News

Clarity needed on how ambulance services will be integrated into STPs

Further clarity is needed to establish how ambulance services will be incorporated into STPs across England, an influential group of MPs has today warned.

In its ‘NHS ambulance services’ report into variation in performance between ambulance services in the country, the Public Accounts Committee (PAC) found that there were serious issues with planning that surrounded integrating ambulance services into STPs, including how it was still unclear how local plans will fit around national objectives to connect emergency care services.

To tackle this, PAC stated that it was vital that NHS England provide greater clarity on how ambulance services will “have a seat at the table” of STPs and how they will be integrated into the wider health system.

The report stated: “Effective collaboration is key to ensuring that all urgent and emergency care services are connected and integrated. However, the complexity of the healthcare system creates challenges for ambulance trusts in terms of engaging with all the relevant local stakeholders.

“It remains unclear how locally driven plans will fit with the national aim of connecting and integrating all urgent and emergency care services and getting a consistent service offer across regions.”

On top of that, PAC found that ambulance trusts were organised around meeting response-time targets, something that undermined the efficiency of the service as ambulances were being sent too quickly to patients who did not need urgent emergency care.

This is an issue that NHS England have previously stated it is aware of, as director of acute care Keith Willet said in March that targets would be changed to lessen the amount of inefficiencies being created in the system.

The committee also highlighted a need to tackle the significant variations in ambulance performance between trusts, as it reported that little had been done by NHS England to understand the difference in care since PAC last looked into ambulances in 2011.

PAC said: “Substantial variations persist between ambulance trusts across a range of performance and efficiency measures. 

“In 2015–16, the proportion of Red 1 calls responded to within 8 minutes varied from 68.1% to 78.5%; the proportion of incidents where one or more vehicles were stood down after mobilisation varied from 4% to 46%; and income per head of population varied from £26.7 to £36.6.

“Key operating framework variables include workforce mix, the types of vehicle used, and number and type of ambulance stations. In addition, ambulance services are not commissioned consistently across England, with differences in how they are funded and what they are funded for.”

And concerns were also raised about the struggle ambulance services were faced with in recruiting and retaining staff, as many services struggled with high sickness absence rates.

An NHS England spokesperson said: “We have undertaken a large, national study of ambulance performance to identify ways it might be improved.  The trials have involved the handling of 10,000,000 calls and early indications are encouraging.”

Today’s news also follows other warnings about the ambulance service, including the Nuffield Trust who said that ambulances had been turned away from A&E departments twice as many times during this winter which has been branded as one of the worst on record for the NHS.

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