Hospital bosses welcome new health secretary's pledge to tackle ambulance delays

A is for Ambulance

It was cheering to see our latest health secretary name ambulances as her top priority.

Therese Coffey’s “ABCD” declaration last night seems to put ambulances ahead of, or at least on a par with, the “backlog”, “care”, “doctors and dentists”.

Senior leaders have been saying for a while ambulance services are overdue an Ockenden-style review as horror stories about late attendances surface across the country.

Hospital leaders have no shortage of things to disturb their sleep at the moment – staff burnout, lack of staff, huge backlogs, plummeting performance, increased mental health problems, unco-operative social care – but ambulance handover is the worst.

“[The] ambulance situation scares me because those patients have not been reviewed at all,” one told London Eye.

Another said “the thought of someone you know having a stroke” and sitting somewhere not getting the treatment that could make all the difference was upsetting.

The West Country saw a chief address this issue head-on before the summer break.

Ms Coffey should take concrete steps on this before winter hits.

Despite the slew of terrible headlines already, just how bad ambulance under-resourcing is still isn’t properly understood by the public. When the energy crisis recedes from the national headlines, the avoidable-deaths-from-delayed-ambulances crisis could take its place.

Accident and emergency more generally is in crisis, for all the reasons above, but the mental health situation appears to be worsening. One hospital leader told London Eye the lack of MH beds to transfer people into led to 76 per cent of their ED bays being filled with MH patients one day last month.

RD CC?

The regional director job is still being done by Andrew Ridley on secondment. At some point, a more permanent arrangement is expected.

The Central London Community Healthcare Trust chief executive is understood to be unpersuaded to take the job substantively and there has been much talk, for some time, about who would take over.

The most commonly mentioned name is Caroline Clarke, the chief executive of the Royal Free London FT.

Enjoying a degree of support from the leaders London Eye spoke to, Ms Clarke is also a familiar figure to the NHS England upper echelons. NHSE chief operating officer Sir David Sloman was her boss when he was chief exec at the Free and she was finance director. She would also be joining former colleague Chris Streather, who left the chief medical officer job at the same trust and is now interim medical director for the London region.

The regional leadership team could be quite different soon anyway. Finance director Ann Johnson is due to leave soon and London Eye has been told to expect further change.

Some things to note about London lately – while performance has dipped to dangerous levels all over the country, London does better on most metrics than everywhere else (although south east London has the highest proportion of its cancer backlog waiting more than 104 days – though part of that might be because of all the Kent work it does).

Also, the regional trend of one-chair-for-multiple-trusts seems to have come to an end. Lewisham and Greenwich Trust’s new chair Mike Bell is still chair of Croydon Health Services Trust but will be leaving that role as his ninth year in it elapses. London watchers might have expected the important non-exec role to be combined with the new joint post across neighbouring Guy’s and St Thomas’ and King’s College Hospital FTs.

To be fair, the trend might also have come to an end because it has been enacted almost everywhere now. How vestigial provider collaboratives leave integrated care boards remains to be seen.