Ambulance Service Conservative Impact

Public ambulance services across the UK are required by law to respond to four types of requests for care, which are:


 * Emergency calls (via the 999 or 112 system)
 * Doctor's urgent admission requests
 * High dependency and urgent inter-hospital transfers
 * Major incidents
 * Non-urgent patient transport services (patients to hospital apointments and hospital transfer)

The ambulance requires a number of skill roles:


 * Ambulance care assistant and Patient Transport Service (PTS) driver
 * Associate ambulance practitioner/emergency medical technician
 * Call handler/emergency medical dispatcher
 * Emergency care assistant
 * Patient Transport Service (PTS) call handler
 * Paramedic (some general and some with specific skills)

Strain on the service
Over recent years the ambulance service has been coming under excessive strain due to:


 * Social Care cuts mean more patients require transferring to hospital
 * Hospitals under pressure for beds are transferring recovering patients home much earlier often resulting in patient re-admittance due to medical complications
 * Shortage of trained paramedics due to lack of training opportunities
 * Time lost when ambulances are forced to hold patients in the ambulance due to no space in hospitals for admittance
 * Increased social issues such as homelessness and poverty leading to drug and alcohol dependancy
 * Increased mental health issues due to poverty and lack of support services

Due to the above factors demand for ambulance services continues to grow rapidly. Between 2009-10 and 2015-16, the number of ambulance calls and NHS 111 transfers increased from 7.9 million to 10.7 million, an average year-on-year increase of 5.2%.

Increased funding for urgent and emergency activity has not matched rising demand, and future settlements are likely to be tougher. Between 2011-12 and 2015-16, income for ambulance trusts’ urgent and emergency care activity increased by 16% from £1.53 billion to £1.78 billion. Over this period, activity (ambulance calls and NHS 111 transfers) rose by 30%. Commissioners have warned that, given current financial challenges in the wider health service, future funding settlements are likely to be tighter.

Ambulance trusts face resourcing challenges that are limiting their ability to meet rising demand. Most trusts are struggling to recruit the staff they need and then retain them. The reasons people cite for leaving are varied and include pay and reward, and the stressful nature of the job. In 2015, ambulance trusts had a paramedic vacancy rate of 10%. Health Education England has set up a programme to train more paramedics and to upskill current ambulance staff but trusts and other stakeholders are concerned that this will not be enough to meet rising demand and fully implement new models of care (paragraphs 1.17 to 1.19)

To be completed