NW ambulance service blames 'protracted' contract negotiations for performance dip

For the year overall the trust met the national target of responding to at least 75 per cent of “Category A” calls – emergencies that may be immediately life threatening – within eight minutes. It responded to 76.73 per cent of calls within the time limit, its report states.

But for the first three months of 2011-12, a quiet period for ambulance services, NWAS was the “worst-performing” ambulance trust in England. It recorded performance against the target of just 74.53 per cent for the quarter.

“Our inability to recover performance was due to a number of factors including continuing high activity levels, in excess of the norm for the time of year, and the impact on resource levels [of] extended turnaround times at hospitals,” the report states.

“However, the single biggest factor was our general resource levels which were inextricably linked to protracted negotiations with our commissioners to conclude the contract for provision of Emergency Services in 2011-12.”

The trust board came under “extreme pressure” from commissioners and NHS North West to “do something” about performance, it continues. It explains that while “a 0.5 per cent deficit against the target may not appear to be too much of a gap to bridge, in operational terms it was massive.

“This was traditionally our ‘banker’ period which enabled performance delivery over the remainder of the year.”

It adds: “The Board was clear on what needed to be done and was equally clear on what was needed to do it. The solution was predicated on a satisfactory outcome to the contract negotiations and the Board was not prepared to accept a contract settlement which would effectively guarantee failure to achieve targets, with a consequent effect on the quality of our service to patients.”

It explains that a “capacity review” jointly commissioned by the trust and its commissioners had found that the NWAS only had sufficient resources to meet the target during periods of “normal” activity. “In effect,” it states “our ability to achieve this key performance target would impaired by either prolonged periods of high activity or by spikes in daily activity.”

The board, it says, “was not prepared to accept a contract settlement which would effectively guarantee failure to achieve targets, with a consequent effect on the quality of our service to patients.”

The contract negotiations concluded in mid June, with commissioners agreeing £11.7m of additional funding, it continues: “The impact of the contract settlement in terms of operational performance was almost immediate and underpinned sustained improvement in performance for the remainder of the year.”

It adds: “Operational performance for the period July 2011 – March 2012 was truly outstanding and, in a national context, the Trust moved from worst-performing amongst the 11 English ambulance trusts at Quarter 1 to third position by 31 March 2012.”