Unite, which has over 100,000 workers in the NHS, including thousands of paramedics, is warning that unprecedented demand is resulting in the ‘wheels being on the verge of falling off’ the ambulance service.
Unite is further warning that if the UK experiences a flu epidemic or a prolonged period of cold winter weather, the service will not be able to cope.
Unite paramedics report a series of problems which have dramatically increased the stress on the service in the last 12 months, which is placing it in crisis.
The biggest problem concerns ambulance turnaround times at hospitals. In extreme cases ambulance crews report that they have had to care for patients in an ambulance for 12 hours and in some cases for 18 hours before they were transferred to the hospital.
Ambulance drivers report that huge amounts of their working time is being lost, often on a daily basis in the delays of transferring patients to hospitals.
In some trusts to cut turnaround times paramedics are being taken out of ambulances and used as Hospital Ambulance Liaison Officers (HALOs) and required to look after up to six patients, often for several hours, before they are admitted to hospital.
A further delay is caused by some hospitals only having the same number of trolleys as cubicles in a ward, which prevents the ambulance from transferring a patient until a trolley is vacated.
A further problem is caused by some ambulance trusts only operating the minimum number of vehicles, resulting in crews frequently starting their shifts but not being able to respond to calls as no vehicles are available, as another crews is still using the vehicle.
In many trusts Unite members report that a lack of maintenance and elderly vehicles is putting further pressure on the service.
Many vehicles have between 300,000-400,000 on the clock and frequently breakdown and are off the road. A problem made worse by a lack of mechanics in many trusts.
Unite believes that the strain on the ambulance service will not be relieved until additional resources are invested in other areas of the NHS such as the GP service and social care.
Unite national officer for health, Colenzo Jarrett-Thorpe, said: ‘This is a stark warning that the wheels are in danger of falling off the ambulance service.
‘Delays in responding to patients are increasing as demand increases and delays mount up, which is placing patients in danger.
‘As other sectors in the NHS buckle under the strain of demand, the ambulance service does not just become an essential service it becomes a service of last resort for the sick.
‘Our members in Unite are now warning that the service is already operating at its maximum capacity and if there is a spell of bad weather or a flu epidemic the service will collapse.
‘Measures being put in place to cut turnaround times are disturbing and potentially dangerous.
‘In the short term all ambulance trusts must ensure they have sufficient vehicles and that they keep them on the road.
‘The problems facing the ambulance service are a direct consequence of the long-term underfunding of the entire NHS and until those issues are fixed the crisis in the ambulance service will not be resolved.’
Elsewhere, in the north of Ireland, ambulance staff have called off their strike action following a victory over pay and staffing levels.
In a statement, Unison says they have ‘agreed to suspend (but not abandon) further plans for strike action in the interim period’.
The move comes after they brokered a deal over pay parity and ‘safe staffing levels’. The union says agreement was also reached on the issue of ‘cohorting’.
They said: ‘The aim of our dispute was to secure pay parity within the Agenda for Change pay bands with that of our colleagues in the UK and to ensure that processes were put in place to ensure future safe staffing levels within NIAS.
‘We are therefore pleased to inform our members that a framework document has been agreed between the senior negotiating team and the Health Minister which will bring about pay parity on the A4C pay scales in line with the current English 3 year model, backdated to April 2019.
‘NIAS has also submitted plans to the Department of Health, which will hopefully increase the NIAS workforce by over 300 in the coming years.’
Unison says the victory has been ‘achieved due to several factors; the solidarity shown by our members, the hard work of our senior negotiators, the tireless dedication of our lay members and officials and the continued and unwavering support of the general public throughout the dispute’.
NIAS workers had been due to down tools at the end of the month.
The union says agreement has also been reached on the issue of ‘cohorting’ whereby ambulance crews are required to look after patients at EDs before they are admitted to the ED (emergency department).
The issue appears to arise when EDs are particularly busy and patients cannot be admitted creating a backlog of people that must be cared for by ambulance crews meaning they are not free to go back out on call.
Unison says ‘this process was being expected of our members’. However, following a meeting on Friday, a number of things have been agreed including that NIAS managers ‘as part of an ED Escalation Plan, when waiting times reach levels posing additional risk to staff, actual and/or potential patients, may request that staff undertake cohorting duties,’ but that no member of staff ‘will be forced to undertake cohorting duties’.
Last week health workers in other sectors called off their strike action after unions had a ‘positive’ meeting with Health Minister Robin Swann, who offered £30m to restore pay parity.
Unison, Unite and the Royal College of Nursing (RCN) had been involved in industrial action, including strikes, in protest over pay and staffing.
Meanwhile, the GMB has warned against the ‘disastrous privatisation of Sussex non-emergency patient transport.
The union is calling on Sussex CCG to publicly commit to keeping Non-Emergency Patient Transport Services (NEPTS) with the current NHS provider.
Concern is growing commissioners are set to award a five-year contract to the private sector.
The GMB is convinced that patients and ambulance staff alike would reject a return to the privatisation fiasco of the Coperforma years.
The union will campaign for South Central Ambulance Service (SCAS) to continue their good work of rebuilding the contract and patient service delivery confidence levels, since the CCG’s attempted failed privatisation in 2016/2017.
Adam Doyle, CEO of Sussex STP, could settle the uncertainty, trepidation and feeling of déja vu for patients and staff with a clear commitment to SCAS.
Initial discussions with the GMB suggested the CCGs were willing to keep the provision with SCAS.
But with the multitude of private providers turning up at the CCG’s PTS procurement announcement event, worries are growing that a ‘cheap as chips’ mentality will take precedence over patient safety and satisfaction.
Gary Palmer, GMB Regional Organiser, said: ‘Why do Sussex CCG want to make the same disastrous mistakes again?
‘During the Coperforma years patients were uncollected and missed or were late for vital oncology and renal appointments, leading to stress and health complications for them and their families.
‘Hospitals were even forced to make their own arrangement to discharge patients.
‘Meanwhile GMB members, working for the PTS, desperately tried to deliver a service whilst often unpaid – forking out for fuel from their own pockets just to stay on the road, having vehicles repossessed as they worked and finding their pensions unpaid and stolen.
‘Despite the CCG’s apparent desire to do so, GMB cannot accept a return to the private fiasco of the Coperforma years.
‘GMB have seen SCAS and its GMB members and frontline staff work incredibly hard to get this contract back from the point of collapse to where it should be.
‘Service Performance levels and Patient satisfaction figures are now excellent, using SCAS as the provider is enabling public money to stay within the NHS and not be syphoned off into the pockets of shareholders for some private profiteers.
‘You usually only get one chance when selling off the family silver, our problem is after all the hard work by everyone else to re-burnish the Sussex PTS silver, the CCG’s want to try to sell it off once more.
‘It’s up to GMB and the people of Sussex to say it’s ours and that’s how it must stay.
‘GMB and its members working within the NEPTS service will mobilise to keep it that way if required, holding all those in Sussex CCGs accountable for poor decision-making.’