Call for improved ambulance response times
A series of recommendations relating to ambulance service provision in West Oxfordshire have been set out by a working party formed by District Councillors to investigate “poor” response times in the area.
West Oxfordshire District Council’s Cabinet has agreed to support the recommendations made in a Report by the Ambulance Services Working Party.
The Report will be given to South Central Ambulance Service (SCAS), which provides accident and emergency services across Oxfordshire, Buckinghamshire, Hampshire and Berkshire, and the commissioning body, Oxfordshire Primary Care Trust (PCT), as well as several other health-related parties (see ‘notes to editors’). The Council requests the Report’s findings and recommendations to influence a development plan currently being worked on by SCAS and the PCT, and lead to improved response times.
Cllr Hilary Biles, Chairman of the Ambulance Services Working Party and the Council’s Cabinet Member for Health, said: “It is essential to recognise the hard work and professionalism of Ambulance Service staff, particularly the dedication of their paramedics and volunteers, and I would like to thank the Service for its openness in helping us to carry out this Review. The Council has been concerned about this issue for several years, but our efforts to get the Service to improve response times in West Oxfordshire have not worked. I hope that this in-depth report, which has not left any stone unturned, will mean that the Service and the PCT take note of the Council’s grave concerns and that of the public, and act upon them.”
The Working Party, which consisted of seven District Councillors, focused on response times to 999 emergency calls in West Oxfordshire. Response times in the District have traditionally been below nationally set target times. In September 2008, only 54% of Category A (life-threatening) call-outs in West Oxfordshire met the 8-minute response time target - significantly below the 75% target set by the Government.
The Report looks into the reasons for these poor response times in West Oxfordshire and explores the clinical need for better response times by ambulances, particularly in cases of cardiac arrest and stroke.
It investigates the coverage provided by ambulances in the District and the impact of SCAS’s use of Fire Service and volunteer Community First responders.
Ambulances are rarely stationed in locations that can get to areas of the District within the Category A 8-minute target time and co-responders are therefore often dispatched. Their response times are currently included in the overall response times achieved by SCAS. The Review found that, without this support service, response time performance in West Oxfordshire would be even lower than at present. It was felt by the Working Party that co-responders were not an acceptable alternative to an ambulance and paramedic, and that SCAS should not include their response times within their overall achievement figure.
The Report sets out a range of other findings and makes the following over-arching recommendations, along with additional specific recommendations:
* The commissioning Primary Care Trusts (PCTs) should dedicate more regional funding to improve ambulance services in rural areas of Oxfordshire. In West Oxfordshire this would be £4.2 million.
* The commissioning PCTs and South Central Ambulance Service (SCAS) should agree minimum targets of meeting 75% of Category A responses within 8 minutes and 95% of Category B responses within 19 minutes for ambulance callouts across all of Oxfordshire.
* SCAS should ensure that the social standby points in West Oxfordshire have back up ambulances in place on a regular basis in order for SCAS to reach their West Oxfordshire destinations in the target times set out in Recommendation 2.
* SCAS should regularly staff ambulance standby points at Witney, Chipping Norton and Carterton to better serve West Oxfordshire.
* Paramedics should be based at Chipping Norton hospital to provide both an Out of Hours service and a paramedic provision for the area and this will reduce the demand on the Ambulance Service and acute hospitals.
* Although providing a valuable service to the community in responding to cardiac arrest, Community and Fire Responder call outs should not, and must not be used to calculate and achieve ambulance call out target times. It is imperative for heart attack and stroke patients to reach the appropriate hospital within the necessary time frames in order to be given the necessary interventions to preserve life and have improved and shorter recovery success. This is ultimately better for the patient and will in the long term have beneficial savings for the NHS.
* That SCAS be requested to respond to the recommendations contained in the report within 8 weeks of its publication.
The Working Party found that, in addition to other factors affecting ambulance service provision, West Oxfordshire has one of the largest predicted increases of older people in the population in Oxfordshire and is therefore likely to have a greater need for ambulance services in the future. It was also felt that the size of the SCAS area needed to be reviewed to provide more localised services.
Cllr Biles added: “West Oxfordshire is the second most rural district in the South East. However, we are not isolated. All residents deserve equity of access to our public services and that of the Ambulance Service is paramount. In West Oxfordshire co-responders, although a valuable resource in certain circumstances, are used because Ambulances cannot realise the target times. Ambulances are centralised in the three largest Oxfordshire towns – Oxford (Kidlington and Headington), Banbury (Adderbury) and Abingdon (Didcot). Therefore it stands to reason that ambulances cannot meet the required government call out times for West Oxfordshire. While we understand funding and government targets are major factors, it is not right that rural areas should suffer because targets are able to be met in urban areas. Centralisation may help budgets, but does not provide essential services.”
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