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East Midlands Ambulance Service branded 'not fit for purpose'

By Lincolnshire Echo  |  Posted: February 22, 2013

Ambulance
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The chief executive of a failing ambulance service has been accused of lacking the vital geographical knowledge required to meet emergency response times in Lincolnshire.

The Echo revealed last week how fresh figures indicate East Midlands Ambulance Service is now the worst performing trust in the country.

EMAS chief executive Phil Milligan admitted response times will never meet national targets until it receives a multi-million pound cash injection.

During a heated two-hour meeting of the health scrutiny committee at Lincolnshire County Council last week, Mr Milligan was heavily criticised by members across all political parties.

Chris Brewis, an Independent councillor, said: "Phil Milligan does not understand the geography of Lincolnshire.

"What we have heard from EMAS is nothing short of a disgrace.

"I know somebody who waited more than six hours for an ambulance.

"Where is our explanation for that?

"Quite simply, EMAS is not fit for purpose and I am appalled."

A three month consultation into EMAS' "Being the Best" ended in December.

The service wanted to close 53 ambulance stations and open 13 purpose-built hubs across the East Midlands.

There were also plans to create 131 standby posts across the region.

But more than 95,000 signatures were obtained in a petition opposing the plans.

Mr Milligan has now revealed there are different proposals on the table and that 27 purpose-built hubs could be built.

But officials at Lincolnshire County Council have said there needs to be another public consultation on the new proposals.

If there isn't, the authority has warned it will refer the matter to the secretary of state.

Conservative councillor Neil Cooper said: "The original consultation period carried out by EMAS was fundamentally flawed.

"We need to get back to having a Lincolnshire Ambulance Service as soon as possible because EMAS is not fit for purpose."

Chairman of health scrutiny at Lincolnshire County Council Christine Talbot said: "EMAS management is being disingenuous and ignoring the people of Lincolnshire."

Mark Smith said: "Rural counties in the East Midlands oppose EMAS ideas on changing the face of the service.

"EMAS does not understand Lincolnshire.

"Until they get a grip they will never move forward."

Labour councillor John Hough said: "There was an overwhelming amount of opposition to EMAS' original proposals of creating very few super hubs in Lincolnshire.

"If EMAS is going to change this proposal there needs to be another consultation period."

Mr Milligan added: "I see no reason why there should be another public consultation on this."

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12 comments

  • Gravity  |  March 01 2013, 7:12PM

    Nice posts. I've got nearly 20 years service under my belt serving the community. I qualified as a Amb Tech in 1993 and as a Paramedic in 1999. EMAS has many problems but they really do boil down to 5. 1) The sheer size of Lincolnshire. there are not enough resources (LIVES and RAF responders don't count). It's not uncommon to be at QEH Lynne and get a job in Skeg or Maplethorpe.. nearly 60 miles. It's too big with no where near enough resources. I've done some shifts in Manchester with a private company and the diffidence is unbelievable, jobs that are 5 miles away and a choice of A&Es. The Bradley Report got blown out the water by the LAS. 2) The 111 services is bleeding us dry. On nights (in particular) all we do are 111 calls, the bulk of which can easily wait till the morning to see their GP or (better still) get in their own car and drive to A&E or the Out Of Hours GP. Simple things like a simple pick up off the floor where the so called carers "have a NO LIFT policy" and we end up driving miles on blue lights to simple pick up of the floors where the patient is totally pain free and uninjured. 3) Critical Care Transfers. Let's look at Pilgrim Hospital. They book a hospital transfer to Leicester, Derby, Doncaster, Halifax, Nottingham or London even, then that ambulance is going from the area. another transfer gets booked, and now you've lost two ambulances. The ambulances don't get back to area as we get caught on the way back and end up doing calls near to the hospital we just transferred to. Now you've a shortfall. Then you've got crews from as far as Grimsby getting calls in Boston, dont forget the calls in Grimsby need covering too. And it's not uncommon for a crew to have worked a 12 hour night shift to be given one of these transfers 11 hours into a shift. This is DANGEROUS. The crew have to get there and can be as much as 5 or 6 hours off late. That's an 18 hour shift 4) Hubs and the closing of stations. This is a total and utter false economy by EMAS. We have stand by points now and when we don't have a call to go to, we get sent there to sit and wait for a call. It's really REALLY rare if we do actually make it to the stand by point. Now, EMAS will tell you that they are "creating" Dynamic Stand By points, hence, giving the impression that there will by the current fleet of ambulances sitting there waiting for calls... there wont be. we don't get to stand by points now because it's so busy. 5) Busy A&Es. It's not uncommon that we are stuck in A&E for 2 hours at times. Coupled with the two ambulances on transfers, the 3 that are on a multiple patient call (ie Road Traffic Collision) and now the 4 crews stuck in A&E. That's why critically ill patients are waiting longer and longer times for a QUALIFIED response.. Now call me old fashioned, but when I call 999 for help I want a DOUBLE CREWED PARAMEDIC response, in an ambulance. Not someone with nothing more than a first aid certificate. Not a single paramedic that cant transport me in his car or the ambulance they have been sent out on. Now managers are mucking about with rotas and trying to cut our unsociable hours payments. Their logic is "well we're not that busy on nights"....really ????? EMAS staff are leaving in droves. A lot of staff have had enough. Staff are leaving for an easier life in the private sector doing event work, film set work, building site cover... were the wages are the same and a far far far lot less grief.

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  • Observer11  |  February 23 2013, 2:16PM

    Well, many people including the county's elected representatives believe it's worth a try. Let's see what the Secretary of State for Health thinks...asap?

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  • icomm  |  February 23 2013, 2:00PM

    But my point is observer11 that having Lincs Ambulance Service back would not reslove the issues causing the problems that EMAS are currently being faced with, All it would do is give the service a new name but adopting the same problems !

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  • Observer11  |  February 23 2013, 1:45PM

    The EMES annual budget is about £168 million. I think Lincolnshire could have a drink from that (it's our money anyway), and quicker than you can say "Systemic Failure", Lincolnshire has an ambulance service accountable to its people.

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  • icomm  |  February 23 2013, 1:33PM

    @Observer11 , I don't want to disclose where I get my information from but beieve me, setting back up Lincs Ambulance Service would cost in the region of 10million pounds despite having all the stations, staff etc. in place. I can understand why people think this would be a better thing and perhaps it would be better in some ways (being smaller, easier to manage); but I know from experience that the many reasons behind the issues with the service at present are actualy nothing to do with the service. Its problems elsewhere in the NHS that are impacting and obstructing the ambulance service carrying out the level of service they aspire to give.

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  • Observer11  |  February 23 2013, 1:24AM

    @ by icomm "Setting up a Lincolnshire Ambulance Service would cost millions of pounds" ++++++++ I'm not sure how you came to that conclusion icomm do you work for EMES HQ perhaps? The Lincolnshire ambulance stations are all in place, as are the staff, the managers, the ambulance fleet, the training school, the ambulance control room, and the headquarters. All the local companies that supported the LAS are still mostly trading and would welcome the work. No time like the present some would say?

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  • Whiley45  |  February 22 2013, 1:52PM

    I do not know what to say Mr Littledyke. With people like you around how did we end up with this mess. You are obviously an expert. Perhaps you can tell us what to do now!

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  • Derp_Lincoln  |  February 22 2013, 12:38PM

    tl;dr

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  • NAPAS  |  February 22 2013, 12:02PM

    I first became involved with ambulance Services in March 1963, and have been involved in the McCarthy and other Inquiries over the years, I have been involved with the Private Sector since 1988 mainly as an Ambulance Consultant and in Regulating this sector. I am surprised at the lack of understanding by NHS Ambulance Officers and Directors that have been paid far more than I, much for their alledged expertise, especialy on some of the projects that I have initiated and undertaken since 1998. One being the " Ambulances the Hub and Rim principle", this is designed as the hub being the Recieving Hospital and the rim being the Ambulance Base stations, each of which are situated some 20 minutes travel from the Hospital around the rim, and each being based some 20 minutes from each other around the rim. The principle being that the ambulance furthest travel time is 20 minutes from a Hospital (the furthest point)the average to an Incident 10 Minutes. The rims overlap Hospital to Hospital, and provided they are planned right the general public would in fact recieve "an Ambulance" not a RRV with an inability to transport, and the added cost of such to most emergency calls would be reduced. The second project I assisted in developing was "Hot Spots" these were not designed to deturmine where to place an RRV, but to map places of incidence, and to be used to reduce those incidences in order to save ambulance requirements, not increase them. for example a cross roads that has a high accident rate, indentify and for the Councils and others to reduce the risks. A nuring home producing freqent calls, for the appropriate authorities, the home, and for commissioners to ensure that Doctors are called, or for additional nursing skills to stop the old person from being transported for treatment, and then sent back to the nursing home for care. And a third project the suggested introduction of Essential First Aid training (one week) into every secoundry School, so that after a short period of time we the Public will have hundreds of thousands of "Responders" whom can provide life support in every club, pub, home, factory, office, and public place, as one thing that I have learnt over the past 50 years is "if everyone at the scene does nothing, then all the targets in the world will only achive nothing, it is that first person that is the greatest assett to the Ambulanceman, without them, "stopping the bleeding and keeping them breathing" We with all the equipment and training in the world I and others have found that the casuality has very little chance of survival or improved quality of life, in many cases the patient may require a surgeon not a Paramedic whom may only be able to undertake the above, using mainly advanced first aid skills. The considered flawed Bradley report on Ambulance Services provided for 79 recommendations, only two were consulted on, the regionalisation of services in order to pay the chiefs more responsibility pay, and the alledged saving of money to the public purse? This report was accepted by the Labour Government and implimented, it however in depth proposed for the disbanding of Ambulance Services and the formation of Emergency Medical Services, perhaps Lincolnshire and many others were never ever consulted on this major change? We are now all however reaping the benifits of this major perhaps flawed report especialy those in Rural Districts. Peter A. Littledyke Independent Ambulance Consultant Chairman British Ambulance Services (Foresight) Panel (BASP) Vice President National Association of Professional Ambulance Services (NAPAS) Vice President Association of European Ambulances (AEA)

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  • icomm  |  February 22 2013, 10:01AM

    Oh here we go again, I thought it's been a while since the ambulance service got another kicking from the media. The county council is so out of touch with reality as per usual, this is not an isolated problem within the ambulance service, there are many reasons that are causing the ambulance service to miss their response times, in my opinion there are 3 main ones and this is nothing to do with the future proposals of new stations/hubs. - Smaller hospitals not taking certain "patients" so ambulances must travel further to other hospitals therefore taking them out their local areas and keeping them engaged with one paticular patient for a considerable amount of time. These are hospitals like Newark, Grantham, Louth, and Skegness which all used to be full receiving hospitals but funding has now been reduced so much that they can no longer offer full services. This therefore puts incereased pressure on the two main hospitals in the County (Lincoln & Boston). - Hospitals are so busy that ambulance crews have to wait sometimes upto 2 hours for a trolley/bed and/or nurse to hand their patients over to. 5 years ago ambulance crews never had to wait this length of time to pass their patients over, sometimes there can be a queue of ambulance crews backing up into the parking bay waiting for hand over but because of this there is no resourses free to goto the waiting 999 calls ! - The 111 service has been rolled out accross Lincolnshire and has been heavily advertised for people to call it when they they require immediate non life threatening help. This is not fit for purpose, they employ reems of unqualified "robots" reading off a screen in a call centre, they do not have the medical experience nor the scope to deviate from the script in front of them and they turn ambulances out to the most trivial of problems (eg sunburn, arm pain for 6 weeks, hang overs etc..) and when the call is passed over to the ambulance control room they are not alowed to question it, even though the ambulance control room has qualified nurses working to triage this type of thing. Setting up a "Lincolnshire Ambulance Service" would cost millions of pounds, money which the NHS does not have plus would it really solve the above probems ? No of course not. The County Council is living in the past if they think this would work, yes before EMAS took over the service the response times were being met but that was then and this is NOW ! Things have changed accross the NHS and every service is feeling the pressure, I have no doubt that if we still had a Lincolnshire Ambulance Service now their name would be all over the papers instead of EMAS for exactly the same reasons. Staff are still proud of what they do and so they should be, they do an excellent professional job and no other organisation could do the difficult job they do. Other areas of the UK do not have the vast geography that we have here so this is maybe why that other ambulance services are coping better than EMAS, its fairly easy to understand that if you have a smaller area to cover you will have a better chance of getting somewhere in a "required" amount of time.

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