Region’s ambulance boss warns service ‘has to change’
- Credit: Su Anderson
The region's ambulance trust must change its operational model or it faces an unsustainable future, its chief executive warned today.
Robert Morton, who has spent just over six months in charge of the East of England Ambulance Service Trust (EEAST), said the organisation's 'traditional service' was expensive, and added a new model was needed to meet the direction the NHS is taking.
His comments come at a time when the service is experiencing a 10pc increase in 999 calls in the region, while question-marks still hang over the organisation's performance.
Missed targets for emergency responses are compounded by a growing frustration among frontline staff who are forced to wait an increasing length of time outside hospitals' A&E departments before transferring patients.
Such is the effect of the current increase in demand that managers this week were forced to postpone an engagement forum in which staff were to debate how to best develop the trust. Mr Morton said EEAST needed to 'recalibrate its workforce' and bring paramedics, GPs, mental health nurses, and other clinicians closer together to help treat more patients at home – a direction of care in which the NHS is travelling.
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He said the trust was introducing a new scheme with care homes to reduce conveyance of frail and elderly patients, in partnership with the NHS 111 service run by Integrated Care 24.
Technology could also play a bigger role, such as frontline staff being able to access patient records and book appointments for them during treatment, and even getting help from a GP through video-calls.
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'We have to start changing by the start of the next financial year (April),' Mr Morton said.
Reflecting on the trust's performance, he said the trust was hitting seven of eight national ambulance quality indicators, which is EEAST's highest score within the last 12 months. But figures show the trust has not hit its emergency Red 1 response target (reach patients within eight minutes in 75pc of cases) since June, while the Red 2 target has not been achieved in any month of this financial year.
Latest figures show emergency targets are only being hit in Norwich in this region, while Red 1 performance is particularly low in North Norfolk (47.54pc) and South Norfolk (43.64pc).
However Mr Morton said: 'In the last two years performance has gone up by 2pc but the volume of patients to respond to has grown by 8pc, so the volume of patients getting a quicker service has gone up.'
• BIG RISE IN HANDOVER DELAYS AT HOSPITALS ADDS TO AMBULANCE TRUST'S CHALLENGES
One key problem which the ambulance trust can only partly control is handover delay at hospitals, which has risen by 20pc according to Robert Morton.
Nowhere has handover become a bigger problem than at the Norfolk and Norwich University Hospital (N&N), where monthly figures have rocketed from 344 hours wasted by crews in February 2015 to 867 hours in February 2016.
Mr Morton said he was building relationships with managers at the region's acute hospitals.
'We engage with 17 different hospitals and have experienced occasions where every single one was on black alert,' he said.
'We're also looking at what we can do to reduce admissions to hospitals, for example by putting GPs in our operations centre to help frontline staff with patient assessments. The clinical commissioning groups have supported this.'
Richard Parker, chief operating officer of the N&N, said the hospital's A&E was the busiest for ambulance activity in the east of England, with nearly twice as many patients arriving by ambulance than in the second-busiest hospital.
He claimed a joint handover plan between the ambulance, hospital, and CCGs was having a 'positive influence'.
'In addition, as a hospital we have made improvements in ambulance turnaround times, introducing the urgent care centre, increasing the capacity of our minors unit, establishing an Immediate Assessment Unit, and recruiting additional A&E staff.'