Response times not what we wish, says ambulance chief

10 October 2018

NORTHERN Ireland’s most senior ambulance official has conceded that the local community has not been receiving the emergency response that it deserves.

The admission from Ambulance Service chief executive Michael Bloomfield came during a public meeting in Downpatrick on Monday night organised by the Down Community Health Committee.

However, Mr Bloomfield hopes the service will improve when proposed changes to how the organisation responds to calls are implemented.

A review of current despatch procedures has resulted in the development of proposals — currently out to public consultation – which aim to provide the most immediate and appropriate clinical response to the most seriously ill or injured.

Mr Bloomfield insisted the proposed changes to the way all calls are categorised were not a cost cutting exercise and nothing to do with achieving targets. He said the main thrust was to provide a safer, quality service.

The chief executive revealed that implementing the new model will require the recruitment of an additional 330 frontline ambulance staff over the next three to five years and cost in the region of £30m.

“Our firm view is that the proposed changes will provide a better quality and safer service and go a long way to meeting the challenge in providing an effective response times to communities such as the one in this area which has not been getting the sort of response that we would wish,” said Mr Bloomfield, who viewed Monday’s meeting as the first in a series as part of the organisation’s consultation on how it aims to improve services for patients.

He continued: “Response times in this area are challenging, but not particularly different to other areas. I have been so impressed at the commitment, dedication and professionalism of our staff to provide the high quality of response that they do in all communities. Without doubt, we only have the quality service we currently have as a result of the huge efforts staff go to.

“I have met staff in Downpatrick and Ballynahinch and the efforts and dedication staff go to to provide the best response they can is humbling and I am proud to lead the organisation, but it is not sustainable. The level of effort that staff are required to put in on a constant basis is not reasonable and not fair to continue to expect it.”

Mr Bloomfield said that while ambulance staff always put the needs of the public first, that level of effort and commitment on an ongoing basis against a rising demand was “simply not sustainable”.

He said the organisation received around 250,000 calls a year, equating to a 50 per cent increase on the number since 2011/12. Mr Bloomfield said the huge increase was “way above” what was typical in any other service and while the number of calls had increased, the organisation’s resources had remained relatively static.

Turning to ambulance response times, Mr Bloomfield said a government target required the organisation to respond to 67.5% of life threatening calls within eight minutes. He explained that while this was achieved in 2011/12 when the rate was actually 72.5%, that has reduced over the years.

In the last financial year, the Ambulance Service responded to 45% of life threatening calls within eight minutes, with the figures for East Down just 32% with patients waiting up to 16 minutes for an emergency ambulance. Mr Bloomfield conceded this was “clearly much more than the eight minute target”.

The chief executive said the organisation was proposing a new way of categorising and prioritising calls.

Currently, calls that come through are categorised as immediately life threatening that require an eight minute response, based on a model which has been in place since 1974, he excplained.

“There have been no changes since and we are trying to respond to 35% of all the calls we receive in eight minutes. What staff tell us is that when they go to many of those calls that have been categorised as immediately life threatening, they discover they are not and many may not even be urgent,” Mr Bloomfield continued.

“Research also suggests that closer to seven per cent of all calls are truly life threatening where time is so important that we need to get there quickly.”

The chief executive said the organisation wanted to introduce a more sophisticated way of answering calls by talking a little bit longer to ask more questions about the patient’s condition to be able to more accurately determine what is their real need.

Mr Bloomfield said this will allow the organisation to make sure people who require a response within eight minutes are dealt with appropriately.

He said the proposed changes were about assessing a patient’s needs more accurately, based on their clinical indication and despatching the right vehicle.

The chief executive also pointed to frustration at turnaround times for ambulance crews when they transfer patients to hospitals outside the district, particularly to the Ulster in Dundonald. He said crews “did not want to be standing around A&E departments waiting; they want to be out providing care to patients”.

He added: “I can understand there may be a view that the proposals are about changing the way calls are categorised in order to change targets or, even worse, that this may be seen as some sort of cost cutting measure. Neither could be further from the truth.”

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