North East Ambulance Service

Nicholas Brown Excerpts

Wednesday 4th May 2016 Westminster Hall

[Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)]

I wish to make a brief contribution to the debate. It is a pleasure to serve under your chairmanship, Mr Bailey. I congratulate my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) on securing a debate on a matter that is of importance throughout the north-east of England. This is an important service, run by good people under extraordinary pressure. To give an example, on Monday 7 December last year, there were 1,837 emergency calls to the service. That is equivalent to new year’s eve and was a 46% increase on the year before. That was accompanied by 1,664 calls taken by the 111 service.

The service is fast becoming a gateway to healthcare as others become more difficult to access and some, such as walk-in centres, are no longer there at all. Repeated requests to the public to call the service only in life-threatening situations can do only so much. I accept that a certain amount of problems are caused by hoax calls and other misuse of the service. People who do such things are completely irresponsible and stand to be condemned, but that is not at the heart of the problems faced by the service in our region.

I would like to touch briefly on a number of issues. The first is commissioning, which is not one of the strongest features of the Government’s national health service reorganisation. How focused are the commissioners on the service they are supposed to be in charge of? Are they working alongside the chief executive in a supportive and encouraging way? When has their role ever been reviewed or carefully considered by those in charge? There is a case for looking at that and at staff morale, as my hon. Friend rightly said, and asking ourselves why it is as it is. Surveys of the service show that 90% of staff are stressed. That is consistent with the picture that came from her address—and no doubt will come from colleagues—of a service that is trying to do its best under enormous pressure.

Like my hon. Friend, I welcome the establishment of the diploma of higher education in paramedic practice, which will start in September at the University of Sunderland. That two-year course has been created to try to meet the shortage of paramedics in the region as well as the national shortage. Evidence suggests that the grading of posts may be too low, and I would be interested to hear the Minister’s views on that. It seems odd that, in a region such as the north-east, where unemployment levels are still higher than the national average, there should be a persistent vacancy rate of between 10% and 15% in the service.

[Anna Turley (Redcar) (Lab/Co-op)]

One of the issues raised with me on recruitment challenges is that it costs £1,200 to get a driving entitlement for C1 vehicles. For many people, that cost is extremely prohibitive and constituents have said to me that that has put them off applying for those kinds of jobs.

[Mr Brown]

My hon. Friend is on to a good point. There is something odd if, in a region of higher than average unemployment, it is difficult to fill those vacancies not just in a single moment in time but persistently. We should look at all barriers to entry into the service. I accept what she said, but I harbour the thought that gradings may have been set too low and that there is a case for upgrading the job.

I have two other points to mention briefly. Legal highs are again putting more pressure on the service as young people in particular misuse them. I suggest that it is not a good idea to take them at all, but taking them results in the ambulance service being called out. There were something like 20 incidents, including a cardiac arrest, in a single day—8 February—and so far this year there have been about 300 call-outs because of the use of legal highs. I harbour the view that they should not be legal, but perhaps that is a different debate.

Finally, I want to mention the pressures that will be put on the service if the supported accommodation proposals that the Government are considering come to pass. If vulnerable people who are housed in projects and given support to lead their day-to-day lives are denied that support and left to their own devices, the consequence for the police, accident and emergency services at hospitals and ambulance services will be much greater, rather than lesser, pressure. That is not the right direction of travel for our society.

--- Later in debate ---

[Jane Ellison]

I intend to follow up on this debate with my colleague in the Department of Health, Lord Prior of Brampton, who leads on the topic, and I will follow up with the service itself. I will make sure that all points raised by hon. Members are drawn to its attention.

The root causes of the increase in demand often lie outside the hands of the ambulance service. NHS England’s review of urgent and emergency care is taking a system-wide approach to redesigning the way that care is delivered. It is important to look at the provision of ambulance services in that context. We need to ensure that people with life-threatening emergency needs are treated in centres of excellence to reduce risk and maximise their chance of survival and recovery. The first part of that is about relieving the pressure on emergency services.

The response time targets are being considered as part of NHS England’s review to ensure that they incentivise the most clinically appropriate response. My hon. Friend the Member for Berwick-upon-Tweed and the hon. Member for North Durham (Mr Jones) talked about having the clinically appropriate response in all contexts. I will ensure that we pick up on those points and draw attention to them. We hope to have advice from NHS England later in the summer on potential changes to ambulance standards in the context of that wider review of urgent and emergency care.

[Mr Nicholas Brown]

Will the Minister give way?

[Jane Ellison]

No, because I have an important point to make at the conclusion. If the right hon. Gentleman will forgive me, there might be another opportunity.

Ambulance services are vital to emergency care and the whole NHS. We all want to be sure that when loved ones suffer heart attacks or are involved in a serious accident, they will not be left waiting, although we have heard about some distressing cases. National targets in response to red, life-threatening calls exist to ensure that that happens, and we all have an interest in ensuring that the ambulance services perform well against them. I will follow up on the points made in the debate.

I draw hon. Members’ attention to the fact that a comprehensive Care Quality Commission inspection was carried out at the NEAS during the week commencing 18 April 2016. CQC’s formal report will be important for all hon. Members and Ministers to read. In the light of the strong feelings expressed in the debate, I think it would be appropriate for hon. Members whose constituencies are served by the NEAS to meet my colleague, the noble Lord Prior of Brampton, who leads on this portfolio, when the report is available to discuss. I hope that that will be helpful for hon. Members. In the context of that report, many of the points made this afternoon can be discussed with Lord Prior. I encourage all hon. Members to engage with the local NHS and to continue to work together to address the challenges in this critical element of our healthcare system.

If the right hon. Member for Newcastle upon Tyne East (Mr Brown) can make his intervention in less than a minute, he may do so now.

[Mr Nicholas Brown]

How does the Minister account for the rise in demand for the service?

[Jane Ellison]

I definitely do not think that that question can be answered in less than a minute. Much of the answer lies in the work that Sir Bruce Keogh is doing as part of the NHS’s wider urgent and emergency care review. It is vital that we get people the right care in the right place at the right time. It is a complex picture, of which ambulance services are just one piece. More will be said when we know more about that review later this year.

Question put and agreed to.

Resolved,

That this House has considered the performance of the North East Ambulance Service.