Daisy Cooper: Ambulances are on high alert across England

A month ago Daisy Cooper submitted a question to the Government, and she has only just received a reply. Her question was:

To ask the Secretary of State for Health and Social Care, how many ambulance trusts have moved into REAP Level 4 in the last six weeks; and how many in total are at REAP Level 4 as at 22 October 2021.

REAP = Resource Escalation Action Plan. Level 4 is the highest level and indicates Extreme Pressure.

The response did arrive after this prompt:

In the last six weeks, all 11 English ambulance trusts have been at or moved to REAP Level 4. On 22 October 2021, all 11 ambulance trusts were at REAP Level 4.

The Government has not made a statement to Parliament about this very worrying situation.  So the Liberal Democrats are calling for an emergency plan to support ambulance services this winter. It recommends:

  • Bringing in military personnel across all ten trusts in England to help address staff shortages
  • Reversing recent and planned closures of ambulance stations
  • Increasing beds and staffing capacity at A&Es to reduce queues of ambulances outside hospitals

Daisy says:

This is shameful. Forget the statistics, we’re talking about loved ones waiting for ambulances that arrive too late or get stuck in queues at hospitals with devastating results.

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  • Chris Moore 24th Nov '21 - 2:55pm

    My mother, who is extremely old, suffered a dislocated hip at home in W Sussex in the middle of the night about six weeks ago.

    She was in agony for 5 hours till the ambulance arrived.

    The personnel told my sister that they were totally over-whelmed and they wanted her to make an official complaint.

    Pressure needs to be applied.

  • Barry Lofty 24th Nov '21 - 2:57pm

    Well done Daisy Cooper, please keep up the pressure on the government to address this very worrying problem which is another awful reminder of how the caring professions are struggling in the present environment without the resources and backing that is desperately needed.

  • Jenny Barnes 24th Nov '21 - 3:40pm

    The NHS and social care have been underfunded since 2010. Part of the problem for ambulances is that they can’t leave their patients because A&E is blocked because there aren’t any spare beds in the hospital because those that are now medically fit but still need care can’t be moved to a social care setting because there aren’t enough staff in either the NHS or social care.. Nurse training bursaries scrapped in 2015, then there were the Lansley reforms supported by inter alia Clegg & Williams when the LDs were in coalition with the Tories. In other news 20% of patients in an Open Democracy survey are being advised to go private https://www.opendemocracy.net/en/ournhs/go-private-for-the-treatment-you-need-nhs-tells-patients/

  • Jenny Barnes 24th Nov '21 - 3:40pm

    2016, not 2015

  • nigel hunter 24th Nov '21 - 4:21pm

    Other nations of the UK ARE DEVOLVED AND CONSIDER HEALTH AS A GREATER PRIORITY THAN ENGLAND WHERE IT IS BEING SET UP TO FAIL.I understand that private companies will be able to sit on NHS boards and ‘advise’ them.WHAT WILL THEY ADVISE THEM ON? About a year ago radio4 had a programme on the US health system.This pointed out that if a hospital did not make a profit the patients were removed to another hospital with all that that entailed.Is that what Johnson wants in England? In the US some are not for profit but the mere fact of that being said is not on.

  • Jenny Barnes is correct, this is a whole system problem (across health and social care) being manifested in delays at the “front door”. The deteriorating ambulance service performance data are one aspect of the evidence; however the ambulance trusts and their hard working committed staff are not the root cause of the problem.

  • Jayne mansfield 24th Nov '21 - 4:35pm

    @ Jenny Barnes,
    I agree with you.
    The staffing problems facing the NHS pre-dated both Brexit and the Covid Pandemic. Both simply illuminated and worsened the problem.

    I feel quite ashamed to say it, because I have always been opposed to patients being treated in accordance with what they can afford rather than clinical need. , but I now travel abroad for treatment for my disabled husband. His long term prospects have already been damaged, and it became impossible not to take these drastic measures.

  • I think the first and possibly most critical problem is the wait time for the first paramedic to attend. The second problem is the total time taken between calling for an ambulance and actually receiving acute hospital treatment, which can exceed 6 hours. So I suggest whils it is easy to pick-up on single measurements, a little digging shows there is a major system problem.

  • Barry Lofty 24th Nov '21 - 5:06pm

    Nigel [email protected] I am in agreement with you, it is a real concern that the PRESENT administration would very much like to outsource more of the NHS resources, probably to their businesses donors and friends as in track and trace, we all know how successful that was.

  • Chris Moore 24th Nov '21 - 5:08pm

    It was very successful for the donors and friends, which is surely what matters?

  • The party is calling for bringing in military personnel across all ten trusts in England to help address staff shortages, I wonder if the shortage of ambulance drivers is connected to the appeal for HGV drivers as this article describes https://www.msn.com/en-gb/news/uknews/uk-government-accused-of-poaching-scottish-ambulance-staff-to-shore-up-hgv-shortages/ar-AAOXSuw

  • Jayne mansfield 24th Nov '21 - 5:30pm

    @ Roland,
    I am sorry to hear of your experience.

    The last time I had reason to call an ambulance for a loved one, the A and E corridor was not only full of patients on trolleys, but also ambulance men and women. The reason being, the protocol for handing over patients to nursing and medical care.

    I may be out of date now, but good practice meant that the ambulance personnel could not leave a patient unattended until there had been a formal handover to a nurse or doctor. The nurses and doctors were, and probably still are, too busy to take formal handovers, so the ambulance personnel remain with the patients on trolleys until this can happen, and are not freed up to attend further emergencies in the community. It is gridlock.

  • Jayne mansfield 24th Nov '21 - 5:46pm

    @ Chris Moore,
    Indeed. A quick visit to the website of the burgeoning private ambulance services is worthwhile to check out how many are commissioned by the NHS and clinical commissioning groups.

    I believe that many have been blind to the level of privatisation that has been introduced in the NHS particularly after the expensive and disastrous Health and Social Care Act.

    First run a service down, encourage the population to complain about the NHS, then introduce privatisation as a solution..Clever.

    As someone who has relatives working in the American system, I fear that those who have criticised the service rather than the politicians who have underfunded it, will come to regret it, but too late.

  • Helen Dudden 25th Nov '21 - 8:15am

    Virgin Care in Bath have been awarded a 54 million pound contract for health care.
    Long waiting lists for OT care is one issue.
    American Medical groups buying doctors practices, this is all heading to being privatised.
    The disability charity I work for in the US constantly reports the problems with medical costs and treatment for disabled people and those less financially secure.
    The problem with actually being able to get treatment is well documented for cancer patients. Fairly recently, after waiting for over a year, I went private on the treat of several broken teeth. My family helped me pay the £1,900 bill.
    It’s not just the virus, the starving of cash and lack of respect for the workforce is another, and privitasion.

  • Helen [email protected] I can concur with you about the need to go private for dental problems as my wife and I could not get an NHS appointment for almost two years and my wife particularly, needed treatment urgently, this has been completed, at a cost, but was carried out with care and efficiency, NHS dentistry,sadly, seems to be in terminal decline? It is wonderful that you have such a supporting family.

  • NHS dentistry,sadly, seems to be in terminal decline?
    Was it ever really properly established?
    From what I can see much of the current situation dates back to the concessions made to achieve a settlement with the royal colleges to establish the NHS.
    In lockdown, the private nature of dentistry came to the fore, it seemed normal ‘concessionary’ NHS appointments disappeared along with advanced booking, effectively making all appointments ’emergency’ and thus chargeable.

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