South East Coast Ambulance Service

Lord O'Shaughnessy Excerpts

Wednesday 1st November 2017 Lords Chamber

[Baroness Smith of Basildon]

To ask Her Majesty’s Government how many 999 calls were made to the South East Coast Ambulance Service on 23 September to which no ambulance was sent; and what was the average waiting time for ambulance attendance on that day in that area.

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, we do not centrally collect that level of information on ambulance trust activity. However, the latest available data published by NHS England shows that in August 2017 the South East Coast Ambulance Service received 68,855 emergency calls, 52,832 of which received a face-to-face response from the service. The median response time for emergency category A calls—that is, the most serious— during that month was 8.7 minutes.

[Baroness Smith of Basildon (Lab)]

My Lords, that does not really answer my Question. I could have picked any day to ask about but I specifically chose 23 September because on that day Bognor Regis Town Football Club called 999 six times and eventually, after almost three hours, had to take an injured player in considerable pain to hospital by car. That is not an isolated incident. This service is in special measures. A recent report exposed a toxic atmosphere, a culture of bullying and a fear of speaking out. The CQC confirmed that the service is inadequate. The noble Lord quoted figures at me but what is really important is that the response rate for 999 calls is getting worse. Only 50.8% of Red 1 calls and 39% of Red 2 calls—both of them codes for life-threatening situations—attended within the Government’s eight-minute time limit. This is the worst performance ever in the UK since these records have been kept. Will the Government now accept their responsibilities to the public and to National Health Service staff and step in to ensure both proper funding and decent and effective management?

[Lord O'Shaughnessy]

I would have liked to have given data at the level that the noble Baroness asked for but it is not available in a way that has been centrally assured by NHS England. I have a responsibility to provide good-quality, verified data, and I hope she will understand that. However, the bigger point, with which I do not disagree, is that this is the worst-performing ambulance trust in the country, and that is the case whether you look at calls data or performance standards for call-outs. The question, as she rightly points out, is what you do about it. The CQC rated the service as inadequate about a year ago and has just followed up. Unfortunately, it is still inadequate, although the CQC says that some progress has been made. About half a million pounds of special measures funding has gone in. A new CEO has been in place since spring this year, and the local sustainability and transformation partnership has asked the ambulance trust for a business-case bid for transformatory funding. Therefore, I realise that this is playing catch-up, because clearly the level of service is not good enough. I understand that the latest data month on month—that is, September compared with July—shows some improvement since bottoming out in July, but I agree with the noble Baroness that it has a long way to go.

[Baroness Andrews (Lab)]

How many ambulances are there across East Sussex and West Sussex at the moment compared with five and 10 years ago? If it is difficult to collect that information centrally, can the Minister make efforts to make it available to us in some other way? I ask that because I had reason to be involved with the ambulance service earlier this year. There is a terrific amount of stress and pressure on paramedics, although they do the very best they can. I would also like to know how many paramedics there are in the service compared with five and 10 years ago. After two years of special measures, it is really worrying that this trust is failing on basic issues of patient safety and response times.

[Lord O'Shaughnessy]

I do not disagree with the noble Baroness. I do not have the specific data on the number of ambulances in that area but I can tell her that the paramedic workforce in that particular ambulance trust increased from 635 in May 2010 to 992 in July 2017. So there are more people, but there is a huge growth in demand, which they have to meet. However, the truth is that there are other ambulance trusts all over the country that do a much better job with similar resources. Therefore, as much as anything, it is a question of leadership and management, and that is part of the special measures process.

[Lord Selkirk of Douglas (Con)]

My Lords, does the Minister accept that in the case of medical emergencies the wise use of defibrillators can, and sometimes does, make the difference between life and death?

[Lord O'Shaughnessy]

My noble friend is quite right to make that point. There has been a big effort to install defibrillators in a number of public settings—they are throughout the Palace of Westminster and many other workplaces. They make a big difference to that immediate response where it is needed.

[Baroness Jolly (LD)]

My Lords, around a million calls a year are made to the South East Coast Ambulance Service and there have been many reports of technical problems with the service. According to a CQC report, the first reports of these malfunctions, which affected the recording of calls, occurred in June 2016. Does the Minister have any information on how many recordings were lost? Have the specific circumstances around any patient’s arrival to NHS premises been lost?

[Lord O'Shaughnessy]

The noble Baroness is right about the technical problems. I understand that two new systems have been put in to address those; one is a computer-aided dispatch system and the other is the moving of the emergency operating centre to new premises. That is part of the special measures investment that has been taking place to improve the quality of service.