ’ฏLucky ๐Ÿ”8868886958๐Ÿ”Call Girl In Chandigarh
Sheetaleventcompany
ย 
Ozhukarai Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Ozhukarai Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetOzhukarai Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Ozhukarai Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 
Mangalore Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Mangalore Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetMangalore Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Mangalore Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 
Tirupati Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Tirupati Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetTirupati Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Tirupati Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 
(Deeksha) ๐Ÿ’“ 9920725232 ๐Ÿ’“High Profile Call Girls Navi Mumbai You Can Get The S...
(Deeksha) ๐Ÿ’“ 9920725232 ๐Ÿ’“High Profile Call Girls Navi Mumbai You Can Get The S...(Deeksha) ๐Ÿ’“ 9920725232 ๐Ÿ’“High Profile Call Girls Navi Mumbai You Can Get The S...
(Deeksha) ๐Ÿ’“ 9920725232 ๐Ÿ’“High Profile Call Girls Navi Mumbai You Can Get The S...
Ahmedabad Call Girls
ย 
dehradun Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
dehradun Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meetdehradun Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
dehradun Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 
Call Girl in Bangalore 9632137771 {LowPrice} โค๏ธ (Navya) Bangalore Call Girls ...
Call Girl in Bangalore 9632137771 {LowPrice} โค๏ธ (Navya) Bangalore Call Girls ...Call Girl in Bangalore 9632137771 {LowPrice} โค๏ธ (Navya) Bangalore Call Girls ...
Call Girl in Bangalore 9632137771 {LowPrice} โค๏ธ (Navya) Bangalore Call Girls ...
mahaiklolahd
ย 
Call Girls in Udaipur Girija Udaipur Call Girl โœ” VQRWTO โค๏ธ 100% offer with...
Call Girls in Udaipur  Girija  Udaipur Call Girl  โœ” VQRWTO โค๏ธ 100% offer with...Call Girls in Udaipur  Girija  Udaipur Call Girl  โœ” VQRWTO โค๏ธ 100% offer with...
Call Girls in Udaipur Girija Udaipur Call Girl โœ” VQRWTO โค๏ธ 100% offer with...
mahaiklolahd
ย 
bhubaneswar Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
bhubaneswar Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meetbhubaneswar Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
bhubaneswar Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 
neemuch Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
neemuch Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meetneemuch Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
neemuch Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 
Bareilly Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Bareilly Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetBareilly Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Bareilly Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 
Thrissur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Thrissur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetThrissur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Thrissur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Call Girls Service
ย 

Recently uploaded (20)

Sambalpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetSambalpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Sambalpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 
Krishnagiri call girls Tamil aunty 7877702510
Krishnagiri call girls Tamil aunty 7877702510Krishnagiri call girls Tamil aunty 7877702510
Krishnagiri call girls Tamil aunty 7877702510
ย 
palanpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
palanpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meetpalanpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
palanpur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near MeVIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
VIP Call Girls Noida Jhanvi 9711199171 Best VIP Call Girls Near Me
ย 
Independent Call Girls Hyderabad ๐Ÿ’‹ 9352988975 ๐Ÿ’‹ Genuine WhatsApp Number for R...
Independent Call Girls Hyderabad ๐Ÿ’‹ 9352988975 ๐Ÿ’‹ Genuine WhatsApp Number for R...Independent Call Girls Hyderabad ๐Ÿ’‹ 9352988975 ๐Ÿ’‹ Genuine WhatsApp Number for R...
Independent Call Girls Hyderabad ๐Ÿ’‹ 9352988975 ๐Ÿ’‹ Genuine WhatsApp Number for R...
ย 
๐Ÿ’š Punjabi Call Girls In Chandigarh ๐Ÿ’ฏLucky ๐Ÿ”8868886958๐Ÿ”Call Girl In Chandigarh
๐Ÿ’š Punjabi Call Girls In Chandigarh ๐Ÿ’ฏLucky ๐Ÿ”8868886958๐Ÿ”Call Girl In Chandigarh๐Ÿ’š Punjabi Call Girls In Chandigarh ๐Ÿ’ฏLucky ๐Ÿ”8868886958๐Ÿ”Call Girl In Chandigarh
๐Ÿ’š Punjabi Call Girls In Chandigarh ๐Ÿ’ฏLucky ๐Ÿ”8868886958๐Ÿ”Call Girl In Chandigarh
ย 
Ozhukarai Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Ozhukarai Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetOzhukarai Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Ozhukarai Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 
Dehradun Call Girls 8854095900 Call Girl in Dehradun Uttrakhand
Dehradun Call Girls 8854095900 Call Girl in Dehradun  UttrakhandDehradun Call Girls 8854095900 Call Girl in Dehradun  Uttrakhand
Dehradun Call Girls 8854095900 Call Girl in Dehradun Uttrakhand
ย 
Mangalore Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Mangalore Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetMangalore Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Mangalore Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 
Tirupati Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Tirupati Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetTirupati Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Tirupati Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 
(Deeksha) ๐Ÿ’“ 9920725232 ๐Ÿ’“High Profile Call Girls Navi Mumbai You Can Get The S...
(Deeksha) ๐Ÿ’“ 9920725232 ๐Ÿ’“High Profile Call Girls Navi Mumbai You Can Get The S...(Deeksha) ๐Ÿ’“ 9920725232 ๐Ÿ’“High Profile Call Girls Navi Mumbai You Can Get The S...
(Deeksha) ๐Ÿ’“ 9920725232 ๐Ÿ’“High Profile Call Girls Navi Mumbai You Can Get The S...
ย 
Call Now โ˜Ž 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.
Call Now โ˜Ž 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.Call Now โ˜Ž 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.
Call Now โ˜Ž 9999965857 !! Call Girls in Hauz Khas Escort Service Delhi N.C.R.
ย 
dehradun Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
dehradun Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meetdehradun Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
dehradun Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 
Call Girl in Bangalore 9632137771 {LowPrice} โค๏ธ (Navya) Bangalore Call Girls ...
Call Girl in Bangalore 9632137771 {LowPrice} โค๏ธ (Navya) Bangalore Call Girls ...Call Girl in Bangalore 9632137771 {LowPrice} โค๏ธ (Navya) Bangalore Call Girls ...
Call Girl in Bangalore 9632137771 {LowPrice} โค๏ธ (Navya) Bangalore Call Girls ...
ย 
Call Girls in Udaipur Girija Udaipur Call Girl โœ” VQRWTO โค๏ธ 100% offer with...
Call Girls in Udaipur  Girija  Udaipur Call Girl  โœ” VQRWTO โค๏ธ 100% offer with...Call Girls in Udaipur  Girija  Udaipur Call Girl  โœ” VQRWTO โค๏ธ 100% offer with...
Call Girls in Udaipur Girija Udaipur Call Girl โœ” VQRWTO โค๏ธ 100% offer with...
ย 
bhubaneswar Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
bhubaneswar Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meetbhubaneswar Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
bhubaneswar Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 
neemuch Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
neemuch Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meetneemuch Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
neemuch Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 
Jaipur Call Girls 9257276172 Call Girl in Jaipur Rajasthan
Jaipur Call Girls 9257276172 Call Girl in Jaipur RajasthanJaipur Call Girls 9257276172 Call Girl in Jaipur Rajasthan
Jaipur Call Girls 9257276172 Call Girl in Jaipur Rajasthan
ย 
Bareilly Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Bareilly Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetBareilly Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Bareilly Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 
Thrissur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Thrissur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real MeetThrissur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
Thrissur Call Girls ๐Ÿ‘™ 6297143586 ๐Ÿ‘™ Genuine WhatsApp Number for Real Meet
ย 

Emergency Ambulance Access Improvement Project