Concerns raised over ambulance response times in Sunderland as service faces 'unprecedented demand'

According to data revealed to members of NHS Sunderland Clinical Commissioning Group (CCG) this week, the North East Ambulance Service (NEAS) failed to meet national expectations for three out of four standards.

Despite being one of the fastest in the region for responding to life-threatening ‘category one’ calls, in July 2021 it failed to meet performance targets in categories two, three and four in Sunderland.

Against the backdrop of service pressures, a ‘no send’ policy has been applied across NEAS to the least urgent calls – with callers in select cases advised to make their own way to urgent treatment centres, A and E or GPs.

However, Sunderland health bosses heard there was a clear clinical policy before this was instigated and in practice, it would only apply to a small number of cases and for “really minor” health issues.

The update came during a meeting of the CCG’s Governing Body on Tuesday September 28, which was held via videolink and broadcast on Facebook.

CCG leaders stressed that the performance was linked to system pressures and was not a reflection on the hard work of ambulance service staff.

Scott Watson, director of contracting and informatics for the CCG, added there had been millions of pounds of investment into the service to improve the situation.

This included the recruitment of extra call takers to help manage demand, investment into extra third party vehicles to respond to calls and additional paramedics and clinical staff – both into call centres and on the roads.

The service is also implementing a text message service to communicate with those who have dialled 999 who are waiting for an ambulance.

Dr Ian Pattison, local GP and Clinical Chair of NHS Sunderland CCG, acknowledged the pressures in the system and paid tribute to health staff.

“I think all of that performance does not underpin the fact that everybody who is working in those services is working their absolute socks off at the moment,” he said.

“So these are systematic problems rather than reflections on the hard-working people who are working there, in fact some working very very hard, trying to recover some of this.

“I think we need to always be mindful of separating out what individual people working are doing from the systemic challenges we’re facing through demand and Covid recovery.

“I think it’s important that we give that distinction as we go forward and pay tribute to the people who are working really hard trying to keep these services going under extreme circumstances.

“But we do have a responsibility to do better.”

Health bosses said there were several factors linked to the pressures on the ambulance service -including increased demands from walk-ins at A and E and callers “abandoning” efforts to get through on the 111 phone service.

They added that the ongoing performance and quality of services was being dealt with at the highest levels.

Dr Pattison added: “I was looking at the ambulance performance [for July 2021] and I know the pressure they’re under.

“On average when you look at the graphs, Sunderland averages to being one of the most affected areas, if not the most affected on average, across the North East.

“Now that’s a concern. Not only are we in a challenged system but Sunderland on average across the four [response time] categories looks the most challenged by aggregate as I calculate it.

“Hopefully some of these things can be addressed through the discussions we’re having, but clearly the pressure on the ambulance service is unprecedented and we need to try and work as a system to do that.”

Paul Liversidge, chief operating officer and deputy chief executive at NEAS, noted the recent investments into the service and also paid tribute to the efforts of ambulance service staff.

Speaking after the CCG meeting, he said: “We have been under severe pressure for several months following unprecedented demand on our services, which is being felt nationally by NHS providers.

“Despite also seeing a higher proportion of life-threatening calls, our performance for the sickest patients remains one of the top in the country, and Sunderland is one of the top performing areas in our region.

“However, prioritising our finite resources for these patients can unfortunately lead to longer waits for patients whose lives are not immediately at risk.

“This increased demand is compounded further by the additional infection control measures which remain in place due to the pandemic, such as additional vehicle cleaning and personal protective equipment, which reduces the time available for our staff to respond.

“Like every industry, staff absence has also increased as a result of the pandemic and it’s important that we continue to protect their mental and physical health.”

Mr Liversidge added: “Additional funding has enabled us to put measures in place to try and improve our ability to respond, including recruiting more clinicians and health advisors, increasing remote working opportunities, and increasing the support provided by third party providers.

“We are also asking some patients to make their own way to hospital where it is safe to do so, have introduced a text message service to remind patients waiting for an ambulance that they should only call us back if their condition worsens, and continue to ask members of the public to consider their GP, pharmacist and 111 online before picking up the phone.

“I would like to take this opportunity to pay tribute to our staff for their consistent commitment to deliver the best care possible to the patients they serve under particularly difficult circumstances.”

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