With all the sweeping charges in the NHS in London now upon us, spare a thought for the London Ambulance Service (LAS) which after the Met deals with the most emergency 999 calls in London if not the country with over a 1.5 million annually.
The LAS has an annual budget £283 million employing about 5,000 people. As a result of the Nicholson challenge it needs to make a saving of 53 million pounds over five years. That is a 19 per cent reduction by 2015/16 compared to 2011/12 with as a result plans now to cut 890 jobs over five years including 560 frontline jobs. This at a time when it dealt with 1.6 million calls in 2011 with calls rising annually by 3 per cent annually and urgent calls rising fastest at 14 per cent in 2012.
Furthermore we have a situation where potentially London could lose up to 8 A&E departments out of 31 across Greater London. In this scenario people are expecting the LAS to pick up the slack, but with even fewer trained staff to do this they simply don’t have the capacity to do it and its only going to get worse. Compounding this situation is our growing and ageing population will undoubtedly put increasing pressure on A&E waiting times, as London’s population races from 8.17m now to 9m by 2020.
If we lose A&E departments we need more ambulances, not fewer. As ambulances are often the first point of contact for emergency patients, A&E department closures will impact on the LAS workload, with fewer A&E departments clearing meaning longer journey times to reach hospital and thus increases to both blue light journeys and non emergency trips. And fewer paramedics mean longer response times for an ambulance to reach the emergency. Not surprisingly in January 2013 the Care Quality Commission reported that the LAS has dangerously low levels of staff and sometimes ill-equipped vehicles.
No-one is appears to be looking at the combined impact of A&E closures and simultaneous ambulance cuts. Over the winter period already the LAS was given an extra £6m to help category A responses to reach 79% within 8 minutes in January when the target is 75 per cent. So London’s emergency patients are being squeezed in a pincer movement of healthcare cuts and lives could be put at risk. The warming signs already there for all to note, so lets not forget the LAS when saving London’s emergency services.
A fulerl version of this blog has been printed in this week Forum column in the West End Extra