Weekly updates and essential insight into the NHS in the South West, by Will Hazell
Ambulance trust withdraws from out of hours contract
For South Western Ambulance Service Foundation Trust, last week was a troubled week for an organisation which was already in difficulty.
The week started with the trust serving notice on its out of hours medical contract with Gloucestershire Clinical Commissioning Group because it could no longer “offer a safe effective service”.
In an email sent to staff the trust referred to “increasing pressures from other services” such as NHS 111, emergency demand and community services.
It said it lacked the resources to improve the out of hours service “within the current contractual constraints”.
HSJ understands the trust will continue to run the service for the next 12 months, but Gloucestershire CCG plans to start a procurement process to find a new provider soon.
For its own part, Gloucestershire CCG struck a philosophical tone in relation to the news. It acknowledged the trust’s “wish to focus their efforts on the provision of 999 emergency care services in Gloucestershire”, and said the change offered ”an opportunity to consider what is needed from the service alongside our work on reviewing the urgent care system”.
Dial I for inadequate
Unfortunately, South Western Ambulance Service’s withdrawal from the Gloucestershire contract was not its only bit of bad news.
Only a couple of days later the CQC rated the trust’s NHS 111 service inadequate.
The Care Quality Commission inspected the service, which serves patients in Dorset, Devon and Cornwall, in March.
Inspectors found there were often not enough staff to take calls or to give clinical advice. Too many calls were being abandoned and patients were waiting too long to be answered, with calls sometimes being answered by untrained staff.
Staff told inspectors they were working long hours, with many feeling high levels of stress and fatigue, and turnover and sickness rates both high.
The findings about tired employees and calls being handled by staff unequipped to deal with them, both have a disturbing resonance.
A report by NHS England in May implicated the 111 service in the death of William Mead, a baby who died of sepsis in December 2014. According to the report, William might have lived if the service had realised the seriousness of his condition.
On the second issue of tired staff, the Daily Mail published a story in February which seemed to show a paramedic and call handler at the 111 centre asleep at their posts.
As a result of the CQC’s findings, NHS Improvement has instructed the trust to carry out a number of actions. These include developing a plan to fix the problems identified by the CQC and making urgent improvements with the help of clinical experts from NHS Improvement.
Residents in the South West will be hoping that last week marked the nadir for the region’s ambulance service, and it will now begin the upward trajectory of improvement.
Deep South is HSJ’s email briefing on the NHS in the South West of England.
It takes an in-depth weekly look at a region which is one of the NHS’s most innovative, but also one of its most turbulent. The patch includes the cities of Bristol and Bath, through Wessex and Dorset, and all the way down the peninsular to Lizard Point.
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