Health minister pledges to visit beleaguered East of England Ambulance Trust

Health minister Lord Howe has said a decision to send a troubleshooter into the East of England Ambulance Service is not a...

Health minister Lord Howe has said a decision to send a troubleshooter into the East of England Ambulance Service is not a vote of no confidence in the management. - Credit: Evening News © 2009

The health minister with responsibility for ambulances has pledged to visit East Anglia to meet the bosses behind the region's beleaguered ambulance trust.

But Lord Howe insisted a government decision to parachute in another chief executive to review the trust does not equate to a vote of no confidence in the current management of the East of England Ambulance Service.

He also revealed the Department of Health has had concerns about the under-performance of the ambulance service since last summer and said it simply has to get better.

Last Saturday the EDP demanded to know why Lord Howe had not stepped in to make vital changes to the much-criticised service and why he had yet to visit a region where the service he is responsible for is failing to hit response times.

Yesterday he confirmed he is planning to visit the region.


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Lord Howe said: 'I have not been up yet but I have only had responsibility for emergency care since autumn.

'There are plans in train to enable us to do that. We are looking at dates and we are looking at coming up during the parliamentary recess. I don't know at this point whether I will come to Norwich or if I will meet the trust at another location.

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'I have been keeping an extremely close eye on the situation with the East of England Ambulance Trust.

'I met quite a large group of ambulance men and women last week, which was extremely helpful, and I have been in close touch with the local NHS.

'But I think there is value for me and for people locally if I visit the area. I am proposing to bring together representatives from commissioning services and other relevant people to make sure we have got a good handle on the issues.'

Lord Howe said his department had been concerned about the performance of the trust, where the service is failing to respond to 75pc of A8-category emergency calls within eight minutes and 95pc of A19 calls in 19 minutes, for months.

He said: 'We see the monthly statistics and, from about last summer, it become apparent that East of England Ambulance Trust was not meeting its response time targets.

'That can happen sometimes because of operational reasons or bad weather, but we became increasingly concerned before Christmas when it was clear the statistics were consistently below standard.

'My colleagues and I were obviously anxious to ensure local management were doing all they could and we asked for a report as to what they were doing. 'We judged it best to let the management team, which was relatively new, to work through their plans to look afresh at the system of ambulance locations, rotas and staffing.

'It was felt it was right to give those plans a chance to bed down, because direct ministerial interference is something we do not do lightly.

'Ministers do not control the NHS, but we do have accountability to Parliament and to the public which is why we have been careful to keep looking at what has been going on.'

And this week, the Department of Health did intervene, bringing in Anthony Marsh, the chief executive of the West Midlands Ambulance Service and a former head of the Essex Ambulance Service, to carry out a review of the trust.

But Lord Howe insisted that did not amount to a vote of no confidence in the management of the trust, of which Andrew Morgan is currently interim chief executive after taking on the role in December following the resignation of former boss Hayden Newton.

Lord Howe said: 'The most recent set of statistics did not reassure us things were pointing in the right direction, so this week we decided to undertake a special exercise to support the management of the service and reassure both them and the public that the plans in train are robust and correct and are likely to work.

'That's why Anthony Marsh has come in. We think highly of him, as we do of the management at the East of England Ambulance Trust, but they are struggling.

'This is not a vote of no confidence, but they clearly need support. Anthony assessment will be complete by the end of April and we expect him to look at all the relevant issues, such as governance, leadership and resources.'

When asked whether a service which takes in Norfolk, Suffolk, Cambridgeshire, Essex, Hertfordshire and Bedfordshire needed to be broken up to provide a better service to the more rural parts of that area, Lord Howe said: 'This question has been wrestled with for a very long time. It's an immense area and the geography is difficult up in The Fens and also in parts of Essex.

'One of the things the ambulance personnel I met told me was how difficult it is to access some part of the patch in the times which are expected of them.'

He said he was aware of the difficulties posed in counties such as Norfolk and Suffolk, which have no motorways and major roads which have yet to be fully dualled.

Lord Howe said: 'I think these logistical difficulties will exist however big or small an ambulance trust is. What concerns me is the way we are measuring performance.

'There are some very carefully worked out targets for ambulances which clearly we must have because response times are crucial.

'I am not so worried about the actual targets as the way they are being implemented and managed. We do have ambulance trusts in other parts of the country which cover similar areas which are performing perfectly well.

'I don't know if its the size or the geographic challenge with is the problem. It may be resources or operational planning which is the issue.'

One of the concerns which critics have raised during the course of the EDP's Ambulance Watch campaign, which was launched last year to fight for better services, is that the trust tends to over-perform in counties such as Bedfordshire, Hertfordshire and Essex, which has helped mask poorer performance in Norfolk, Suffolk and Cambridgeshire.

Lord Howe said: 'I understand the concern and that has been relayed to me a number of times. I hope Anthony Marsh will bring us closer to some answers on that, but I reserve judgement at this stage. But I understand the concern.'

Norfolk and Suffolk MPs earlier this week called on ambulance trust board members to consider their positions over ongoing performance issues at the trust.

Nine East Anglian MPs met bosses of the under-fire East of England Ambulance Service in Westminster to quiz bosses over what they were doing to resolve slow response times.

Suffolk Coastal MP Therese Coffey, said: 'Members of the board need to reflect on their own accountability for where we are after what has happened in the last few years. A culture of hitting regional targets but not focusing on each county feels like hitting the target and missing the point.'

But Lord Howe said he had received no information on the 'efficacy' of the board, although he said Mr Marsh's review would be examining the leadership and governance of the trust.

And he was similarly circumspect on whether the trust's failing should lead to a public inquiry, a step which was ordered by former health secretary Frank Dobson during major problems with the region's ambulance services in the 1990s.

Lord Howe said: 'I think that's a couple of leaps ahead. Obviously, depending on the review's findings, there might be a number of matters we will have to deal with in the appropriate way.

'But Mr Marsh might report that his is a trust doing its level best to serve the people of the region, but for this or that justifiably understandable reason it has not been able to meet the expected level of service.

'That would merit a different kind of approach.'

Local MPs will meet with Lord Howe in Westminster on Monday night to discuss the ongoing problem and to find out what the Department of Health is doing to address the situation at the East of England Ambulance Service.

He said: 'I have already been speaking to the local MPs, including Norman Lamb (North Norfolk) and Dan Poulter (Central Suffolk and North Ipswich).

'All are saying similar things and their concerns are pretty much the same. We clearly cannot have a service that is falling below standard as this one is and one way or another we have got to make sure that it is improved.'

A report into the ambulance service by health watchdog the Care Quality Commission is due to be published next week, following an unannounced inspection by the regulator.

Ambulance chiefs launched a new campaign to hire dozens of extra frontline staff earlier this year and is in the process of recruiting a total of 199 new paramedics and emergency care assistants (ECAs) to try to improve the service.

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