Ambulance Waiting Times — House of Commons, 2016-10-17
Topic: Health
Philip Martin Dunne (Conservative, Centre-right): My hon. Friend will be aware that the clinical commissioning groups around the country commission services from ambulance trusts. I am sure he will have looked into the experience of the CCG in his constituency to see whether it believes it is getting the service that his constituents and its patients require. I can speak for my area, where a change to the disposition of response vehicles, particularly ambulances, was proposed by the ambulance service. A trial period took place, and the CCG was persuaded that it needed to provide more money to the ambulance service to fund additional crews to improve coverage. It is specific to individual areas, but CCGs need to work with ambulance trusts to ensure that the relevant standards are achieved The South Western Ambulance Service established an action plan in response to the CQC report to identify activities to improve its performance and demonstrate the benefits of the ARP, including addressing staffing and fleet requirements, and working with A&E departments in hospitals to which it conveys My hon. Friend made some startling observations about the challenges and consequences of extended handover times, and his examples were instructive. It is clearly a problem when ambulance crews are unable to discharge their patients into emergency departments as efficiently as they would like. NHS Improvement is working with local commissioners and trusts to tackle those problems, including handover delays, when they present a continuing problem. The amount of time lost to handover delays at hospitals is a significant concern in the south-west service, as he indicated. He mentioned an aggregate figure. The figure I have is that, on average, 60 hours per day were lost to handover delays in August 2016. In July, a regional workshop was run by NHS England and the Emergency Care Improvement Programme, attended by the South Western Ambulance Service, acute providers and commissioners. A set of actions to address handover delays were agreed upon and a plan to implement them is being developed. Hopefully he will see the benefit of that shortly We recognise that there is currently a shortage of paramedics nationally. As my hon. Friend mentioned, the south-west area is no exception. A number of initiatives are being implemented to address that, from recruitment campaigns for ambulance staff and paramedics, to training schemes to upskill the existing workforce. In the CQC report, it found that South Western Ambulance Service has an appropriate mix of skills to provide a safe service, and that, where staff numbers are below planned levels, the trust is making good efforts to recruit new staff At the end of September, there were 1,568 ambulance paramedics at the South Western Ambulance Service, almost double the number of ambulance paramedics there in 2010. That is an impressive achievement, but there remains a vacancy rate at the trust of just over 3%, equivalent to 134 members of full-time staff. Health Education England is working with the College of Paramedics and has invested more than £2 million in a two-year paramedic pre-degree pilot, through which potential paramedic students are recruited into roles providing structured care in urgent and emergency care settings. Health Education England is also providing funding to ambulance services to invest in their existing workforce, train ambulance technicians to become paramedics, and upskill paramedics to advanced or specialist paramedic level In the south-west, Health Education England has provided £350,000 in funding to help retain staff so that they stay longer than my hon. Friend indicated they have in the past, and to improve engagement and provide the opportunity to train with the very latest equipment. I am pleased to note that 100% of the trust’s rapid response vehicles and dual-crew ambulances are funded to have a paramedic on board. In the six months to May 2016 there was, on average, a paramedic on almost 92% of all A&E conveying vehicles. The service is approaching the level for which it is funded, and I hope those initiatives ensure that there are sufficient paramedics to hit that 100% target In addition, to help to reduce system pressures, NHS England is undertaking a public information campaign about urgent care services. My hon. Friend urged us to do that to encourage the public to present at the right place and do the right thing. In particular, he referred to the use of NHS 111 as a front door to the integrated urgent care system to help improve its credibility as the place to get initial advice, rather than people dialling 999 To conclude, I again emphasise that ambulance services are vital to emergency care and the NHS as a whole. We all want to be sure that, where loved ones suffer heart attacks or are involved in a serious accident, they will not be left waiting for medical help to arrive. The initiatives being taken in response to the record demand facing the urgent and emergency care system will ensure that patients continue to receive the quality care that they need My hon. Friend concluded his remarks by asking for a new approach to the integration of NHS services, to which I would add the integration of NHS services with social care services. He could have been describing the sustainability and transformation plans that are currently being finalised by health areas across the country for presentation to NHS England by the end of this week. They are bottom-up plans prepared by clinicians and senior management within NHS organisations alongside local authority organisations responsible for social care, which is precisely what my hon. Friend called for. I am pleased to say that, under this Government, that is being delivered Question put and agreed to.