Published: 22/09/2005, Volume II5, No. 5967 Page 5
The number of ambulance trusts n England will be slashed from 31 to 11 by April, HSJ can reveal.
The Department of Health's plans to reduce the number of trusts by two-thirds, to fit broadly with government office regions, are due to go out to public consultation at the end of next week.
The proposed map of the 11 new organisations - which may be rebranded as emergency care trusts to reflect wider roles - was shown to ambulance trust chief executives and chairs by NHS chief executive Sir Nigel Crisp and the government's national ambulance adviser and London Ambulance Service trust chief executive Peter Bradley last week.
The reconfiguration proposals are expected to be 'ratified' by strategic health authority chief executives at a 'top team' meeting at the DoH today.
Under the proposals, the country would be divided into 11 areas representing the nine government office regions, with the South West and South East each split into two.
The two areas have been treated differently in order to reflect the merger across Avon, Gloucestershire and Wiltshire SHA that is already out to consultation, and in acknowledgement of the high population density in the South East, HSJ understands.
As a result, it is unclear if the government will go ahead with its plans to have all ambulance trusts co-terminous with SHAs, which are due to be reduced from the current 28 by April 2007.
HSJ understands there is opposition to allowing an SHA retaining its existing boundaries of Avon, Gloucester and Wiltshire to remain.
There is discussion about whether the SHA that would cover the South East government region should cover two ambulance trusts - when all other SHAs would just have one.
The proposals follow a wideranging review and recommendations for the future of ambulance services by Mr Bradley.
But the plans have raised some concerns among chairs and chief executives, chiefly around the lack of clarity for the rationale behind the changes. According to one chair, Sir Nigel admitted that at last week's meeting the changes were driven by the manifesto pledge to find£250m savings in NHS management and administration costs. The chair said the changes had been 'not been thought through operationally'.
'There is a very major question to be asked: What is the major benefit for patient care in all this? Their answer would be there will be£250m extra to go in [to patient care]. But it will not be like that, ' the chair challenged.
A DoH spokesman confirmed that the review of the ambulance service, which he said had been widely supported, proposed fewer, larger trusts.
He said the review showed ambulance services 'would benefit from greater strategic, operational and financial capacity and capability'.
And he described boundary reconfiguration as 'an administrative issue that will free up resources for investment in ambulance services'.
The new trusts
1 Cumbria Lancashire Mersey Regional 2 Tees, East and North Yorkshire North East Greater Manchester 3 South Yorkshire Lincolnshire West Yorkshire Metropolitan 4 West Midlands East Midlands 5 Essex East Anglian Bedfordshire and Hertfordshire 6 London 7 Kent Surrey Sussex 8 Hampshire Oxfordshire Royal Berkshire 9 Dorset Westcountry 10 Avon Wiltshire Gloucestershire 11 Staffordshire Coventry d arwickshire Hereford d orcester (Two Shires Ambulance trust will be split between regions 4 and 8)
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