Councillors have welcomed the proposed “watershed review” in the ambulance crisis and related issues in Shropshire. The proposal for an inquiry into the growing delays with ambulances attending patients and handover times once the ambulances arrive at the county’s two A&Es, was first made in February this year by Tracey Huffer.
The chair of the Performance Management Scrutiny Committee told the council’s cabinet on Wednesday that the review would take place over three days. The review is expected to look at:
- prevention, primary care and 111
- arrival at A&E and admittance to hospital
- discharge from hospital.
Tracey Huffer, Shropshire Councillor for Ludlow East picks up the story:
“In February, I called on the Shropshire Council to set up an inquiry to get answers from the hospital trust, from the ambulance trust, the CCG and others, and to hear views from across the county. I said an inquiry would be a powerful statement from Shropshire Council that is not a passive player when the health service in our country is struggling and too often failing to deliver services that we need.
“In May, I asked the council to establish a working group to investigate how an inquiry might operate. That was agreed and a task and finish group was set up.
“I am disappointed that the group did not recommend a full inquiry but I appreciate the resource constraints the council has. The three day “watershed review” is welcome. It will mean that Shropshire Council is last tackling one of the most important issues facing our county.
“I am worried that a short review might find that it does not have all the data it needs or hasn’t interviewed sufficient witnesses. The review must be rapid but if it needs a bit more time to come to the right understanding and recommendations, it should be allowed it.”
Heather Kidd, Shropshire Councillor for Chirbury and Worthen adds:
“The proposed review is really welcome but it needs to ensure that it gets answers to any questions it asks. For that reason, it is good that it will working closely with the Joint Health and Overview Scrutiny Committee, which has statutory authority to request information. For too long we have seen statistics that only cover broad areas, such as the whole West Midlands region. We need a detailed breakdown that will allow us to look at the impact on rural areas where ambulance arrival times are longer and where it can be harder to find care facilities for people on discharge from hospital.”
Full details of the review are not yet available. Among the areas it might look at are:
- The cost of delivering services in rural areas and the timeliness of ambulance responses in rural areas.
- The availability of staff to deliver services and care in hospitals and in social care.
- The perception and reality of accessing GP appointments prompting people to attend A&E.
- Making links to key strategic developments in the NHS such as the Fuller Report.
- Learn from other predominantly rural areas, for example Powys, about how they have delivered services in rural communities reducing the need to travel to acute hospitals and A&Es.
- Whether investment into prevention, urgent and emergency care, faster response times and reduced time to treatment reduces longer-term costs to the NHS.
This review seems to assume the problem is the slow down in patient flow within the hospital, maybe its time to look at the number of emergency call outs, is this the same as in previous years or has the demand increased and if so why.
The number of ambulance callouts is similar to pre-pandemic levels. The proportion of patients conveyed hospital is around 50%, lower that pre-pandemic. However, there is an 10% increase in patients arriving at the two hospitals under their own steam. The review will look at all this data.
Do you have the figures ? Nationally 2021 was busier than 2020 by over 1m call outs, and waiting times in AnE over 4hrs in 2022 up 20 % on previous year.