Single Responder Ambulances

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Conference
2009 Health Care Service Group Conference
Date
1 December 2008
Decision
Carried

This conference notes with concern the policy being adopted by many ambulance trusts of sending a lone ambulance practitioner as an initial response to most emergency calls rather than a traditional double crewed vehicle.

This system, known as “the front loaded model” is being initiated in response to the increasing resource pressures on Ambulance trusts. These pressures have been brought to bear in part by an ongoing increase in emergency calls of around 10% per year across the UK and a tighter system of recording response times that came into effect in England on 1 April 2008.

Conference believes that the motivation behind the front loaded system is flawed in that it is primarily driven by a desire to meet target times as opposed to actually improving patient care outcomes. It seeks to do this through spreading resources more thinly as opposed to increasing them. This is underlined by the fact that most single responder vehicles are neither designed nor suitable for transporting patients which leads to either undue delay in conveying patients for treatment or staff being forced to transport patients in vehicles that are not “fit for purpose.”

Conference is also very concerned at the impact of the front loaded model on staff health and safety. It will increase the number of lone workers who are at greater risk and vulnerability from physical assault (amongst other dangers) without a partner to watch their back. Further, distressing and traumatic situations are routinely experienced by Ambulance staff and the benefits of sharing the experience of these with a colleague should not be underestimated.

Conference also notes that another Health and Safety concern arises out of the propensity to deploy single responders on a standby basis at street locations in their vehicles as opposed to being based at ambulance stations. This not only leaves them more vulnerable but is ergonomically unsound.

Conference therefore calls on the HSGE to:

i.Seek a review of the impact of the introduction of the front loaded model on patient care outcomes and staff health and safety;

ii.Take appropriate action to encourage all ambulance trusts to have a lone worker policy in place that incorporates best practice as endorsed by UNISON and the Counter Fraud and Security Management Service (CFSMS) including monitoring of implementation and regular review;

iii.Maintain a policy position that provides for increases in demand in any area of the NHS to be primarily addressed through a commensurate increase in resources rather than thinning out existing provision;

iv.Encourage a consistent and more systematic approach to fundamental operational change in the NHS that includes use of pilot sites, in-depth health and safety risk assessments of the impact on patients and staff as well as those required by equalities legislation.