A supplementary submission from Bransford EOC staff* and Richard Burt, Liberal Democrat Parliamentary Candidate for West Worcestershire & Health Spokesman for the West Midlands Region.


*Staff members: Liz Kabani, Melissa Price, Ken Dunkley, Keith Douglas, Karen Ashcroft, Penny Sant, Stefan Cartwright, Julie Darkes, Alison Ball, Lin Ferguson, Andy Timms, Rebecca Coss, Mike Clarke, Kendra Yates, Emma Jones, Alex Emanuel, Cate Smith, Matt Jones, Sue Hinton, Diane Pearson, Stephanie Birt, Nic Jones, Michelle Dickens, Max Sutton, Ali Webb, Angie Durham, Alan Sprague, Aaron Martin, Allan Watson, Martin Kay, Laura Watson, Richard Brown, Pennie Harrison, Tracy Baker, Belinda Davenport




Statement by staff representative Liz Kabani & Richard Burt

Following the announcement by West Midlands Ambulance Service NHS Trust on 5 September, to delay the decision on its proposed reconfiguration of the region’s emergency ambulance control centres, we the authors of the alternative proposal sent to the Trust on 22 August, wish to constructively engage with managers to come to a common solution.

The Trust has long stated, as we all have in the ‘Save Your EOC’ campaign that the current situation is not good enough, and ‘doing nothing’ is not an option.

Incorrectly however, the Trust has thus far equated any alternative to their plans as ‘doing nothing’. In our alternative proposal, we highlighted that we wish to see the same goal as Trust managers: an improved level of ambulance care for the West Midlands. We simply disagree on how to achieve that common goal.

This supplementary submission outlines further concerns relating to the Trust’s proposed reconfiguration, and outlines an additional case for our alternative proposal.

The ambulance services in the West Midlands region have consistently out-performed other NHS regions in the UK for many years. Unlike other NHS regions, the West Midlands did not, before July 2006, amalgamate any of its ambulance services and maintained its 5 control centres. Over the last year, the control centres have remained and response times have remained high.

We have a unique opportunity. We can reap the benefits from having a larger integrated, regional ambulance service whilst being able to maintain the locally based controls that have served the region so well. We believe that with common will from all sides, we can improve ambulance cover across the West Midlands in a form that can act as a beacon to other regions.


Liz Kabani

UNISON Staff Representative at Bransford EOC


Richard Burt

Liberal Democrat Parliamentary Candidate for West Worcestershire & Health Spokesman for West Midlands Region

 

 

 

 

Further concerns with the current Trust proposal

The Trust’s proposal was based on a business case prepared by Mason Communications, an organisation with expertise in IT and telecommunications management but no experience in emergency control centre and design and operation.

Mason Communications were commissioned by the Department of Health in January 2007 to produce a report, published in May 2007, on “Operating Models for NHS Ambulance Control Rooms in England”.

The West Midlands consultation document omits some key conclusions raised in this report. In particular:

• Trust control rooms made up of both emergency and non-emergency services form a critical component in the provision of unscheduled care.

• The emerging models that best met the agreed evaluation criteria are trust-based hubs. These are defined as a small number of multiple sites that have a fully integrated, workload balanced, call delivery plan, and are supported by common operational systems.

• They will operate with the support of skilled and dedicated staff that use the common set of systems and processes, and supported by trust-based supporting infrastructure that includes management information and workforce planning staff and logistics support functions that enable call takers, dispatchers and supervisors to focus on their core activities.

• The trust-based operation should work to a set of common principles and standards, which should be monitored and supported by an overarching corollary organisation that monitors and advises on standards.

The above conclusions would support the retention of existing call centres operating with common equipment to common protocols and systems but based in local areas – as suggested in the alternative proposals we presented to the Trust on 22 August.

The current consultation document does not state why it has chosen the preferred option of two control centres over and above other potential options such as the one outlined by the authors of this document.

The limited financial information in the Trust’s document does not identify staffing and other recurring revenue costs in detail. Estimates for the sale of existing property are ambiguous and unlikely to be accurate. Staffordshire Ambulance Service cannot accommodate both the existing services housed at the Tollgate depot and existing ambulance HQ at Stone Road, Stafford, into the current space available at Tollgate. No costs have been shown for additional accommodation required.

The data provided for call volume for Staffordshire is incorrect and should read 660 per day with an average per hour of 28 with a variance of between 39 peak and 12 minimal against the provided figures of 300 per day and 14 per hour, an inaccuracy of 50%.

Doubt is also cast over the call volumes provided for the Birmingham and the Black Country as the call volumes provided for national statistics show an average of 1,160 calls per day and therefore 48 per hour against the figures provided of 867 per day and 36 per hour.

The proposal to operate emergency call taking separate from the dispatching function would have serious consequences of delaying response and placing lives at risk. Emergency call takers are required to have direct verbal contact with emergency dispatchers.

Evidence from within the UK and around the world shows that large emergency control centres are expensive to operate and provide poor emergency response performance.

 

 

 

 

An additional case for our alternative proposal

Maintaining the current control centres would not be expensive. Costs of software are generally based on the number of operating users which would not significantly rise above current total user facilities.

Modern software would allow a ‘virtual’ control centre to be operated with the servers based in Birmingham, and a ‘thin client’ operation in the local centres. Thus, such centres operating on similar systems would be able to manage serious and major incidents, the Trust would be able to monitor the whole, and reallocate resources to demand as required. In the event of one control being disabled the others could take on additional demand.

In the event of a loss of a control, and particularly a main control at either Brierley Hill or Stafford, greater sustainability and continuity is achieved by retaining all five centres than the reduction proposed provided all controls operate using common systems and protocols.

Retaining the current local control centres also facilitates:

• An expansion of the PTS to cover periods of raised activity outside office hours, ensuring appropriate use of frontline emergency crews during the same period, i.e. to prevent the necessity for frontline crews to undertake routine transport duties.

• The opportunity for West Midlands Ambulance Service Trust to enter into negotiations with PCTs to transfer the GP Out Of Hours Service for Herefordshire & Worcestershire to Bransford Control.

This arrangement would enable better use of existing resources at Bransford, provide additional revenue for West Midlands Ambulance Trust commissioned by the PCTs, more appropriate prioritisation of calls and thereby leading to better patient care.

 

 

 

 

 

Next steps

As outlined in the above statement, the authors of this document wish to work constructively with the Ambulance Service NHS Trust to achieve the aims we share with them. Thus, we will be undertaking the following actions in the coming days and weeks to contribute further to the consultation process:


• We are sending a survey to 42,000 homes across the county constituency of West Worcestershire to ascertain the opinion of local people, and to allow them to have their say on the Trust’s proposals;

• We will be seeking to meet with Trust Chief Executive, Anthony Marsh to explore alternative proposals.