Yorkshire Ambulance Service boss says work has stalled on implications of proposed A&E closure

Andrew Simpson, Yorkshire Ambulance Service (YAS) Trust’s Head of A&E Operations for Bradford, Calderdale and Kirklees, told a Calderdale Council “People’s Commission” meeting yesterday that Calderdale Royal Hospital is the destination of 95% of ambulance trips in Calderdale.

But in response to a question from a member of Calderdale 38 Degrees NHS campaign, he could not say if information had been collected about the extra number of ambulances and staff that would be needed if Halifax A&E closed – creating longer traveling times – and how much that would cost.

NHS Commissioners’ plans to make changes to community health and social care without public consultation have put both the Ambulance and the Hospitals Trusts on the back foot.

Calderdale 38 Degrees NHS Campaign reports that Andrew Simpson told the “People’s Commission” meeting that the Hospitals Trust had approached YAS to consider the options for centralising services at Calderdale Royal Hospital or Huddersfield Royal Infirmary, but this has now been left with the Hospitals Trust because of Calderdale Clinical Commissioning Group’s decision to delay public consultation on the hospital cuts.

But Calderdale CCG made that decision in August. The proposed closure of Calderdale Royal Hospital A&E was announced last February. That makes 5 months when no-one did anything to work out if the ambulance service would be able to cope.

A consultancy company called Jacobs which has carried out ambulance service reviews in other parts of the country, was asked to advise but decisions about resource implications have been put on hold.

Hospitals Trust Chief says Trust is working very hard to understand Commissioners’ proposals

The Hospitals Trust Chief Executive Owen Williams has recently told staff of the Trust’s response to NHS Commissioners’ proposal to delay public consultation on the proposed acute hospital service cuts:

“I know that a number of you have been keen to understand the position of our local Commissioners regarding the Strategic Review and the Outline Business Case (OBC) submitted by us and other partners earlier this year. As you may have read in the press over the past few weeks, Commissioners have indicated a desire to focus on building “stronger and better services up to support the needs of patients in the community as well as safe and effective hospital services”. Commissioners have also indicated that the “timing of public consultation on hospital services
is crucial and to attempt consultation now risks losing the opportunity for long-lasting change”.

We have been and will continue to work hard with our provider partners and commissioners to fully understand what this means for local people and the services that you and many others provide on their behalf. Once we have greater clarity, by October at the latest, we will fully communicate our understanding and thoughts on next steps. In doing so, you can be very assured that each of our four pillars (e.g., putting the patient first; go see; work together get results and do the must do’s) will be very evident across all of these discussions.”

Calderdale NHS Commissioning Group  to face questions from Calderdale Council’s Scrutiny Panel this evening

Calderdale Council’s Adults Health & Social Care (AHSC) Scrutiny Panel previously wrote to Calderdale Clinical Commissioning Group (CCG), asking them not to make any decision to carry out significant changes to health services by implementing the community health care part of the proposed “Right Care Right Time Right Place” NHS shakeup, without first consulting the public.

The Scrutiny Panel has called in the CCG for questioning this evening. If the Scrutiny Panel decides that the CCG must consult the public on its proposed NHS service changes, the CCG will have to do this.

The “Right Care” plan centres on cutting acute and emergency hospital services and replacing them by a new community health & social care system that is based on the American private health care system used by the Kaiser Permanente company.

Calderdale and Huddersfield CCGs recently approved a joint commissioning intentions document that re-branded the proposed new community health and social care system as “Care Closer to Home”. This is the major service change the CCGs want to carry out without public consultation.

Both Calderdale and Kirklees Councils are co-commissioners with the CCGS of significant parts of the new community health and social  care system.

Kirklees and Calderdale Councils’ Joint Health Overview Scrutiny Committee is meeting on 22nd September in Huddersfield Town Hall at 10.30am, to start the process of reviewing the Right Care/Care Closer to Home commissioning intentions of Calderdale and Greater Huddersfield Clinical Commissioning Groups.

If the JHOSC is unhappy with the commissioning intentions, it can refer them to the Secretary of State for Health.

Increased red (urgent) ambulance calls and effects on staffing

Mr Simpson told Calderdale “People’s Commission” that the introduction of the 111 service appears to be increasing red (urgent) ambulance calls.

He said there were no plans to downgrade numbers or qualification levels of ambulance staff due to financial reasons, but that staffing was rationalised according to urgency of the calls.

He  said that all ambulances have at least one paramedic (some used to have 2)  and different grades of staff carry out different tasks. There are urgent tier crews for major incidents and lower levels for others. There are now care assistants who can support a paramedic or drive patients who have been assessed by a doctor, to hospital. They have 8 weeks training and can carry out basic tests.

However, this information at odds with information from Unite, the Trade Union that represents YAS staff.

YAS frontline staff are battling management over patient safety issues

It begs the question of why Calderdale “People’s Commission” seems only to be taking evidence from Trust management, not from the staff who drive the ambulances and care for patients.

Calderdale journalist Mark Metcalf reported on 4th September that YAS staff are battling management over patient safety, union de-recognition and pay and conditions.

Mark reported that,

“YAS are making cuts of £46m over five years. Facing £300 a month pay cuts, trained support technicians who work with paramedics are being replaced with emergency care assistants (ECA) with just six weeks training. With patient care seriously compromised, Unite members took strike action in April 2013.

Management reacted by re-employing previously fired employees, permitting the use of private ambulances with less qualified staff and de-recognising Unite despite the union putting forward a well-researched alternative financial plan.

As predicted, working conditions and patient safety, which go hand-in-hand, have deteriorated since last year. Paramedics and technicians are regularly working in excess of 13-hour shifts without even having time for a meal break.

With management having refused to engage in positive talks, YAS Unite members have continued their battle to maintain a top quality service by taking regular days of action over the last 18 months.

Over 30 per cent of seriously ill and injured people are currently failing to obtain 999 help within eight minutes across Yorkshire… a large majority of YAS Unite members were on strike on September 2, joining the battle to preserve an essential top quality service.”

Ambulance privatisation “a possibility”

Replying to a question from Calderdale 38 Degrees NHS Campaign about the risk of the ambulance service being put out to tender and taken over by a private company who might downgrade the staffing levels, Mr Simpson said that was a possibility.

Here is the joint commissioning intentions document from Calderdale and Greater Hudderesfield Clinical Commissioning Groups.

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