Patients must be the focus

As you reported, a recent meeting of the Northumberland North Area Committee, held in Ord, heard a presentation from the North East Ambulance Service (NEAS) (Berwick Advertiser, March 17).

Friday, 25th March 2016, 12:00 pm

Despite a plethora of statistics, it was clear that the service’s performance required improvement.

No one doubted the professionalism of the operational staff. The problem must surely lie in resource allocation and the management of those resources.

Management of NHS provision is in the hands of a network of trusts, which have been spawned by the market-led ‘reforms’ much beloved of Whitehall and Westminster ideologues.

Unfortunately, they are fine in theory, but wanting in reality. Corporate lawyers, accountants, statisticians and management consultants, rather than patients, are the main beneficiaries of this situation.

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The NEAS covers an area from the North Yorkshire Moors to the Scottish Border, but it is subject to a series of contracts arranged by no less than 12 clinical commissioning groups (CCGs).

Assessment of contract compliance seems mainly to be through the establishment of arbitrary, and sometimes simplistic, notional targets, which are relatively easy to monitor.

It is admitted that not all the statistics lovingly gathered do actually inform the monitoring processes.

By and large, ambulance service statistics, which are effectively only averages, focus on the period between receipt of a call and hospital hand-over, rather than the totality of the patient experience. Averages mask individual reality.

Here, the Northumberland Clinical Commissioning Group is responsible for making the contract which governs ambulance service provision in this area.

Nationally, ambulances are expected to reach 75 per cent of life threatening and similarly serious incidents within eight minutes. However, Northumberland has agreed to a 73 per cent target, which suggests that locally we are being short-changed by this acceptance of lower standards.

At the meeting, I wanted to know the thinking behind this agreement, especially since targets have a habit of becoming the norm and reduced targets rarely encourage improvement in service delivery.

I got no answer to my question, only a dose of management-speak – the CCG is working with NEAS to achieve a 75 per cent target.

When asked about time-scales for this hoped-for improvement, the answer came there were none.

Only if every segment of the NHS is firmly focused on the patient, and only when its various constituent parts are subject to effective local accountability, will we see any real improvement in ambulance service delivery in this part of the county.

In the meantime, it would be good to get straight answers to simple questions.

Colin Wakeling

Berwick-upon-Tweed