More ambulances could be hitting our roads as part of a 999 overhaul designed to reach rural patients more quickly.
After years of missed targets and stories of critical delays, East of England Ambulance Service is revamping its response system.
The changes were revealed by chief executive Robert Morton at a time when the service is failing to meet any of its target response times in some parts of Norfolk and Waveney.
But ambulance bosses hope adopting the ambulance response programme that has been introduced in other parts of the UK will improve patient care.
A key part of it is that call handlers will have 240 seconds to assess patients and select the right service before the response clock starts.
But, in the most serious cases, paramedics will have to get to the scene in seven minutes, not the current eight.
Mr Morton said: 'The existing targets are over 40 years old. And there has been a change in attitudes but it's also about the number of calls which have grown.
'For example, 40 years ago people were not living to 90. If you were in your 60s 40 years ago and had a stroke or heart attack, these were fatal events.
'And 40 years ago when people dialled 999, it was really an emergency. Now, we've moved to a position where people have become medically dependent on the ambulance service.'
He added: 'There are a number of conditions, under things like mental health, that we're dealing with and we've become the last resort. There's a recognition something needs to be different.'
Five years ago, this newspaper launched its Ambulance Watch campaign to push for better response times.
But over the past 12 months, EEAST has not once hit the target of reaching 75pc of calls within specific times - based on their severity - in either south or north Norfolk.
Targets for the two most serious categories of calls - known as red one and red one - are set nationally, whilst the less severe categories - green one and green two - are agreed locally.
Mr Morton said demand outweighed supply, which meant the overhaul was needed. He said there would be three main changes:
? Call handlers will ask much earlier how serious the call is, meaning the sickest patients can be prioritised much quicker - and those who do not need emergency care can be diverted. Mr Morton said it was about 'hunting on the call for the biggest, sickest patients'. He added: 'We expect about 8pc of all 999 calls to fall into that category.'
? The second change will see more ambulances on the roads and reducing the use of cars. 'It's about the resources we do have and using them better,' said Mr Morton. He said at the moment they would often have multiple resources going to the same call, including cars. But if calls could be better prioritised, only the most serious would get an ambulance response. But that would require more ambulances. In July, an anonymous EEAST paramedic accused the trust of sending rapid response vehicles to 999 calls rather than ambulances in order to hit targets. Mr Morton said: 'If we take longer to analyse these calls, we can send the right resource, if you need to send anybody. We think one out of 10 calls does not need a resource at all.'
? The third change, he said, would be for staff, who may have to change their rotas and work on ambulances instead. 'We're doing this as we step into winter and we're expecting quite a difficult winter with the flu,' he said. 'I hope this will alleviate some of the pressure on our staff and make the organisation better and more efficient. What won't change is the fact we still have a capacity gap. We still don't have sufficient resources to respond to all our calls.'
The trust is currently being looked at in an independent audit to look at what it needs to do to improve the situation.
It has particular problems in south and north Norfolk, where the number of red one calls reached within eight minutes was as low as 29pc in the last year.
Ambulance Watch: What has changed in five years?
Five years ago this month this newspaper launched its Ambulance Watch campaign, which called for improved performance at EEAST and speedier response times for patients in their time of need.
While some things have changed - including Robert Morton becoming the trust's first permanent chief executive for three years - others haven't. Still, the trust struggles to meet response times in south and north Norfolk. Meanwhile demand has continued to rise.
During 2016/17, there was a 21.8pc growth in demand for the most serious calls. And crews attended 45,000 more incidents than the previous year. The trust launched a significant recruitment programme. However delays handing patients over at hospital meant they still heavily relied on private ambulance services to fill the shortfall in care.
Despite this, the trust reports a 'continual and steady improvement' in their annual report.
Union concerns over changes for staff
A union representing ambulance crews at EEAST said there was concern over moving staff from RRVs into ambulances and called on CEO Robert Morton to show he respected staff.#
Fraer Stevenson, Unison branch secretary said: 'We're really very concerned about the change management process the trust is putting in place to move staff from RRVs to ambulances. Some staff who have worked their entire careers on an RRV have been informed they will be moved onto an ambulance relief rota, without any right to a notice period. Some staff have also been informed that the trust will not accept grievances and they do not have a right to representation.
'This is an ideal opportunity for our chief executive to demonstrate some strong and supportive leadership and ensure the process is as supportive as it can be, shows respect for staff working on the frontline, and keeps within NHS national terms and conditions around change management.'
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