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Why ‘no harm done’ is not enough

The decision by the chair of East of England Ambulance Service Trust to commission a senior sector figure to “independently” review its operational management of the winter following allegations of avoidable patient harm and deaths is welcome.

Sarah Boulton revealed exclusively to HSJ that a “senior ambulance figure” was being lined up to scrutinise how the organisation has been operationally led this winter, which included a crisis hit three weeks in which the trust recorded 138 “significant” delays including one of 16 hours and another of 14 hours.

Ms Boulton also disputed allegations by a whistleblower that at least 40 patients were “harmed or died following significant ambulance delays”.

It will not be possible to judge the credibility or independence of the review until it is known who will carry it out and what the terms of reference are. It must also be transparent.

The trust has said there has been “no evidence of patient harm” as a result of ambulance delays “so far”. But Ms Boulton also said it had not completed assessing the 22 cases which it has deemed serious incidents.

A message of “no harm done” is a good media soundbite. But it cannot be deemed legitimate until it is backed up by robust evidence, and full and clear explanations following a large number of distressing episodes which have in some cases resulted in tragic loss of life.

They included a man with a brain haemorrhage who waited 14 hours for an ambulance, and an 81 year old woman who died at her home after waiting almost four hours for an ambulance having called 999 complaining of chest pains.

A robust independent review of the decision making over winter can hopefully assist in getting to the bottom of one of the most disturbing episodes in what has been a hugely challenging winter for the NHS.