Transforming NHS ambulance services - Public Accounts Committee Contents

3  Collaborating with other emergency providers

13. Ambulances services are looking to reduce the time taken to hand patients over to A&E departments in hospitals.[35] Over one-fifth of patient handovers take longer than the 15 minutes recommended in guidance. One ambulance service estimated that, based on the current level of delays, £4 million per year is required in additional resources due to hospital congestion.[36] The cost of this falls on the ambulance services, not the A&E department. We heard that ambulance services have, in conjunction with many A&E departments, set up screens which show when ambulances are due to arrive at hospital so that the hospitals can be prepared for them. Ambulance services told us that this is helping to reduce turnaround times.[37]

14. Currently, hospitals and ambulances have separate targets which do not incentivise cooperation. A&E Departments have their own clinical quality indicators, one of which relates to time to initial assessment of patients arriving in an emergency ambulance.[38] The guidance that relates to it, however, shows that the measurement clock starts only after the patient is handed over to the A&E department, or after the ambulance has already been waiting for 15 minutes.[39] The witnesses told us they plan to ensure that objectives across urgent and emergency care providers are better aligned.[40]

15. Ambulance services are looking into reducing back office costs through sharing finance functions with each other and also sharing some support functions with other areas of the NHS.[41] In some areas, ambulance services currently share a number of stations with the fire service and police force. These three emergency services also already carry out some joint procurement, for example, petrol and radio systems. The ambulance services admitted that more could be done and that they are currently looking into the joint procurement of uniforms.[42]

16. We also asked what scope there was for emergency services to work together better at the front line. The witnesses said that in their view, that joint front line services with the fire service, would lead to a second-rate service.[43] However, we heard of an example in Hampshire, where more coordination between the fire and ambulance services has led to a reduction in double ambulance responses being sent as the fire services are used as first responders on the scene.[44]

35   Q 34 Back

36   Q 106; C&AG's Report, para 3.29 Back

37   Q 107 Back

38   Q 135 Back

39   Department of Health, Technical Guidance for the 2011-12 Operating Framework, January 2011  Back

40   Qq 71, 135, 137 Back

41   Q 85 Back

42   Q 70 Back

43   Q 95 Back

44   Q 62 Back

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© Parliamentary copyright 2011
Prepared 16 September 2011