Report into London’s NHS demands urgent review of emergency ambulance services

A report into the service provided by the NHS in London has demanded an urgent review of emergency ambulance services, including further investment and greater clarity on pathways of care among its key recommendations.

The People’s Inquiry, commissioned by the Unite union, has said that the present trajectory of financial constraint and fragmentation within the NHS in London, if unchanged could lead to increasing strains on frontline services and commissioning budgets, primary care, mental health and community health sectors.

Malcolm Alexander, chair of the Patients’ Forum for the London Ambulance Service NHS Trust (LAS), spoke of the increasingly long delays in responding to calls from category C1 and C2 patients. This seems to suggest that frontline staffing levels and resources of the ambulance service are not keeping pace with the rise in urgent and emergency calls across London.

The report raised concerns over the lack of transparency over the issue, recommending that there should be an obligation on ambulance control to notify callers well in advance in cases where it is clear that delays are inevitable in the dispatch or arrival of an emergency ambulance, so that they know the situation, and in some cases may be able to make other arrangements.

The report also raised concerns over the misleading rhetoric of pathways of care, which conceals the fact that none of these pathways appears to have been clearly established or are viably operating. A recommendation was made for the clarification of pathways of care to ensure local services are viable and clearly understood by all health professionals involved.

Finally, the re-establishing of a reliable and accessible Patient Transport Service (PTS) is discussed, recommending an appraisal of the costs, benefits and viability of the expanded network of PTS that would be required for LAS to provide reliable services that could enable less mobile patients to travel further for outpatient treatment in the event of hospital organisation.

Taken from Journal of Paramedic Practice, published 26 March 2014.