3 Collaborating with other emergency
13. Ambulances services are looking to reduce the
time taken to hand patients over to A&E departments in hospitals.
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.
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.
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. 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.
The witnesses told us they plan to ensure that objectives across
urgent and emergency care providers are better aligned.
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. 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.
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.
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.
35 Q 34 Back
Q 106; C&AG's Report, para 3.29 Back
Q 107 Back
Q 135 Back
Department of Health, Technical Guidance for the 2011-12 Operating
Framework, January 2011 Back
Qq 71, 135, 137 Back
Q 85 Back
Q 70 Back
Q 95 Back
Q 62 Back