Thursday, 23 July 2015

Mission to Parliament: What Has Anthony Marsh Ever Done For Us?

Chloe Smith (Con), Norman Lamb (Lib Dem) and Daniel Zeichner (Lab) accept the petition from Fraer Stevenson
Earlier this week, a group of East of England ambulance staff travelled to Westminster to deliver a petition appealing for better working conditions for road staff and to retain the services of the chief executive who supports them. Their hopes were to gain ministerial support to help persuade the Secretary of State for Health to intervene and allow them to retain Anthony Marsh longer term as their Chief Executive.

I was fortunate enough to be able to travel with them to get a better understanding of the issues.

As I sat on the minibus heading for Parliament, I listened to the conversations of the ambulance staff who had taken time out from their home lives to maintain the push for positive change within East of England Ambulance Service (EEAS). The group exchanged stories about their front line experiences and the organisation that facilitates them with all of the disgruntled passion I recall from the crew rooms of old. It was this kind of cathartic debrief which allowed under pressure ambulance personnel to offload and vent. I knew how valuable these conversations were, despite often seeming critical or negative, as a way for ambulance clinicians to feel their concerns were being heard, even if only by each other. It was how they coped with the burden of their work.

Sadly, these days the growing pressure for ambulance Trusts to perform with ever dwindling resources leaves road crews with little opportunity for such informal confessionals as they are rarely on station to meet each other. Back to back emergency calls, aggressively enforced hospital turnarounds and soul-sapping late finishes mean that individual crews are often ships passing in the night.

But hopefully today their concerns would be heard by a far more influential audience.

Given their discussions, I was a little worried that their message might get lost under a deluge of anecdotes about inappropriate emergency calls and internal politics. Fortunately, as we arrived in central London, the spokeswoman of their merry band said a few words to ensure that everyone was clear on the matters in hand. Fraer Stevenson, ambulance clinician and UNISON Branch Secretary, underlined the importance of focusing on the key issues of the petition they carried; supporting moves to offer staff greater protection from late finishes and backing incumbent Chief Executive Dr Anthony Marsh to stay in post despite pressure from the board for him to be replaced.

On first impression, Fraer cut an unusual figure as the individual at the epicentre of the struggle for staff welfare. A diminutive blonde woman with a small voice who, while having the bedside manner of Florence Nightingale, you might think would be out of her depth dealing with headstrong and determined executives. Apparently not; a steely determination to fight for what is right, whatever the cost, hides just beneath the surface.

I had only spoken with Fraer once before today, a lengthy phone conversation (after weeks of missed calls) had revealed she and I had been walking a parallel path for a long time. Concerns about East of England Ambulance had prompted me to start this blog back in 2012 after I became aware of a growing outcry among North Norfolk residents at the poor service they were getting from EEAS. Fraer was involved in much of what I went on to write about on The Broken Paramedic during that period: campaigning when staff grievances were ignored and seeking support from concerned Norfolk politicians including Norman Lamb (Lib Dem) to the battle for EEAS’s soul against a misguided executive board which eventually stepped down. The catalyst for much of that was a brave and candid stand made by staff at Cromer Ambulance station on the North Norfolk coast. I believe that the corner which EEAS is perceived to have turned is very much something for which Cromer staff deserve no small amount of credit.

Is Anthony Marsh the Right Man for the Job?

Dr. Anthony Marsh, EEAS & WMAS Chief Executive
After piecing together our shared history, I took the opportunity to air some niggling concerns I had about the purpose of her mission to Parliament. Nationally, ambulance staff are in a desperate situation and I’m unequivocally behind anything that will give crews a better chance of surviving their own careers, but why is she so convinced Anthony Marsh is worth fighting for? Since publishing my previous article backing the petition to retain his services, I’d been contacted by various parties who expressed concerns about the move, from decisions he made at West Midlands Ambulance Service to his failure to address a bullying culture allegedly present within East of England. It seemed that not everyone was as convinced as she was that he was the right man for the job.

Her reasons were manifold. Now she is UNISON branch secretary, she has a good ‘partnership’ relationship with Anthony Marsh, enabling her to push for positive changes which benefit staff, pushing for improvements to the diabolical conditions they labour under and ultimately bolstering their ability to provide a good service to the public. She believes that Mr Marsh is a good man making brave decisions to right a listing ship. She identified some of the supportive measures he’d brought into EEAS include upskilling paramedic and EMTs to band 6 and 5 respectively, saving about 100 staff from having to leave the Trust after the loss of Patient Transfer contracts (under TUPE [Transfer of Undertakings (Protection of Employment) Regulations 2006] legislation they would have been absorbed by private providers) by bringing in a new tier of health care referral teams undertaking urgent work.

It is fair to say the role of any ambulance trust chief executive (or indeed any other senior management position) is a poison chalice. In the current target-obsessed, resource-starved climate, it is an impossible mission for anyone, but Fraer presented plenty of evidence to suggest that Mr Marsh is at least willing to factor staff needs into his strategies. The same may not be said of any replacement waiting in the wings, especially given that, due to the current period of uncertainty, many positive proposals under Anthony Marsh have already stalled and current changes threatened with reversal. Any incoming chief executive will surely be expected by the board to continue down that line.

Whatever your thoughts on Anthony Marsh’s tenure, the ground made in EEAS under his watch is at stake and I’m inclined to give him the benefit of the doubt, largely because Fraer is. I am convinced she is absolutely a force for good, someone who is prepared to stand up for staff and stand up to the less savoury aspects of ambulance culture, even to her own detriment.

Parliamentary Friends

Clive Lewis (Lab) and Gavin Shuker (Lab) listen to staff concerns.
When we arrived in Westminster, the meeting itself went well, with some encouraging dialogue taking place between the assembled ambulance personnel and the MPs who found time to escape the halls of power on the day of the Welfare Bill debate.

Gathering on the green often used by the reporting media outside Parliament, we were met by Chloe Smith (Conservative MP for Norwich North), Daniel Zeichner (Labour MP for Cambridge), Norman Lamb (Liberal Democrat MP for North Norfolk), and later by Clive Lewis (Labour MP for Norwich South) and Gavin Shuker (Labour MP for Luton South) all of whom were attentive and supportive, listening to concerns and supporting the petition. It was fantastic to see such positive cross-party support.

Norman Lamb talking to BBC Look East
I was particularly impressed with Norman Lamb, who I’ve always viewed as sort of a kindly uncle, but in person was far more steely. His commanding performance in front of the BBC Look East camera showed that he was a very capable man able to marshal facts from conversations he’d had moments before into what sounded like a polished, pre-prepared speech. His comments were insightful and had weight, asking ‘is it wise to lose a chief executive who has the confidence of staff and has made real progress.’ Certainly, it’s worth considering that, in light of concerns about Anthony Marsh’s other role as West Midlands Ambulance Service chief, he has still had successes, where his full-time predecessors had failed.

Thankfully, all of the MPs pledged to do what they could for the cause, with promises to write to Jeremy Hunt, Secretary of State for Health, to bring the matter to his attention. I hope it’s a matter which Mr Hunt feels is worthy of his time. After all, now more than ever, he is a man who could do with the opportunity to appear supportive toward the needs of NHS staff.

Perhaps more importantly, I hope that the East of England executive board are able to see whatever influences are driving the decision to oust Anthony Marsh and to make the right choice to support the staff that make their organisation work.


Wednesday, 15 July 2015

The Fight for Positive Change in Ambulance Trust Culture Needs You


In a country of beleaguered ambulance Trusts facing staffing shortages, pay freezes and dwindling resources, things are looking bleak right now for employees and the public alike.

But there is a glimmer of hope.

After a desperate few years, East of England Ambulance Service has been experiencing the beginnings of a positive shift in culture and attitude. A change which, if successful, could show the way for other Trusts and prove to be the template for the much needed shot in the arm ambulance services nationwide need. Among other things, this grassroots initiative led to the production of the powerful and incisive video below about pressure and late finishes and accompanying petition, which solicited this encouraging response from the Association of Ambulance Chief Executives. But it's an initiative that needs your support, wherever you are in the country.


Although this blog's recent focus has been on London Ambulance Service's institutionalised abuse of its workforce - a conclusion borne out by the recently published, damning independent investigation into bullying and harassment - LAS's current culture echoes that of EEAS' in the past. With the recently announced departure of LAS Director of Operations, Jason Killens, it seems every bit as plausible that London staff could hope for a positive shift in their fortunes in the future. It just takes the right kind of bold and positive influence and leadership.

The kind which Dr Anthony Marsh is providing for EEAS in his role as Chief Executive.

During his tenure, Dr Marsh has proven to have an ear for staff and public concern, supporting moves to address late finishes, stopping the practise of fudging response time figures through the use of single-manned rapid response vehicles where a double-staffed ambulance is more appropriate. He has encouraged increased transparency and communication. He has backed a push to support wage increases for low paid Trust staff. He has started to build a belief that the workforce is valued. In his Clinical Governance Report of 2013. he challenged the kind of negative culture which brought EEAS to its knees in the past and has more recently seen LAS fall from grace. But there is much more which still needs to be addressed - his work is far from done.

Sadly, the remaining proponents of EEAS' former, negative culture are understandably not happy with the threat Anthony Marsh poses to the status quo and are making moves to oust him, already preparing his replacement in the wings. Dr Marsh's departure would be a regressive move for the Trust and the public it serves. It would endanger any hope of continued positive change and threatens to see a return to the blinkered and damaging practises of old.

If ambulance Trusts around the country are to find a way to evolve past the archaic 'command & control' management structure which has proven to grind staff into the ground, if they are to mature into a public service which supports its staff and delivers the world class service the country expects, then we need to stand with progressive leaders like Dr Anthony Marsh, who is also chair of the Association of Ambulance Chief Executives.

It is for these reasons that East of England staff have been running a petition to the Secretary of State for Health asking for support to keep Dr Marsh in their Ambulance Trust. Hundreds of staff have signed the petition, which says, ‘We believe that without Dr Marsh things will again quickly start to unravel in our Ambulance Trust; there are already discussions to remove some of the supportive changes we have seen, and this is severely impacting morale. We feel we need to petition you [Jeremy Hunt], as we do not believe our Board is acting in our best interests.’

Frontline staff are traveling to Parliament on 20th July (next Monday) with the support of former Minister of State for Care and Support Norman Lamb and other MPs. I will be travelling with the group and hope that they will be listened to and supported by MPs and the Secretary of State for Health. I’ll post details of our mission both on this blog and in other social media.

They, and I, would be most grateful for your support and help. This could be a tipping point for ambulance culture nationwide.

Please follow this link to sign the petition.