Ambulance targets missed in first four months of new system

An ambulance driving along icy roads. Picture: Chris Bishop

An ambulance driving along icy roads. Picture: Chris Bishop - Credit: Archant

Patients could been left waiting for potentially life-saving treatment for longer than they should have, despite new measures being brought in to ensure paramedics reach them on time.

New measures were brought in at East of England Ambulance Trust (EEAST) in October, after years of missed targets and critical delays.

They were designed to ensure the quickest response was sent to the most serious 999 calls by giving call handlers more time to assess patients properly.

This was meant free up crucial crews who may previously have been rushing to jobs not serious enough for their response.

But new figures released since the new Ambulance Response Programme (ARP) introduction showed targets were still being missed for the most life-threatening situations in the south, north and west of the county, and in Great Yarmouth.

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The targets are set regionally and take into account how long it can take to reach rural areas.

Under ARP crews should respond to category one calls - those which are immediately life-threatening - within a mean time of seven minutes, and at least nine out of 10 times within 15 minutes.

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The trust received 4,996 of this type of call from November to February.

Targets were also missed in all four months for category two - these are still emergency calls with an average response time target of 18 minutes, and with 40 minutes in nine out of 10 cases. The trust received 29,233 of these calls.

Urgent calls, known as category three, did not have a mean response time target, but the aim was to respond to at least nine out of 10 calls within 120 minutes.

This was also breached for every area in every month, with 9,971 calls received in total.

And the picture was the same for category four calls - less urgent calls with an aim to respond with 180, nine out of 10 times. There were 5,838 of these calls.

Kevin Brown, EEAST director of service delivery. Photo: EEAST

Kevin Brown, EEAST director of service delivery. Photo: EEAST - Credit: Archant

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Kevin Brown, EEAST director of service delivery, said: 'The ARP is focused around making sure the most appropriate response is provided for each patient first time, rather than planning against just the time it takes to get to a patient. With further investment, we expect to see progressive improvements across all standards. Our performance against the new standards for patients with the most serious of illnesses or injuries is in line with where we expected it to be at the start of this new response model.'

Could new funding plug capacity gap?

For years, EEAST has admitted there is a 'significant capacity gap' in its service, which meant it could not reach patients as quickly as it wanted to.

A line of ambulances waiting outside the A&E Department at the Queen Elizabeth Hospital in King's Ly

A line of ambulances waiting outside the A&E Department at the Queen Elizabeth Hospital in King's Lynn. Picture: Ian Burt - Credit: Archant

This was especially apparent in the rural areas of Norfolk and saw targets repeatedly missed under the old system where calls were categorised as either red one, red two, and so on.

In the year up to October 2017 EEAST did not once hit the target of reaching 75pc of calls within specific times - based on their severity - in either south or north Norfolk.

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When ARP was introduced the service admitted it would take 'a considerable amount of time' to deliver to the new standards due to the capacity gap.

But it is hoped more funding could soon be put towards the trust, as commissioners mull over an independent service review.

Previously a senior manager said 120 more staff and 20 extra vehicles could be needed in Norfolk and Waveney.

The review was due to be released last week but publication was delayed as the chiefs were still negotiating a new contract.

A challenging winter

The figures come after a difficult winter for the trust, where pressures on the NHS as a whole had a disastrous impact and meant crews were stuck queuing outside hospitals, unable to handover patients.

A House of Commons debate in February heard suggestions up to 81 patients may have died due to ambulance delays in the east of England over a three week period.

It followed whistleblower claims in a leaked list that at least 40 patients died or were harmed due to delays over Christmas and New Year - including one person who froze to death.

MORE: 'Most difficult winter in NHS history' could continue into spring, hospital leaders warn

East of England ambulance. Picture: Simon Finlay

East of England ambulance. Picture: Simon Finlay - Credit: Archant Norfolk

Trust board papers revealed last week that the list was believed to have been an early copy of a list of patients developed by the trust's patient safety team which was being prepared for a the quality governance committee as part of an investigation.

But EEAST disputed the figures, and said there were just 22 patients who may have been harmed due to delays, which were being investigated.

Watchdog satisfied on steps to improve

Alex Stewart,chief executive of Healthwatch Norfolk said: 'Given the extreme pressure the service has been under over the winter months these results are unsurprising but we are satisfied at present that the necessary steps are being taken for things to improve.

Alex Stewart, chief executive of Healthwatch Norfolk. Picture: DENISE BRADLEY

Alex Stewart, chief executive of Healthwatch Norfolk. Picture: DENISE BRADLEY - Credit: Copyright: Archant 2018

'The recent weather and Norfolk's geography are always going to be problematic but following January's risk summit we are seeing closer working between the hospitals and ambulance service to reduce delays and improve handovers.

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'Hospitals are also operating under very challenging conditions but patient safety has been the primary objective of this review and the emphasis is on getting those who need urgent care to hospital in good time.

'The feedback we receive from patients remains positive on the whole; particularly about the quality of care given by the paramedics and we encourage the public to keep sharing their stories on all NHS and social care services with us.'

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