Clock to start ticking from 'hello'

AMBULANCE services across the country will soon have to start the clock as soon as they pick up the phone. The new regime means crews will have to work faster to meet their targets.

AMBULANCE services across the country will soon have to start the clock as soon as they pick up the phone. The new regime means crews will have to work faster to meet their targets. Health reporter HAZEL BYFORD asks how Suffolk intends to keep up.

TOUGH just got tougher for the East of England Ambulance Service.

The battle against an increase in 999 calls, versus pressure to meet government targets is to be tested to the limit as the service is told to cut 45 seconds off its response times.

From April next year the way response times are measured is changing. At the moment the clock starts ticking once the call handler finds out what and where the emergency is, which has led to inconsistencies across the country.

The new system will see the clock started as soon as calls are connected - which in our region currently makes around 45 seconds' difference.

Rob Lawrence, chief operating officer for Suffolk, said: “The government is right in that this will give a level playing field across the country and put pressure on services to process calls faster, identify where the emergency is faster, and respond faster.

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“The clinical outcome is, for example, if we get out quicker to a cardiac arrest, those 45 seconds can be the difference between life and death. For every minute's delay in getting to a patient in cardiac arrest, the chances of survival reduce by 10per cent.”

“The government's target times are not changing, so responses really are going to have to be quicker.”

Lord Warner, the health minister when the changes were announced, said: “We are making changes to ambulance response time requirements that will ensure a better performance from all trusts and greater certainty for patients. But, to implement these, many ambulance trusts will have to make changes to their control rooms and to their vehicle fleets.”

Ambulance services have to reach 75per cent of category A (life-threatening calls) within eight minutes (last year the East of England service recorded 75.2pc), 95pc of category A calls within 19 minutes (96.2pc was recorded in the east), 95 per cent of category b (non life-threatening calls) within 19 minutes (94.1pc met in the east) and 95per cent of GP urgent calls within the time allotted by the doctor (92.6pc met in the east).

The East of England Ambulance Service was rebuked in January when it failed to adhere to government guidelines on how to record its response times. An independent investigation was made into the failure of the former East Anglian Ambulance NHS Trust to stop amending times, after the Department of Health (DoH) stated the practice must end.

The problem occurred after the DoH said ambulance services could no longer amend the category of emergency calls, even if a call originally classified as life-threatening turned out not to be so. The trust put it down to “an error of judgement” and said it “never set out with any intent to improve performance through call editing by unfair means”.

When the new response time changes are first introduced in April, the percentages are expected to drop at first, even if response times get faster.

Mr Lawrence said: “One way we will make up those extra 45 seconds is by putting in extra resources, vehicles and staff. We also want to do more treating patients in their own home and we can do this by using more rapid response vehicles instead of ambulances. Rapid response teams can arrive and assess the patient and decide if they need an ambulance after all, or a falls coordinator, or a GP, or social services, or if the patient is okay seated and can be taken to hospital in the back of the rapid response vehicle.

“This is particularly useful for falls, as we attend more falls than anything else. About 20pc of all calls in Ipswich are to falls.”

Investment in vehicles and staff will help the service meet demand, but the system is more sophisticated than simply putting more ambulances at its stations. Vehicles are also parked on standby where emergencies are predicted to happen next - and they can be predicted.

Mr Lawrence said: “Accidents are easy to predict, as we are creatures of habit. People wake up and fall over in their homes. On the way to work they have road traffic accidents, at work there are industrial accidents and then there are more rush hour accidents on the way home from work and then people go and get drunk and have nighttime drink-related incidents.

“For each hour of the day we have a plan, and place ambulances around the region according to where they are most likely to be needed. Then, if one is called out, with replace it with another from the lowest priority area.”

The service is also looking to recruit more community responders, who are volunteers on call to give first aid for 999 emergencies. But while the service has money to invest in new recruits, it is difficult to get people to sign up.

And as the number of 999 calls more than doubled in Norfolk, Suffolk and Cambridgeshire - from 88,185 in 1996/97 to 194,235 in 2006/07 - and July was the service's second busiest month ever, the investment in the next eight months will prove critical for the future.

More people than ever before are dialling 999 in the east. The reasons include a higher than average increase in population, a more 'risk averse' society where people are quicker to dial 999 than 20 years ago, an increase in the number of drink and drug related incidents, the public perception of poor access to GP out of hours services, and an increase in using mobile phones.

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HEADING the ambulance service in Suffolk, is former army officer Rob Lawrence.

After travelling the world the Royal Army Medical Corps he joined the NHS in 2000 as an ambulance services commissioner based in Norwich.

The job involved commissioning accident and emergency ambulance services for the 17 primary care trusts in Norfolk, Suffolk and Cambridgeshire.

In April 2005, Mr Lawrence, of Beccles, joined East Anglian Ambulance as director of operations, corporately responsible for 999, patient transport services and GP out of hours services to a population of 2.1million people.

On the creation of the East of England Ambulance Trust, he took up the post of Suffolk chief operating officer.

Rob works under interim chief executive Hayden Newton, whose appointment - while the chief executive Dr Chris Carney is absent with illness - started in May.

A former manager at Peterborough Ambulance Station, Mr Newton moved to Scotland before returning to England as director of performance for the Bedfordshire and Hertfordshire Ambulance Service.

He was chief executive of Kent Ambulance Service before moving to a post at the Department of Health, and then to the east.

IN 1996 the Evening Star launched Ambulancewatch, to urge the turnaround of a failing ambulance service.

The campaign was launched after an ambulance took 40-minutes to reach heart attack victim Brian Woolnough.

The campaign resulted in the organisation's chief executive resigning in 2001, and a public inquiry being launched into failings. It was needed again in 2005 when David Halley-Frame died after an ambulance took more than half an hour to reach him, and Terri Calvesbert had to be taken to hospital by police after she suffered burns in 1998 because there was no ambulance available. Police also had to take Ricardo Wells to hospital with a severed artery in his arm earlier this year, because an ambulance did not arrive quick enough.

The East of England Ambulance Service is now the largest ambulance service in the UK.

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