Friday, 19 October 2012

No A&E, No Ambulance, No Chance

In my ongoing efforts to banish the veil of misinformation that confounds the general public when it comes to their local Ambulance Service, I was recently given the opportunity to write a piece for the Welwyn Hatfield Times. Sadly, for space reasons, they were unable to fit it in. They did quote me, although those quotes did not come from my submission. It is possible they were alluding to something I said on the phone, but I'm not entirely comfortable with the tone of the quotes and I'm disappointed with myself if I ever used the word "speedy" (unless I was talking about a Mexican cartoon mouse).

I certainly did not intend for ambulance crews to sound like they're a liability - only to underline that the constantly exhausted and overworked road staff would be less capable and less efficient. From personal experience I'm pretty sure I was of fairly sound mind for the first 8 or 9 hours of a non-stop shift. It was only after that things would start to get woolly.

In any case, the Welwyn Hatfield Times are at least getting the message out to the public that things are not in good shape. I hope they can step up their focus in the manner the Eastern Daily Press has. The EDP has been providing almost daily coverage of local ambulance issues and have been really getting the drains up on East of England Ambulance Service, setting up a survey, gathering patient accounts and reporting ongoing issues. I appreciate that they are a regional newspaper with far greater resources, but I'm really impressed with the way that Kim Briscoe and her colleagues are attacking the issue. It's certainly having some impact. I hope more local journalists take up the cause.

For clarity, below is the final submission I sent to the Welwyn Hatfield Times and the message I believe that local residents need to hear.

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No Ambulances to Send

I am a local paramedic with 12 years experience and I am sorry to say that your ambulance service is failing. Despite the current inability of the ambulance service to cope with the volume of emergency calls, new proposals will see a further reduction in available ambulances. The plans will reduce the number of ambulances at Welwyn Garden City, Hertford and Cheshunt. Potters Bar will have no ambulance cover after 2am.

With the effective closure of the A&E department at Queen Elizabeth II Hospital in Welwyn Garden City, the need to transport patients to more distant hospitals will leave few, if any ambulances available nearby.

In an effort to protect response time targets, ambulance chiefs have decided to increase the number of ambulance cars, which were originally intended to support ambulances, not replace them. This practice sees lone-response paramedics stranded on scene along with potentially critical patients. Even before the cutbacks, these scenarios are already occurring too frequently, with desperate requests for ambulance backup from the single responder being met with “Sorry, we have no ambulances to send.”

In some cases, single response paramedics have had to resort to transporting seriously ill patients in the car. This is life threateningly dangerous - the patient may deteriorate in transit, yet there is no means for the driver to provide immediate aid. The paramedic is being given no choice, but to continue waiting on scene could have even worse results.

Trust claims that “...there are currently places and times when we have too many vehicles and crews...” are patently untrue and there is overwhelming evidence to to contrary - day and night, every crew and single responder is already working flat-out throughout their shifts. Ambulances are routinely dragged far out of position by the requirement to attend Lister Hospital in Stevenage, or further afield to specialist stroke and cardiac centres. There is no slack to be taken up. To claim otherwise is either delusion or lies.

Ambulance staff pushed beyond safe limits have genuine concerns for their own families who live locally, as well as for the general public. They know how dangerous this situation really is, but are powerless to prevent it. Ambulance bosses attempt to dress up government cuts as "efficiency measures". Front line crews and support teams describe the current situation and future proposals as "horrifying" and "frustrating" and are struggling against overwhelming odds to deliver good care to those in need. But it has become an impossible task.

If those with the power to stop this erosion continue to prioritise money over the welfare of patients and ambulance staff then we should question their motives. The continued sacrifice of health and lives for the sake of targets and a bottom line is immoral.

You have no local A&E services and your ambulance service is being rendered increasingly unable to help. I urge patients and concerned relatives to speak out.

Contact the Welwyn Hatfield Times and tell them of your experiences, write to your MP Grant Schapps, learn when it is necessary to dial 999 and what other services are available for non-emergencies, do everything you can to stop this attack on the services that are there to help you when you really need it. If you don't, the day will come when help is unavailable when you, or someone you care about, desperately needs it.

Your health and lives are at stake. Please don't wait until it is too late.

36 comments:

  1. Best of luck with your campaign. I was a Paramedic first at Hertford and then at Biggleswade. Back in 1999 I organised publicity to keep the ambulance at Biggleswade, when management wanted to remove it (after already taking away the part time second vehicle) and replacing it with a car - an increase in service to the public, they were selling it as.

    I remember well single responder cars being introduced, initially they were always sent at the same time as a fully crewed vehicle, they really were just to get someone there even quicker than the ambulance, the ambulance should still arrive within the 8/19 (urban/rural) minute target. In fact, I believe the original ORCON standards when I initially worked in control only applied to a fully crewed, double-manned ambulance. A single responder then wouldn't count towards the targets.

    The only patient scenario that management was presenting to the public back in 1999 was cardiac arrest. It doesn't matter if you get two paramedics in an ambulance, or one in a car, as long as they can defibrillate they'll save you're life. So you don't need an ambulance. That was what was fed the press and the public. Totally ignoring the fact that something like 99% of emergencies weren't cardiac arrest. What if you've collapsed with abdo pain with an ectopic pregnancy, or your headache is the start of a cerebral bleed?

    Two things strike me as just appalling in the ambulance service now. The fact that it seems only category A emergencies have a response time target. Sorry, but its impossible to assess with 100% accurancy over the phone, depending on the self assessment of the patient or the caller, how serious the emergency is. He's fallen over, no don't think he's hurt himself, yeah he is conscious and breathing. Think he just needs picking up, he's fallen before like this. So, how many hours can he wait then? You CERTAIN he's not having a silent heart attack, TIA, slow brain bleed from his fall, pressure sores forming from laying on the floor....??

    Secondly the introduction of the new, lower grade of ambulanceman, the Emergency Care Assistant. Below the level of the original entry-level Technician, it seems a far cry away from the pledge in 1990 to have a paramedic in every vehicle. As I understand it they're not allowed to attend emergencies alone, they have to be crewed up with a qualified Tech or Paramedic. I also understand that this isn't kept to, regularly attending emergencies alone to back up single responders, in some areas making first attendences alone, and I know of one specific case where two improperly crewed together on an ambulance delivered a baby.

    Do the public realise that the guy dressed in green that jumps out of the ambulance isn't necessarily even trained to the standard of basic ambulance staff recommended by the Millar Report in 1964?

    I used to be proud to work for the ambulance service. I left because I hated the way the service was changing. That was 12 years ago. I think I made the right choice.

    terry-hewitt@hotmail.co.uk

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  2. More common sense above from a former Hertfordshire paramedic.

    Mat, before I was pointed in the direction of your blog I never realised that virtually all current road staff are of a similar mind on the current appalling situation.

    I am glad that some of our directors and senior managers are finally taking some flak. It is not a tenth of the flak we currently take from patients and relatives when they have waited hours for an ambulance because there weren't any and someone has downgraded their call because no ambulance could get there in 8 minutes or a car has achieved the 8 and 19 minute response.

    They need to stop saying to callers that talking to the call handler will not delay the ambulance response because clearly if their call is downgraded it will.

    Also when a cat A call is more than 8 minutes away so passed over to "Enhanced" Clinical Triage to downgrade, they just tell the caller an ambulance will be sent. In most cases of downgraded cat A calls they deceitfully do not inform the caller that their call has been downgraded so a response may be delayed or they are responding a car to 'assess' first, delaying the ambulance further.

    I notice on a previous thread 'EMD' from another service informed us that their trust, as well as sending the nearest resource regardless, uses clinical triage to deal with the green calls, either advice or transferring them to GP services or another service able to deal with their call.

    EEAS on the other hand targets its clinical triage at cat A calls more than 8 minutes away in an attempt to downgrade as many cat A calls as possible. Clearly this is not in the interest of the patient but their questionable response figures.

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  3. I see the health secretary Jeremy Hunt is pandering to the local press in Norfolk and Suffolk intimating that the problem with EEAS is unique to their region (EDP). I can assure you it is not.

    EEAS are providing the same, if not worse, appalling service and pulling the same stunts throughout its region including Cambridgeshire, Essex, Bedfordshire and Hertfordshire.

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  4. Apart from no training, no career progression (unless you are good with computers, figures and bullshitting at interviews) a pay freeze for a number of years, a horrific workload, loss of bank holiday pay, a sickness policy that is a disciplinary process, an increasing retirement age and as an experienced paramedic my concerns being completely ignored by trust managers. The one thing I looked forward to was treating and helping my patients, but now I find that all I am used for is getting to calls in 8 minutes if the call has not been downgraded and, when manning a car, sit about for hours with annoyed patients and relatives waiting for ambulances, pointless.

    Nobody can continue to work like this for long. Paras are snapping, jumping ship or being driven to an early grave. I firmly believe that the whole trust board should resign for not recognising and allowing things to get so bad for both patients and their staff. If you can't look after your staff how do you expect to look after your patients? It's called an 'ambulance' service, the clue is in the title, you need 'ambulances'.

    To quote Danny Glover in 'Lethal Weapon' "I'm too old for this shit" and it looks like nobody else is taking it either. EEAS you have been rumbled, lost the confidence of your staff and your reporting times are nonsense.

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    1. You forgot to include the prerequisite for management progression, a 'bullying personality' or what HR may euphemistically refer to as a 'firm decisive leadership track record'. Once you have a proven track record HR will ensure you are untouchable.

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    2. Also 'selective deafness' and good at 'figure manipulation'.

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  5. I see our medical director is now asking for the public to request more funding.

    A good start but a bit late now dear, your patient has already been admitted to intensive care.

    Like our response figures, a bit late, patient deteriorated but true figures not recognised.

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  6. Does EEAS lone worker policy exist any longer? Has it been abandoned in favour of response times?

    HEOC send single responders to anything at any time of day or night. Intoxicated, suicidal, self harmer, substance abuse, mental disorder, pubs, lying in the street in the middle of the night, domestics, fights.

    What do they mean by "just go and assess" and "don't take any risks" and "let us know if you require the police" or "what backup you require".

    'Defusing' does not work for these types of patients and 'withdrawing' once you have arrived on scene is likely to inflame the patient and 'bystanders' further.

    They may hope you don't get assaulted but in reality they don't give a shit about your safety as long as you have achieved the 8 and 19 minute response time with a car.

    Of course it's "for the benefit of the patient", is it? Who is at more risk the patient or the single responder from being assaulted verbally, physically or sexually? When you are off sick following an assault at least the trust will support you with their sickness / disciplinary process?

    And of course if the deranged, intoxicated, drug induced or self harmer happens to stab you in the chest with a knife, pair of scissors or other sharp implement then at least the stab vest you are all not issued with will protect you until the welfare check a couple of hours later. You certainly will not get ambulance backup at 3am, there aren't any. And what do they expect you to do with your potentially violent, deranged or intoxicated patient, convey them in the car?

    Nice to know the trust wont let your safety or any health and safety / lone worker regulations get in the way of its response times.

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    1. My "dynamic risk assessment" would be, get the police, run away and don't send a single responder in the first place.

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  7. I see the cyclist with the broken hip conveyed in a furniture van due to no ambulance available has returned to the media spotlight with further information (London Evening Standard, news link right).

    It says he was lying in agony on the roadside in the rain for 2 hours because there were no ambulances available and he couldn't be given morphine.

    I think I would rather be euthanized than go through the trauma and agony of lying there for 2 hours. If it happened to a member of my family then no corner could hide the trust board and senior managers from the consequences.

    Have they no shame? Apparently not - a spokesman for the East of England Ambulance Service said: "Ambulance crews at the scenes of incidents have to think quickly on their feet and make rapid decisions to treat and stabilise their patients."

    "On this occasion, the crews were aware the ambulance en route to them was diverted to a more life threatening call so the decision was to utilise a vehicle to assist them to get the patient to the awaiting aircraft."

    "Crews often commandeer vehicles to help transport their patients to awaiting helicopters." ...blah..blah.. bullshit...bullshit...

    So it was 'downgraded', it wasn't even an emergency, that's alright then.

    As someone asked on a previous thread - "how many of these 'spokespersons' does EEAS have and how much do they get paid to spout this propaganda bullshit."

    The patient has it right, comparing his care to that of a third world country and stating "the lack of ambulances in this day and age,.. London in the 21st century.. is just unacceptable."

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  8. North Norfolk Silver surfer22 October 2012 at 21:54

    Kim Briscoe, Health correspondent, Eastern Daily Press has been running some very interesting articles in her Ambulance Watch Campaign. Three in particular struck a cord with me.

    The first (17.10.12) was raising questions over the structure of the service. In it, North Norfolk MP Norman Lamb says that he is keen to hear people's views about the scale of the service's area and responsibility and he is certainly conscious that it was a massive increase in what went before. My question: Is that when it all started going wrong for North Norfolk in particular?

    The second article (19.10.12) explained who the decision-makers are on the East of England Ambulance Service NHS Trust board and explained that they are accountable to the people of Norfolk and Suffolk - just how that works I don't know. Apparently their application to become an NHS foundation trust is currently being considered. Kim Briscoe explains that NHS Foundation Trusts are not directed by government and have greater freedom to decide their own strategy and the way services are run. My thought: If they are fraudulently fixing things now, what happens when they have a totally free hand?

    The third article (17.10.12) informed us that outgoing chief executive Hayden Newton will be taking with him a pension Fund of more than £1.2m. Ten out of ten to Dan Poulter MP for Central Suffolk and North Ipswich for complaining that excessive management pensions were unacceptable - what is he going to do about it? But according to EEAS spokesman Gary Sanderson, it's OK folks because under Hayden Newton's leadership, you folks managed to consistently hit those targets for him! My thought: The tax payer must just be pleased that the regulator Monitor has not yet made EEAS an NHS foundation trust. Mind you, I don't think Mr. Newton has gone yet either.

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  9. How much does Gary Sanderson earn and how many spokespersons do EEAS have?

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    1. North Norfolk Silver Surfer23 October 2012 at 19:18

      I have no idea how much Mr. Sanderson earns or how many spokesmen there are but todays EDP reported on a meeting between the regulator Monitor and 3 MPs - Dr. Theresse Coffey (Suffolk Coastal), Peter Aldous (Waverney) and David Ruffley (Bury St. Edmunds). The meeting was to discuss the performance of Suffolk's ambulance service and its application for foundation trust status.

      The EDP report stated:

      "A spokesman for the trust was unavailable for comment but it has already said that under Mr. Newton's leadership the service has consistently hit the targets it was funded and commissioned to meet.

      During his time as chief executive, Hayden has moved the trust to a stable and sustainable organisation compared to six years ago," the spokesman previously said. "The services the trust offers are more tailored to individual patients."

      At least you seem to have frightened the spokesman away. Do you think you can make them see that things aren't very stable or sustainable?

      The EDP report also stated that MP Dr.Therese Coffey said "There is more to do, including a key meeting with the chairman of the ambulance trust in early November to further discuss constituents' concerns."

      If you live in any of the three constituencies mentioned above, write to your MP before the November meeting and let them know how you feel. They will only take on board comments from residents of their own areas. I've already written to Norman Lamb.

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  10. Road staff could have 100+ spokespersons. It's anonymous ffs. Do it !!!

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  11. East of England Ambulance Service 'improvement plan' was devised by managers and a consultancy firm using computer modelling based on historical data.

    A few concerns come to mind. Firstly do the consultants have any responsibility or how are they accountable? How much was their fee?

    Secondly with computer modelling garbage in = garbage out.

    If the models were based on the trust 'achieving' the A8 and A19 response targets with a car because these are the figures being reported, then what are they achieving? These figures do not equate to good patient care or even to timely transport to definitive care (hospital), garbage in = garbage out.

    If the models were based on the figures being reported by the trust, and the trust have 'inappropriately downgraded' calls to achieve the response targets (as many contributors to this site report) then the data is false, garbage in = garbage out.

    If the improvement plan was based on the trust achieving nothing, it will achieve less after implementation.

    Common sense will beat computer models any time.

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  12. Is your employer inciting you to break the law by pressurising you to convey critical patients in the car?

    This question arose while I was spending my time usefully with traffic police on a night shift watching an intoxicated 'unconscious' patient get wetter and colder lying at the side of the road waiting about an hour and a half for an ambulance (the police had already waited an hour before my arrival). While attending my patient (assessing and applying blankets) I was playing a game of 'battle scars' swapping horror stories with the police about who had the most horrific long wait for an ambulance (I won).

    When I mentioned some of the patients I had conveyed in the car the police said if they had seen me they would have either prevented me or prosecuted me for dangerous driving. Why? Because they considered that driving with some of the patients I described while trying to monitor and treat them on route would be so distracting that it was equivalent to driving while intoxicated and using a phone at the same time. I protested that on those occasions I conveyed them in the patients best interest as otherwise they may have deteriorated while waiting for the non available ambulance. They retorted it wouldn't have been in the patients or other road users interest if we had crashed on route and the conversation continued down the lines of what an ambulance is and a vehicle being used that was designed and fit for the purpose it was being used for (it doesn't have a stretcher) as well as the obvious distraction while driving problem. They also pointed out that an employer also had an obligation to provide a vehicle fit for purpose as they would prosecute an employer who knowingly provided a vehicle, such as a van, to transport more employees than it was designed for (normally 2), therefore if the ambulance service (EEAS) are providing a car but expecting you to convey critical patients, are they knowingly inciting you to break the law?

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    1. When the cyclist with the fractured hip was conveyed on the public highway in the back of a furniture van ('commandeered' by paramedics) as well as being a bumpy ride that was definitely illegal. So were the police on scene inciting an illegal act?

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  13. Stop conveying patients in the car. You are merely helping to sustain the current diabolical system. I'm sure you do it in the interest of the patient but it's an unfortunate fact that patients will have to suffer for it to become evident to all that this broken system requires fixing.

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    1. It should be well known that the cars are on the road illegally as they are taxed and registered and 'marked up' as ambulances when they obviously are not.
      They do not comply to the definition of an ambulance in any way.
      Anonymous 26th October 04.17 the Police were correct and you were lucky they did not book you. It is a pity they did not push it further and prosecute the authority.

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    2. An ambulance can be any vehicle used for ambulance service purposes, there are regulations for type of markings and warning lights / sirens for vehicles used for emergency work.

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  14. There are so many terrible ambulance stories getting in the press such as the 78 year old woman who fractured her femur waiting six and a half hours for an ambulance (Essex Enquirer).( http://www.theenquirer.co.uk/read.aspx?id=8831 ). Where did it all go wrong? If 'smarter working' means we can't get an ambulance to someone who needs it we need to rethink.

    How is it we are unable to afford to fill the many vacancies we have had for years and yet we can pay for private ambulances with questionable levels of training and competency? Also many of these private ambulances attend emergency calls, because "they are the nearest resource" and yet you find many of the crews are not trained in emergency driving. So why the f*&% are they attending emergencies? If they attend a critical patient either as a first response or to backup a paramedic in a car then what are you supposed to do about transporting 'on the blues'? You can't attend and drive, even if you were insured and they can't drive on the blues. Do you call a 'real' ambulance and delay conveyance? Do you allow them to drive under normal road conditions again delaying transport? (especially in rush hour traffic). What a stupid, crazy and f*%£$d up system! Can you imagine the police or fire service allowing drivers to attend emergency calls who are not qualified to drive on blue lights?

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  15. Has anyone got hold of this 'top secret' document from the department of health that stealthily and deceitfully lowered the standard for category A8 and A19 response to that of a car only in order to cut costs?

    Yes it is so secret and hush hush that ambulance staff, unions, politicians, patients and public know nothing about it! It doesn't appear to be a publicly available document.

    I can only assume it must be an 'internal' document for 'eyes only' and written in such a way as to be interpreted in a number of ways, 'a fudge'.

    Who produced it and allowed the lower standards? I assume it was the coalition government under the request of ambulance service advisers (trust chief executives who now appear to be jumping ship).

    Why would they allow it? Certainly not for the benefit of the patient but to cut costs and enable struggling trusts to 'achieve' response times. This is also why they allowed the ridiculous decision to lower standards and targets for cat B and C calls.

    Wonder why we are in the shit? There's your answer the standards have been lowered to cut costs and give the impression of 'achieving' improved response times when in reality you are providing a worse service for patients because their response is 'downgraded' and they are left for hours for a dwindling number of double crewed ambulances to convey them.

    The government should be raising standards not lowering them so that "any 'private' qualified provider" can take over.

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    1. Talking about lowering standards and cost cutting, what about all the ECA's we are recruiting. Do the public know they are not even allowed to administer salbutamol or atrovent nebulisers if the patient is literally dying from an asthma attack? Not that they would not be capable of being trained to administer some drugs.

      The only reason they 'can't' be trained? Because the increase in skill level would mean they would be moved up a pay band. So much for 'working smarter,' raising standards and making changes 'for the benefit of the patient'. Some trusts are even paying an incentive to technicians, who can administer most drugs, to leave in order to save on the wage bill and recruit lower salaried ECA staff. Lower qualifications and pay make it easier to privatise.

      Delete
    2. The impact of the loss of A&E departments on ambulance services has also been severely underestimated. For instance Hertfordshire went from 5 A&E departments accepting all ambulance cases to 2 taking most and no A&E department in Hertfordshire accepting major trauma.

      For every A&E department closing, the job run or turnaround time has increased significantly and emergency ambulances also attend the old hospitals to transfer patients to the 2 left. Another result is that ambulances are left out of place and out of area.

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  16. Yes as highlighted above, the 'front loaded model' in place in East of England Ambulance Service Trust is supported by the coalition government because it lowers standards and cuts costs and enables private providers to bid for services. But getting a car first to a patient before responding an ambulance is merely a trick to achieve response targets and disadvantages patients further as it delays ambulance response and conveyance.

    Critical patients in East of England territory who are unlucky enough to be more than 8 minutes away from a resource are disadvantaged further as their call is increasingly likely to be downgraded because enhanced clinical triage is targeted at those patients. It's a triple disadvantage or a 'three line whip' to downgrade and lower your response. First you are already more than 8 minutes away so if any excuse can be found your response will be downgraded. Secondly you are more likely to be responded to by a car or unqualified resource before an ambulance is sent. Thirdly once the car has arrived your response targets have been 'achieved' and any ambulance available to convey is likely to be diverted to achieve another cat A target.

    The front loaded model was adopted and later discredited by a Healthcare Commission inquiry when in use by Staffordshire Ambulance Service. This has not stopped the coalition government from reviving it. The inquiry also criticised the lack of training in Staffordshire because they appeared incapable of standing personnel down for training, a policy East of England Ambulance also appear to have adopted.

    What has happened to the training budget? When work was commissioned surely the commissioning process included ring fenced money for staff training including covering shifts? They weren't that stupid were they?

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  17. The latest Care Quality Commission report on Thames Ambulance Service (October 2012) shows they were not meeting CQC national standards and they required improvements, specifically in standards of staffing and standards of quality and suitability of management.

    So why is East of England Ambulance Service NHS Trust utilising a company not achieving national standards? Is there any connection between senior managers or directors and Thames Ambulance?

    Yes, Director of operations Neil Storey has declared a personal friendship with Thames chief executive Rob Ashford and Rob Ashford was formerly Locality Chief Operating Officer for East of England Ambulance and must know most if not all the Trust board and senior managers.

    Strangely the minutes of an Essex County Council meeting 15th November 2010 show that a "Brad Lane" from East of England Ambulance Service attended the meeting along with Rob Ashford from Thames Ambulance. Mr Lane gave a presentation and in response to a question about dealings with other ambulance services stated that East of England Ambulance Service contracts directly with Thames Ambulance Service by tender. There is no explanation as to why it had been pre-arranged for Rob Ashford from Thames Ambulance to attend the meeting with a representative from East of England Ambulance Service.

    One thing is for sure, the plans to reduce the number of double crewed NHS ambulances and qualified staff and increase the number of cars will certainly contract more work to private providers such as Thames Ambulance.

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    1. I'm sure Rob Ashford from Thames Ambulance has more 'friends' than Neil Storey in East of England Ambulance.

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  18. Someone suggested on a previous thread that health minister Norman Lamb should ensure that ambulance services are banned from allowing cars to be classed as a transportable vehicle for critical (Cat A) patients. He hasn't acted yet so is he saying that if a member of his family suffered a stroke, heart attack, breathing problems, was unconscious or suffered multiple injuries he would expect them to be carried over the shoulder of the response paramedic, thrown into the back of the car, taken to hospital in the car or sit and wait for hours for a double crewed ambulance because the car has 'achieved' all the ambulance service targets including the A19 transport target?

    Yes even the question sounds silly, but that is the current state of affairs. It's about time these MP's started using some common sense and acted in the interests of their constituents, patients and ambulance staff rather than lower standards to make it look like ambulance services are achieving targets they are not.

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  19. This broken paramedic thing was a fantastic opportunity for overworked, demoralised even bullied ambulance staff to begin the fight back. I saw it as an acorn from which a mighty oak tree of protest would grow. A tiny snowball that gathered momentum until it was a colussus of discontent. Well it never happened. Do you know why ? Cos you are all broken paramedics/technicians/ecp's/eca's whatever. All of you broken cos you've given up. There is no fight left in you. The battle is over. Mat Westhorpe take a bow. You gave it your best shot but you didn't realise the apathy that exists amongst your former colleagues. You are realising now though I think. Full marks to you Matt. The rest of you......oh what's the point !

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  20. I agree with Anonymous 15 November
    Matt tried hard to make it better for those left in. I tried by sending this to my local MP and Panorama. MP just didnt get it - thought it was all about not getting a meal break and heard nothing back from Panorama. Its really sad because the more who speak up the bigger that snowball would get until there would be nothing that could hold it back and they would have to do something about it.

    Come on all you service personal (I'm ex service but would still love to make a difference), lets roll the ball some more

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  21. Sorry, I have gone a bit quiet, haven't I? It wasn't entirely by design, but as I am no longer employed by EEAST, I have to devote my time and resources to mine and my family's future as well as pushing for a better ambulance service.

    I still feel just as passionately about the ailing ambulance service, but there's only one of me and I'm having to divide my efforts and forge a new career. I found pressing the ambulance issue was becoming an unsustainable and all-consuming obsession which was, quite frankly, getting me as frustrated as when I was still in the service (but without the benefit of a salary). I think that frustration started to show in my increasingly negative and angry tone of writing in later articles, which was never what I intended.

    Although there is much more I would like to write about - and I certainly do intend to write more - I think the essence of the issues have already been captured on this blog. The truth is, the last two commenters are right, the real push needs to come from union members and staff within the service.

    During my experiences writing and researching this blog, I've learned that the desire for change and improvement is out there. As well as the overwhelming number of comments found on every page of this blog, government officials I've dealt with and an assortment of media representatives are also concerned. As well as contact from the office of Norman Lamb (Minister of State for the Department of Health), in the last couple of months I've been approached by The BBC's The One Show and Look East, a Channel 4 journalist, The Mail on Sunday and a number of local and regional papers. The barrier I hit was that I am not current (or in some cases not in the right locality). They want a voice from today's front lines, not yesterday's and it needs to be tackled locally as well as regionally or nationally.

    I could seek out a role as a union representative or try to pursue a political or journalistic position to "get back in the fight", but that feels like the path to madness. As much as it's not what readers want to hear, I'm far, far happier now, away from the ambulance service. it's nice having a sleep pattern and not being abused by an employer. The ambulance service has become a toxic working environment due to intolerable pressures, mismanagement and lack of resources and I found its debilitating effects are still effective from the other side of a computer monitor.

    I know how exhausting it is out on the road, so I can't entirely blame the frontline workforce for any apathy. Folk just want to survive their shifts, get home and forget about the ordeal. It's entirely understandable.

    I'm sorry I couldn't sustain the momentum of the first few weeks, but rest assured, I'm not entirely done yet. I just hope others are still pushing.

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  22. Silver Surfer in Norfolk17 November 2012 at 23:43

    I am keeping my fingers crossed that you and your working colleagues have pushed the right buttons here in North Norfolk.

    Today’s EDP front page Campaign Exclusive by Kim Briscoe is ‘Review into 999 Service’. In the article she states that EEAST are bringing in an (as yet unnamed) independent senior ambulance clinician to review its Norfolk operations in a bid to restore public confidence and improve its care for patients.

    The review is thought to be starting before Christmas and it seems that Norman Lamb is pushing for the concerns of paramedics to be listened to with reference to how the system is operating. Please continue to speak up for yourselves and for me and mine!

    I am not sure this will work but I am going to cut and paste the link to the article so you can read it for yourselves:

    http://www.edp24.co.uk/news/health/ambulance_trust_to_launch_independent_review_of_norfolk_s_under_fire_service_1_1697030

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  23. Don't make me laugh!

    EEAST arranging its own "independent review"?
    A bit like "News Corporation" arranging its own independent review into phone hacking.

    They will probably get one of the "Essex boys" to review it (remember the "booze run") when they removed markings and back seats on an ambulance car and a number of senior Essex managers, including Paul Leaman and Richard Lane took it untaxed and uninsured over to France to pick up alcohol for themselves and possibly other senior Essex managers. They also colluded with a company selling health service equipment and hassled colleagues to give the firm business. Paul Leaman subsequently followed Essex Chief Executive Anthony Marsh up to West Midlands along with Rob Ashford who is now Chief Executive of private ambulance provider Thames Ambulance, which EEAST gives business to. Our current director of operations Neil Storey was also an Essex Ambulance Manager and has disclosed a personal friendship with Rob Ashford (who was also an Essex Manager).

    When the fleet manager Paul Holmes reported Paul Leaman and Richard Lane he was "bullied and victimised" and after complaining unsuccessfully that no action had been taken against them (yes the ambulance service "independent" investigation was a whitewash) Paul Holmes reported them to the HPC who subsequently (2009) found them guilty of misconduct.

    The HPC stated that "the fact there was no disciplinary action taken against them (the booze cruise runners) by the ambulance Trust did not of itself show the event was not serious but may simply show a poor management culture within the Trust at the time". Anthony Marsh, Chief Executive of West Midlands Ambulance Trust and Hayden Newton Chief Executive of East of England Ambulance Trust were both character witnesses on behalf of Mr Lane and Mr Leaman.

    Paul Leaman was found guilty of misconduct, suspended from the HPC paramedic register for a year and subsequently received a caution for the following four years, he voluntarily withdrew his name from the paramedic register in 2011. Richard Lane received a caution for five years.

    Paul Leaman is currently an Associate Director for East of England Ambulance Service.

    Nice to see EEAST takes bullying, victimisation and collusion with private providers seriously.

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    Replies
    1. Thanks for the info, I see all the information you give regarding the "booze cruise" and HPC hearing is available online. Explains a few things about meetings, here in Essex pubs, between several senior EEAST Essex managers and Rob Ashford from Thames Ambulance. So no disciplinary action was taken against them for the misconduct by any ambulance service chief executive but they felt it was important to be character witnesses at their HPC misconduct hearing. I notice the HPC report doesn't say they were character witnesses for the informant/complainant, Essex fleet manager Paul Holmes, he didn't have friends in high places, all he got was bullied and victimised and an 18 month final written warning for writing a personal letter to the council complaining about Christmas bin collections. Has the "poor management culture" changed? No it's worse.

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  24. Interesting posts above. Anyone else with information?

    As regards "independent" review, why only Norfolk? Not a very good start on terms of reference. Its much worse in the rest of East of England territory.

    I note the meeting with East Anglia MPs at Westminster resulted in EEAST reporting monthly "response time targets" to MPs. The problem is that the response targets and the way they are reported are the cause of much of the problem. Because former coalition Health Secretary Andrew Lansley allowed the lowering of standards so that a single paramedic in a car 'achieved' all the response targets for life threatening category A calls namely the A8 (8 minute response time) and the A19 (19 minute response time for an ambulance to convey) when clearly a single paramedic in a car cannot convey a critical patient in a car "in a clinically safe manner" and results in the patient and paramedic waiting for hours for an ambulance to convey, because they have already 'achieved' the response targets with the car but to the detriment of the patient. It also results in more cars (because they are 'achieving' the response targets) but less ambulances (although they are the vehicles conveying the patient, they are not 'achieving' the response target). Will the "terms of reference" include this investigation or investigation into transport waiting times? (Doubt it).


    Will the "terms of reference" include an investigation into "downgrading" of category A calls if they are more than 8 minutes away by enhanced clinical triage or clinical support desks in order to 'achieve' the targets? (Doubt it).

    Will the "terms of reference" include an investigation into training levels, protected training times and funding (doubt it).

    It pays to be cynical, with inevitable outcomes it avoids disappointment.

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  25. about lone response control in my area say the same please asses my answer was no and DONT FORGET YOU ARE COVERED IN LAW TO REFUSE IF YOU ARE SURE THAT YOU COULD BE AT RISK OR ARE IN DANGER I have told control many times that I will not be going as I feel at risk be sure control will stand you off right away they have been told by every trust chief officer they cant take the risk do you think they will risk losing there salary midlands chief £203,150 I don't think so.

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