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Ambulance response time in West Oxfordshire
It's appalling" says District Councillor.

The scrutiny committee of West Oxfordshire District Council has passed a vote of no confidence in the ambulance service. It learned that, for category A emergency call-outs, where an ambulance should be at the scene in eight minutes, the success rate in west Oxfordshire in February was 41.2 per cent, compared to a government target of 75 per cent.

In April last year the service managed 72.4 per cent. Committee chairman Peter Handley said: "We're on a downward spiral. It's appalling. The rural areas are losing out. The service conceded that there had been a "significant drop" in response times, but said they were taking on more staff.

Oxfordshire's ambulance service was merged into the South Central Service in 2006, which also includes Berkshire, Buckinghamshire, Hampshire and the Isle of Wight, with calls routed through Milton Keynes.In February, there was an hour's delay in treatment when an ambulance called to treat an unconscious 14-year-old girl in a skate park in Grove, near Wantage, was sent to a skate park at Grove in Bedfordshire.

Ambulance service spokesman Alison Brumfitt said: "In February there was a significant drop, but it is not a steady decline. Rural areas like west Oxfordshire, unlike the urban ones we cover, are more difficult to get to by ambulance."

The webmaster writes: Somebody needs to remind the Ambulance Service that before they sold Chipping Norton Ambulance Station they were  required to show that they could meet the response time targets. (75% of Category A calls within 8 mins) Mr Nichol personally promised when he met the Town Council that there would be a standby ambulance at the Fire Station. I remember Councillor Biles actually went out on hair-raising emergency calls to satisfy herself it was actually possible to reach the Wychwoods in 8 mins from Chippy Fire Station.  Councillor Coles kept telling us that there wasn't a proper ambulance on standby at the Fire Station and she doubted there ever would be. (How right she was!) Mr Nichol also talked about paramedics on motor bikes. They have never transpired. In fact what happened was that the Ambulance Service moved out to Adderbury and left us to our own devices. If it weren't for the backup First Responder service by the Fire Service we would be in deep deep trouble. These latest figures call for an expression of complete outrage. We have been duped. The front line members of the emergency services must understand that we do appreciate the job they are doing. Absolutely nobody is criticising them. They cannot be expected to defend poor management and government budget cutbacks.  But we - the public - have no alternative but to kick up a stink. I am amazed at how readily some people seem to simply accept that there's a shortage of money so - hard cheese. Its all you can expect out in the sticks. That may seem a very cool attitude to a fit and healthy thirty year old. Just you wait until one of your parents or one of your kids is suddenly struck down by a life-threatening accident or medical emergency. Forty-five minutes will seem like an eternity. I can tell you about it - and so can many others. Full marks to the WODC Scutiny Committee. No confidence in the management of the Ambulance Service is absolutely spot on. But words won't get us anywhere. Why don't the Committee lead a march on Ambulance HQ I will be happy to help organise a Chippy contingent.


The Ambulance situation gets worse and worse

News on Ambulance response times gets worse and worse. I am indebted to Chunky Townley for a briefing on the meeting last week in Witney when the WODC  Economic Overview and Scrutiny Committee met the management of the Central South Ambulance Service.

Here's the most worrying statistic of all to emerge. Category A calls are life-threatening emergencies. There should be a response to 80% of such calls within 8 mins.  The requirement used to be that an ambulance had to get to the patient.  To everybody's eternal shame this requirement was relaxed two years ago to allow first responders like the Fire Service to be counted in to the figures - thus letting the Ambulance Service off the hook in a big way. With such a huge concession we all expected to see the Ambulance Service easily hitting the 80% target.

The following response rates have been achieved in West Oxfordshire in the last twelve months. These figures include Fire Brigade first responders.

March  2007 70.07%
April 72.48%
May 73.50%
June 73.77%
July 68.79%
August 63.70%
September 60.42%
October 57.49%
November 72.22%
December 50.56%
January 2008 47.73%
February 41.21%

What on earth is going on In the middle of last year things took a turn for the worse and have been heading downwards ever since. The January and February figures are disgraceful. Goodness only knows what the figures would have looked like without the Fire Brigades help. Apparently the committee was told that it was the government who should be blamed. They were simply not coming up with the funds. The Service needs more ambulances. Apparently there are going to be 12 new ambulances in West Oxfordshire in the coming year. One of these would be stationed on permanent standby in Witney. "Can we have one in Chipping Norton" asked Councillor Townley "We are more remote and the area served from Chippy is at least 15,000 people. Well over 10% of the District and surely justifying one of the 12 new vehicles" "And this is only what we were promised two years ago" added Councillor Biles. There was some discussion about the comments from Paramedic PudlicotePete in the chippingnorton.net Forum. Apparently the Ambulance Service managers knew all about these already. Was an ambulance ever stationed at Chippy Fire Station or wasn't it Councillor Biles provided the definitive answer - "I know the person who has been told officially that he can park his car in the Ambulance bay at Chippy Fire Station because it is not required for an Ambulance any more."  Well that seems conclusive enough. The managers promised that they would do everything possible to get one of the new Ambulances stationed in Chippy - and at the new hospital when that is open. We will have to keep on their backs about this. But meantime they really must look to improve performance using present resources. In February there were 165 emergency calls in West Oxfordshire...they only got to 68 of them within the required 8 mins. This must mean that most of these calls are being serviced from Adderbury and Kidlington. We don't stand a chance of an 8-min response out here in the hills! The debate now moves on to the WODC Cabinet who will be asked to endorse a vote of "no confidence" in the current level of service.  The Cabinet must get its biggest guns out on this issue. It is difficult to imagine anything of more importance to the rural communities of West Oxfordshire. And please keep up the good work Chunky and Hilary. We are counting on you!



On 27th March Mr John Divall, Director of Corporate Affairs of the South Central Ambulance Trust and Mr John Nichol, Divisional Director (Oxfordshire & Buckinghamshire Division) met the Economic Overview and Scrutiny Committee of WODC. Everyone should read the minutes of that meeting. They are deeply worrying. http://www.westoxon.gov.uk/files/reports/8624.pdf  Here are a few extracts

John Divall pointed out that the Category A (emergency calls) response target of reaching 75% of life threatening calls within eight minutes was the standard that applied across the whole of the Trusts operational area. Mr Divall advised that he considered it unlikely that category A targets could be met universally due to the rural nature of parts of the operational area and the distances and levels of demand that were an inevitable consequence of geography. It was likely that rural areas would always experience a lower level of response than urban areas as assets would be concentrated where the main resources were required, demand profiles governing the allocation of resources. However, the Trust would continue to strive to improve performance and provide additional resources but was constrained by the financial resources available to it.

Mr Nichol explained that the Trust operated to the requirements and within the resources provided to it by the Primary Care Trusts as commissioners. He advised that the ambulance service had provided its commissioners with details of the level of resources that would be required to meet the Category A performance standards universally throughout its entire operational area.

Mr Townley and Mrs Biles referred to assertions made on a local website that the standby point in the town was never utilised. In response, Mr Nichol accepted that the point was not utilised as often as would have been liked but refuted the suggestion that it was not  used at all.

In addition to their undertaking to station an ambulance on standby in Witney, Mrs Biles asked Mr Divall and Mr Nichol to station one at Chipping Norton hospital to serve the northern half of the district. Mr Nichol undertook to consider such an arrangement making it clear that he could not give any commitment to doing so at this stage given that the Trust had to consider how best to employ its limited resources.

The Cabinet consider the matter on Wednesday 16th April.


999 fears if base moves

Moving Oxfordshire's fire control room to a regional base in Hampshire will increase the potential for 999 call handler mistakes, a former firefighter has warned. John Farrow, county firefighter for 38 years, fears the transfer will lead to incidents similar to a South Central Ambulance Service (SCAS) bungle which saw an ambulance directed to the wrong county. On that occasion a call handler in Milton Keynes accidentally sent an ambulance to Grove in Bedfordshire instead of Grove in Wantage. The 14-year-old girl who had collapsed, survived but stopped breathing during her hour-long wait.

Once the county's fire control room in Kidlington is moved to Fareham in January 2011, phone operators will take calls from people in eight counties twice the size of the SCAS area. Mr Farrow, who worked in the county's control room for 14 years, said: "Fire operators are trained very highly to deal with the county and surrounding counties, but you can't expect someone sitting in Fareham to know the ins and outs of north or south Oxfordshire. It is a very large area to cover and it increases the possibility of error."

Mr Farrow, a former county council cabinet member for community safety, added: "With the ambulance service incident there was a degree of human error involved. A similar mistake could happen with the fire service." The Government wants to establish nine regional control centres to allow emergency services to better co-ordinate responses to major incidents like the Buncefield fire and London bombings. Oxfordshire's control room in Kidlington will be merged with eight others, with operators 83 miles from the current control room. It is hoped the move will save 1.4m a year in running costs, 3.4m less than was previously estimated in July last year. Oxfordshire Fire and Rescue Service acting assistant chief fire officer Colin Thomas said: "I can understand the concerns and our view is that local knowledge is always a good thing. But the technology provided actually traces the calls and provides handlers with a geographical mapping system so we know exactly where the call is from."


West Oxfordshire District Council set up a group to look into appalling ambulance response times

The Ambulance Service were not allowed to sell Chippy Ambulance Station until they had demonstrated that they could meet the government's action standards for response times. Specifically they were required to respond to 80% of life-threatening calls within eight minutes. They produced plans involving ASAPs, standby ambulances at the Fire Station and paramedics on motor bikes. It is now clear this was all fiction. They have never met the response time standards in rural areas and this year the figures have got so bad that the District Council have set up a working party to report on the whole matter. Hilary Biles is the Chair and Chunky Townley is one of the members.(pictured left at Witney) Both of these people know the Chippy situation backwards. They know how everyone feels. Most importantly they are both tough fighters who we can feel confident are not going to accept soft answers. We are relying on them and if they need any help or support they only have to ask.

In a Press release this week WODC said : "The working party, which includes seven District Councillors, aims to report its findings to the Councils Cabinet and Environment and Social Overview Scrutiny Committee in February 2009. A report will also go to the Oxfordshire Joint Health and Scrutiny Committee and Witney MP the Rt Hon David Cameron. Cllr Hilary Biles, Chairman of the Ambulance Services Working Party and Cabinet Member for Health, said: For several years now there has been an ongoing problem with ambulance response times in our market towns and especially the villages of West Oxfordshire. A development plan is being produced by the Primary Care Trust and the South Central Ambulance Trust. West Oxfordshire District Council seeks to influence the development plan through our review of the ambulance service in West Oxfordshire.



John Nichols (Head of the Oxfordshire Ambulance Service) has said..."We acknowledge that our performance in rural Oxfordshire remains below an acceptable level"  The Ambulance Service made a presentation to the Joint Health Overview and Scrutiny Committee last week in Witney. Chunky Townley addressed the committee at the beginning of their proceedings. Here is a shortened version of what he told them.....

Since 2002 attempts have been made to get the Ambulance Service to improve coverage in West Oxfordshire especially in the rural areas in the North of the District. You may be aware that a Working Party has been set up by WODC to carry out a Review of the Ambulance Service - which will report next month. The consultations taking place as part of this Review have flagged up significant shortcomings in the performance of the Ambulance Service in our area. The claimed improvements have not been evident. Some of the response times have worsened rather than improved in the more rural areas - especially in and around Chipping Norton.

The national targets for reaching Category A calls (life threatening) within 8 mins is 75%. In Chipping Norton the figures show an average of 50%. Last December they actually dropped to 40%! The national target for category B calls - reaching the scene within 19 mins is 95%. In Chippy the performance is 60%  These figures show the response times for Chipping Norton are more than 33% BELOW national targets.

These performance figures cover co-responders (including the Fire Service). In many cases it is they who arrive first at 999 calls. Without their contribution it is difficult to imagine how bad the performance tables would look. Often the fire engine with 4 or 5 firemen, then a co-responder, then an ambulance arrive to answer the same call. Surely the cost of all these resources would be better spent on buying additional ambulances.

Until a few years ago when it closed Chipping Norton had an Ambulance Station equipped with two ambulances and paramedics. I find it difficult to see how South Central Ambulance Service think they can convince people living and around Chipping Norton that the service is improving in their area. Surely the very least we should expect is for an ambulance to be manned and on standby 24/7  at the new hospital when it is completed.

At the moment Chippy is served mainly from Adderbury Resource Centre. It takes 15 mins to travel from that station to Chippy by car - and a further 5-10 minutes for an Ambulance. Clearly it could never be done in 8 minutes - but it is also unlikely it could be done in 19 mins even if the driving conditions were excellent.

The Ambulance Service say there have been increases in ambulances and trained paramedics. This may be true but we have seen no evidence of it in our area, We all pay the same taxes so why shouldn't people in West Oxfordshire expect the same level of service as other places in the region

The Ambulance Service say that an ambulance stationed at Chipping Norton would not receive enough calls to justify it. We don't agree. As I have already said, we used to have our own station with two ambulances full-time. Standy points for ambulances have been created around the area  -including one at Chippy Fire Station. It is hardly ever used and performance figures haven't improved. It is obvious there is a need for more ambulances - with additional funding dedicated to Oxfordshire and specifically rural areas. It is also obvious that the South Central Ambulance Service Area is too big and covers too large an area. Big is not always better.

Hilary Biles (left) also spoke at the meeting and wrote to us afterwards: "The Joint Health Overview and Scrutiny Committee strongly came out in support of the representations made by Chunky and I and have asked for the Ambulance Trust to go back and get a business plan together to bring back to the next meeting on 15 May. I am also taking one of their Directors on a tour of the area so they know first hand what the area is like. An absolute necessity as they are based in Winchester. It is so good after all the battles to see a glimmer of hope. They were told that should they not conform to what the Committee asked they would be referred to the Secretary of State.

Scrutiny committee chairman Peter Skolar later met senior trust representatives to demand improvements. He said: We are looking for extra ambulances, extra staff and more money. The problem is that outside Oxfords ring road the service is not able to hit the eight-minute target as required. I cannot see how things can get better without a great deal of extra resources from the Oxfordshire Primary Care Trust, and ultimately from the strategic health authority.

The meeting agenda and charts of the presentation can be viewed at http://www.oxfordshire.gov.uk/content/public/Resources/hlpdownloads/JH/jh.htm  http://www.oxfordshire.gov.uk/content/public/Resources/hlpdownloads/JH/JH-07.doc

Well done to Chunky and Hilary. keep up the good work. We are depending on you!


Hilary Biles' working party produces a really fantastic report on ambulance response times in West Oxfordshire.
A report that will make a difference!

A series of recommendations relating to ambulance service provision in West Oxfordshire have been set out by a working party formed by District Councillors to investigate poor response times in the area. West Oxfordshire District Councils Cabinet has agreed to support the recommendations made in a Report by the Ambulance Services Working Party. The Report will be given to South Central Ambulance Service (SCAS), which provides accident and emergency services across Oxfordshire, Buckinghamshire, Hampshire and Berkshire, and the commissioning body, Oxfordshire Primary Care Trust (PCT), as well as several other health-related parties . The Council requests the Reports findings and recommendations should be taken into account in the development plan currently being worked on by SCAS and the PCT, and lead to improved response times.

Cllr Hilary Biles (pictured left), Chairman of the Ambulance Services Working Party and the Councils Cabinet Member for Health, said: It is essential to recognise the hard work and professionalism of Ambulance Service staff, particularly the dedication of their paramedics and volunteers, and I would like to thank the Service for its openness in helping us to carry out this Review. The Council has been concerned about this issue for several years, but our efforts to get the Service to improve response times in West Oxfordshire have not worked. I hope that this in-depth report, which has not left any stone unturned, will mean that the Service and the PCT take note of the Councils grave concerns and that of the public, and act upon them.

The Working Party, which consisted of seven District Councillors (including Chunky Townley from Chipp), focused on response times to 999 emergency calls in West Oxfordshire. Response times in the District have traditionally been below nationally set target times. In September 2008, only 54% of Category A (life-threatening) call-outs in West Oxfordshire met the 8-minute response time target - significantly below the 75% target set by the Government. The Report looks into the reasons for these poor response times in West Oxfordshire and explores the clinical need for better response times by ambulances, particularly in cases of cardiac arrest and stroke.

It investigates the coverage provided by ambulances in the District and the impact of SCASs use of Fire Service and volunteer Community First responders. Ambulances are rarely stationed in locations that can get to areas of the District within the Category A 8-minute target time and co-responders are therefore often dispatched. Their response times are currently included in the overall response times achieved by SCAS. The Review found that, without this support service, response time performance in West Oxfordshire would be even lower than at present. It was felt by the Working Party that co-responders were not an acceptable alternative to an ambulance and paramedic, and that SCAS should not include their response times within their overall achievement figure. 

The Report sets out a range of other findings and makes the following over-arching recommendations, along with additional specific recommendations:

  •  The commissioning Primary Care Trusts (PCTs) should dedicate more regional funding to improve ambulance services in rural areas of Oxfordshire.  In West Oxfordshire this would be 4.2 million.

  • The commissioning PCTs and South Central Ambulance Service (SCAS) should agree minimum targets of meeting 75% of Category A responses within 8 minutes and 95% of Category B responses within 19 minutes for ambulance callouts across all of Oxfordshire.

  • SCAS should ensure that the social standby points in West Oxfordshire have back up ambulances in place on a regular basis in order for SCAS to reach their West Oxfordshire destinations in the target times set out in Recommendation 2.

  • SCAS should regularly staff ambulance standby points at Witney, Chipping Norton and Carterton to better serve West Oxfordshire.

  • Paramedics should be based at Chipping Norton hospital to provide both an Out of Hours service and a paramedic provision for the area and this will reduce the demand on the Ambulance Service and acute hospitals.

  • Although providing a valuable service to the community in responding to cardiac arrest, Community and Fire Responder call outs should not, and must not be used to calculate and achieve ambulance call out target times. It is imperative for heart attack and stroke patients to reach the appropriate hospital within the necessary time frames in order to be given the necessary interventions to preserve life and have improved and shorter recovery success. This is ultimately better for the patient and will in the long term have beneficial savings for the NHS.

  • That SCAS be requested to respond to the recommendations contained in the report within 8 weeks of its publication.

The Working Party found that, in addition to other factors affecting ambulance service provision, West Oxfordshire has one of the largest predicted increases of older people in the population in Oxfordshire and is therefore likely to have a greater need for ambulance services in the future. It was also felt that the size of the SCAS area needed to be reviewed to provide more localised services. Cllr Biles added: West Oxfordshire is the second most rural district in the South East. However, we are not isolated. All residents deserve equity of access to our public services and that of the Ambulance Service is paramount. In West Oxfordshire co-responders, although a valuable resource in certain circumstances, are used because Ambulances cannot realise the target times. Ambulances are centralised in the three largest Oxfordshire towns Oxford (Kidlington and Headington), Banbury (Adderbury) and Abingdon (Didcot). Therefore it stands to reason that ambulances cannot meet the required government call out times for West Oxfordshire. While we understand funding and government targets are major factors, it is not right that rural areas should suffer because targets are able to be met in urban areas. Centralisation may help budgets, but does not provide essential services.