Recruitment and retention of ambulance workers

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2015 Health Care Service Group Conference
24 November 2014

Conference notes the mounting crisis in ambulance services across the UK around the recruitment and retention of ambulance staff. This crisis is growing as more staff leave their jobs as paramedics, ambulance technicians and control staff to pursue other work. Over the last few years, the ambulance workforce has changed, as has the work itself. The ambulance service is fast becoming the default contact for the public who cannot get appointments to see their GP or the services they need are not available. This surge in demand has come at a time when the Government has imposed a real term cut in funding to ambulance services. 999 calls in 2014 were the highest ever – over 9,000,000 last year whereas 10 years ago it stood at 5,000,000. At the same time the numbers of ambulance staff have only risen from 16,000 to 18,700.

The Keogh review in 2014 recognised the role that ambulance services provide to urgent and emergency care provision yet there has been no national recognition that action is needed to prevent staff from leaving in such numbers. Graduate paramedics can get find alternative employment at a comparable rate without having to work nights and weeks in gruelling mental and physical conditions. Work within ambulance services is already stretched beyond capacity with staff regularly working 12 to 14 hour shifts with no adequate breaks. Staff are no longer working the overtime needed to cover the shortfalls in shifts.

Universities have reached maximum output for paramedic courses with employers struggling to provide placements for students but this is not stemming the flow of highly trained clinical staff leaving the service. Each ambulance service is responding to this crisis independently without a national strategy supported by Government, fighting over the available paramedics and offering incentives to new staff. Information obtained from 12 of the 13 ambulance trusts in England show that the number of paramedics leaving the service since 2012 has doubled. This translates to 1 in 15 paramedics leaving the ambulance service. One of the consequences of this lack of strategy is the increased use of private ambulance providers to plug the gaps in staff.

UNISON agrees that the urgent and emergency care provision would benefit from a comprehensive review and a properly funded well trained, properly resourced and well paid workforce is critical to delivering safe quality care. UNISON further believes that a review of training for ambulance services needs to take place with the reintroduction of vocational as well as graduate education pathways to support staff development for existing ambulance staff.

Conference calls on the Health Service Group Executive to:

1) seek information from ambulance employers on the scale of the retention issues in ambulance services across the UK;

2) campaign and use political influence to highlight the current state of ambulance services and the effect of budget restraint on staffing levels;

3) campaign around the workforce factors and the impact on our members of shift work, demand and the pressure of working longer;

4) work through the National Ambulance Social Partnership Forum to find solutions to some of the issues creating the retention problems.