Ambulance crews working '˜flat out' after service is branded '˜shambles'

Ambulance crews are working '˜flat out' but delays outside packed hospitals mean they sometimes only get to three or four jobs in a night, it has been claimed.

Wednesday, 14th February 2018, 12:23 pm
Updated Thursday, 1st March 2018, 1:15 pm
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One union representative said the knock on effect on patients was ‘not acceptable’ as the North West Ambulance Service came under scrutiny for failing to hit response time targets.

It followed a debate in the House of Commons when MPs heard the state of the beleaguered service was putting lives at risk.

UNISON’s North West regional organiser David Atkinson said: “It is not acceptable that patients are having to wait for so long.

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“Ambulance crews are working flat out to try to meet patient need – responding to call after call without any downtime - but investment has not kept up with demand.

“A key problem is that ambulance crews are unable to transfer patients quickly at hospital A&E departments.”

His comments follow a Commons debate last month when NWAS was branded a ‘shambles.’

The government’s shadow minister for housing, Tony Lloyd MP, made the claim in Parliament, when he said not enough ambulances were getting to seriously ill people on time.

He said: “The sad reality is that the North West Ambulance Service is a shambles. That, of itself, underlies something much more serious – as a shambles, it is of course putting people’s lives at risk.

“This is simply unacceptable in modern Britain.”

The Rochdale MP said ambulances are only reaching the most serious cases in an average of 11 minutes, when targets say 75 per cent should be answered within eight.

And he said they are taking an average of 44 minutes for the next category of calls, when 75 per cent should be reached within 18.

“Those are calls that are serious and certainly cannot be dismissed as trivial,” he said. “Something is going very wrong.”

In response, NWAS said he was referring to ‘out-of-date’ targets that were not comparable to new measures brought in back in August.

A spokeswoman said: “We are not only monitored by the timeliness of our response, but also a number of clinical outcomes that check the level of care that we give to our patients and for those who perform well.

“It measures our care for patients who have suffered a stroke, heart attack, or cardiac arrest.

“We acknowledge that our performance against the national standards has not been as good as we would like but we would like to assure the public that much is being done to improve this.

“With the support of our NHS colleagues, both staff on the frontline and management have been working extremely hard to fill vacancies, improve hospital handovers and to make sure that the people of the North West get the service they need.”

Mr Lloyd said it ‘would be tempting’ to blame the winter crisis for the figures, but said NWAS – which he called ‘he worst performing ambulance service in England – had struggled to hit its targets since 2014.

The number of highest category calls – where someone is not breathing or their heart has stopped – has rocketed by 50 per cent in the past six years, Mr Lloyd said.

But he said the number of paramedics had only increased by 16 per cent, while the number of ambulance technicians had increased by 28.

He also said paramedics were being forced to wait outside busy A&E departments ‘in some cases for hours on end’ as a ‘daily reality’ waiting for patients to be handed over to emergency department staff.

He added: “Such cases mean that the skilled staff in those ambulances cannot be out on the road going to the next job where they are needed and to the one after that.

“One of the paramedics — a whistleblower, as it were — with more than two decades of service in our ambulance service told me that when he started, he typically went to nine different jobs during a working shift.

“It is now sometimes as few as three or four jobs a night, because he and his colleagues spend their time waiting outside hospitals.”

NWAS said the number of emergency calls had increased by 50 per cent in the past 10 to 11 years, and the number of paramedics had gone up by 37 per cent since 2010/11.

The number of technicians last year was 1,311, down from 1,350 in 2010/11.

The length of time paramedics are left waiting at Blackpool Victoria Hospital’s A&E department has soared by 450 per cent since 2013/14, The Gazette reported last year.

Stephen Barclay, the minister of state for health and social care, said the ambulance service was dealing with ‘unprecedented demand’, with 11m calls every year and almost 7m face-to-face responses in 2016/17 – a 14 per cent increase on the past five years. He also said NWAS had a ‘strong record of recruitment’, with its vacancy rate of 2.4 per cent now one of the lowest in the country. But he said the government recognised NWAS’ performance against standards ‘is not good enough’, and said NHS Improvement, NHS England, and health commissioners are working with the trust ‘to ensure it adapts successfully’ to new standards brought in last year.

The way the ambulance service responds to 999 calls was overhauled last August in a bid to reach seriously ill patients even faster.

Previously ambulances were expected to get to the most urgent 999 calls within eight minutes 75 per cent of the time.

Those targets have now been scrapped, and the new standards will see paramedics aiming to reach the most serious emergency cases within an average time of seven minutes, and within 15 minutes nine in 10 times.

An 18-month trial found that by giving operators more time to assess patients during the initial phone call, urgent conditions were identified more quickly – without slowing down response times or resulting in any harm to patients.

More than one in three ambulances called to the most serious cases in Lancashire failed to arrive within the eight-minute target in 2016/17.

Just 65.4 per cent of ‘red one’ cases met the standard while the figure fell to 60.5 for ‘red two’ cases, the next most serious. The now-defunct targets called for 75 per cent of such ambulances to arrive within eight minutes.

Rural areas typically have longer response times and NWAS hit targets in Blackpool for the year, with an 81.8 per cent success rate in the most serious cases.

But figures for June – the most recent available before the old targets were scrapped – show NWAS missed the targets in Blackpool, with just 62.5 per cent of ambulance arriving within eight minutes.

Across Fylde and Wyre, fewer than half – 49.7 per cent – of the top priority cases got a response within the target time between April and June 2017.