Once Done, No Reversal For Ambulance Station Closures

December 5th 2012

In August when I first heard about East Midlands Ambulance Service's plans to shake up the way ambulance stations are organised I'll admit I was on the fence. Knowing nothing of how ambulances stations operated, I was willing to consider that EMAS could have a workable plan for improving response times and maintaining an acceptable level of service for the public. I thought: these people work in the ambulance service, maybe they know what's best for it? Everything I've learnt since then has underlined how thumb-suckingly naive that position was.

The real experts

At the town council meeting of 27th November we heard from the real experts, those who work in the ambulance service locally, rather than just the upper management. The staff of Louth Ambulance Station wrote to EMAS outlining their concerns, and their proposals for alternative changes.

You say potato, I say portacabin

The major change suggested in the Being The Best consultation document is replacing existing ambulance stations with five large hub stations, in Lincolnshire, and a lot of "community ambulance points" or "standby points", only one of which will be in Louth. There's no picture of standby points in the document, but they are basically just portacabins and portaloos.

In their letter to EMAS, Louth Ambulance Station staff had this to say:

• "The idea that some of these standby points are to be 'porta-cabins' is unacceptable for the fact that this poses problems of separate toilet facilities, cleanliness (who will clean these stations) and security."

When I spoke to Jackie Featherstone, who is co-ordinating the campaign to save Louth ambulance station, she explained the security concern more clearly. Paramedics need to administer morphine and similar drugs, and these need to be kept in safes. But it's easy to break into a portacabin. The first part of portacabin refers to the fact that it's portable, but if you need to move one of these you're either left with a drugs safe concreted to the floor, or you don't have a secure location for keeping medicines in the first place.

Costs

Ambulance workers wrote of their concerns that a lot of the costs of these changes haven't been taken into account. These are not limited to the increased staff travelling expenses to hub stations.

• "On top of this are the costs of the new Hubs themselves, the creating of Tactical Points such as porta-cabins and providing key access to all EMAS staff to every TSP and Hub across the 5 divisions. ... It seems that this proposal will not be 'cost neutral' as it is expected to be."

This echoes the criticisms Councillor Brian Burnett has made at previous town council meetings.

Travel times

When it comes to staff welfare, the letter made a lot of points about how this change would impact on travel times.

• "Staff will still need to return to Hubs to re-stock unless there will be access to controlled drugs at all Tactical Points. Staff are not allowed to carry food within vehicles under Infection Control and so still need to return the distances to have breaks. It will be impractical to carry spare uniforms in vehicles and so staff will need to return to Hubs to change if the need arises."


• "Many staff within Lincolnshire live close to their work place and so the impact of up to an hour's journey before and after each shift will be immense. The EEC Working Time Directive allows for 11 hours off between shifts but this does not include travelling time. ..."


• "There are concerns about how staffing will be covered when the weather turns inclement and the further increases in staff travelling time to workplace when the weather changes. Lincolnshire does not have a good road network ... It is felt like patients in rural areas are being abandoned and this is a little like a postcode lottery. ..."

Driving to Skegness from Louth takes around 40 minutes on a good day, which makes for a lot of wasted petrol and time.

No going back if hubs fail

The all-encompassing nature of the proposed changes are another cause for alarm:

• "... it is concerning that we are doing such a huge change in one go because if there is a sale of all existing estates which is ploughed into major Hubs and then this does not improve patient care and call times, we can not go backwards. Why not look at the option of closing the single stations first and review the response times."

I can think of another man who made sweeping changes to a vital community service: Dr Richard Beeching, when he closed down all the railway branch lines. Louth still hasn't recovered from that disaster, which shows how hard it can be to reinstate services and infrastructure once land and buildings get sold.

Targets

The impetus behind these changes is the fact that EMAS is missing its response targets. With so-called "red category" calls, those that are serious and life threatening, it is meant to respond to 75% of these calls within 8 minutes and 95% within 19 minutes. Actual figures for 2011/12 indicate ambulances arrive at 75.15% of these within 8 minutes, and 92.32% within 19 minutes.

That sounds bad, but not a complete disaster, and it's at least an improvement on the figures for previous years. However what these figures don't show is the enormous variation within those response times, as illustrated by some of the horror stories that have come to light recently.

What I don't see is how anything EMAS is proposing could possibly have a positive effect on response times, especially in Louth. We're not getting a lot of new standby points, because most of the 28 that are earmarked for spots in Lincolnshire will be in the south of the county. And we're not getting any more ambulance staff or vehicles, which is what would really make a difference.

Petition signatures

So far 2246 people have signed a petition opposing the closure of Louth Ambulance Station. David Hall has been out campaigning for Save Louth Ambulances. He found that a lot of people were disappointed about the level of public consultation by EMAS, but once they understood what was at stake the response to the petition was overwhelmingly favourable.