'Only the dedication of exhausted ambulance staff is saving service from collapse'
999 unit insider says overstretched workers are at 'breaking point'
The Ambulance Service in Northern Ireland would “collapse overnight” without front line staff pushing themselves beyond what is expected, it has been claimed.
The stark warning has been issued by an Ambulance Service worker as “overstretched” staff and unions voiced concerns that patient safety could be at risk if workforce problems are not addressed urgently.
Currently the Northern Ireland Ambulance Service (NIAS) has 84 front line staff on sick leave — leading to claims that those still on duty and having to fill in are at “breaking point”.
The Belfast Telegraph’s source says that pressures to hit response times have in cases led to crews without full emergency training being sent on calls that are more serious than anticipated.
The NIAS insider said that Patient Client Services (PCS) crews, who are employed to move existing hospital patients, have been sent on calls where the seriousness of a person’s condition requires urgent treatment in A&E.
“PCS crews are trained in first aid, basic life support and using a defibrillator, but not to administer treatment,” he said. “This has led to concerns that some staff are not able to spot potential health problems.”
The source claimed the Ambulance Service has initiated a practice of sending PCS staff to attend what are known as doctor’s urgent calls, or AS2s.
“AS1 calls are commonly known as 999s, AS2 calls are the next level of urgency, deemed by a doctor to require that the patient be taken to A&E by ambulance as a matter of urgency, although the patient is not deemed to be suffering a life-threatening illness,” he said.
“My concern is that PCS staff arrive and the situation is more serious than anticipated. Patient safety could be at risk.”
The health worker added that morale among Ambulance Service staff is “pretty much non-existent”.
“If it wasn’t for the front line staff pushing themselves beyond what is reasonably expected of them, the service would collapse overnight,” he claimed.
The staffer’s comments come after members of the Unison union adopted a vote of no confidence in the NIAS Trust Board, the chief executive officer and directorship. The union said an inquiry is urgently needed into how the service is managed.
Regional organiser Brian Ferguson said Unison was aware of instances when PCS staff were attending a certain category of calls and then needing to request emergency crews.
“This highlights the reasons behind the vote of no confidence,” he said. “The NIAS needs to recruit more people and have more ambulance cover.”
Liam McIvor, chief executive of the Ambulance Service, admitted it had experienced difficulties in providing cover over recent weeks. He described an almost 30% reduction in operational cover during the last weekend of July as “a watershed”.
“The trust took action to improve the situation with a number of measures including reprofiling relief shifts and making use of voluntary ambulance services,” he said.
Mr McIvor added: “The use of voluntary ambulance services is carefully monitored to ensure that cognisance is taken of their skill set when despatching them to calls on our behalf.
“They deal with non-emergency calls to enable NIAS staff to respond to life-threatening calls. However, their contribution has been, as it always is at our time of need, invaluable.”
Mr McIvor added that the trust will continue to work to improve the levels of cover at all times.
“I recognise and appreciate their (the staff) efforts in ensuring that everyone who needs an ambulance gets one and that patient safety is not compromised.”
Unison’s Mr Ferguson said, however, at the root of the problem lay the huge financial constraints facing the health budget.
“The worrying thing is that the Health Minister bid for £120m in the June monitoring round and only got £20m to share around five trusts,” he said.
“There is going to be a huge hill to climb in addressing the issue of getting more staff.”
Story so far
An external inquiry into how the Northern Ireland Ambulance Service is managed has been demanded by the union Unison. It comes after a unanimous vote of no confidence in the NIAS by members.
About 750 ambulance staff said they no longer had confidence in the trust board or in the chief executive.
Among the key issues are staff shortages. At the end of July there were only 37 ambulances in service, instead of the usual 52.
The NIAS said it responded to all the emergency calls it received, but added that there were delays in “many cases”. At the start of July, the NIAS said the current level of paramedic cover is “as required”.