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Lincolnshire is famous for Sir Isaac Newton, Margaret Thatcher and Alfred, Lord Tennyson. But HSJ’s research suggests one thing it will not become known for is timely arrival of ambulances.
In the area served by Lincolnshire East Clinical Commissioning Group, performance at the 90th percentile for “category two” ambulance calls is close to an hour and a half — meaning one in 10 patients who call for conditions such as suspected strokes or heart attacks wait for 86 minutes or longer.
The target times for category two calls are 18 minutes on average and 40 minutes at the 90th percentile.
Altogether, 27 CCG areas had a 90th percentile performance of longer than an hour. Among them were some densely populated parts of Essex, as well as Leicester City.
There are also big differences within sustainability and transformation partnership areas. Neighbouring CCG areas Brighton and Hove and High Weald Lewes Havens had average performances of 11:07 and 23:52 respectively, while Hull CCG had an average response time less than half of that in North East Lincolnshire despite being in the same STP — Humber, Coast and Vale.
The breakdown on a CCG level is important. Ambulance trusts are commissioned by CCGs often working in groups to match the trust’s catchment. It is a long-standing dilemma that they are accountable for meeting performance standards across their whole area (some don’t, but that is another story) — but not to do so in each CCG area.
It’s costly and difficult to reach those targets in sparsely populated areas like Lincolnshire and much easier to reach them — and boost a trust’s overall performance — in urban areas.
So inequalities which arise may be hidden by the trust-wide performance. HSJ’s research sheds light on this, yet it won’t be repeatable at the same granularity once more and more CCGs merge in April, next year. It raises some uncomfortable questions about what level of variation is acceptable and how well rural areas are served by the NHS.
First it was recently retired doctors and nurses, now the government is eyeing up another talent pool in the fight against coronavirus.
Chief medical officer Chris Whitty said on Thursday that final year medical students and first year doctors could be drafted in, along with clinicians who retired up to three years ago, if the spread of the disease increases as expected.
He warned the Commons health and social care committee there will be a window of about three weeks of “huge pressure” where the NHS will get half of the UK’s total coronavirus cases, with efforts to delay the peak of the infection rates until later in spring, and to flatten it.
Professor Whitty also told MPs there will be no vaccine for coronavirus available this year.
The warnings come as the number of coronavirus cases in the UK hits 90 — and the government moves from the “contain” to the “delay” stage of its strategy against the disease.
Arm’s-length bodies are also heeding warnings about the coronavirus. The Care Quality Commission has said it still intends to continue its inspections, but will take a “pragmatic approach” and limit its demand on providers.
In a letter to providers, chief executive Ian Trenholm said some inspections could be cancelled at short notice.