Ambulance cover in isles ‘deplorable’

By ROSALIND GRIFFITHS

AMBULANCE cover in Shetland is in a “deplorable” state and morale within the service at rock bottom, The Shetland Times has been told by two separate sources this week on condition of anonymity.

One source said the local service, which is under the wing of the NHS, was “poorly run and underfunded, with bosses providing the minimum service they can get away with”.

He claimed lives may have been lost because of the inadequate cover and in some cases patients stand a better chance of survival by phoning a taxi rather than waiting for the ambulance.

Referring to the incident related in last week’s Shetland Times when a hospital porter took heart attack victim Alan Woodworth to hospital in a car because the ambulance was not available, he said: “Funding is the problem. Rural communities are not cost-effective, not like urban areas, and never will be, but they are entitled to cover. They get less than the basic cover but the trouble is nobody will complain.”

In the instance highlighted last week, the source said ambulance staff could have been available to take the patient to hospital if the service had been properly organised. “The availability was there but it wasn’t used.

The ambulance crew may have been off-duty but they were still at the end of the phone and could have made a response, and in any case it would only take one ambulance technician to provide back-up in a second ambulance.

The other source said: “This is one case you’ve heard about. There are many cases, more serious, you haven’t heard about. The service should be shook up – we don’t want to see lives lost.”

Until the ambulance service was reorganised in 2007, there were two A&E vehicles and one on stand-by at night. Since the change, the source said, it has been “nothing but disaster”.

Only having one A&E ambulance means, for example, that if there was a serious road traffic accident in a remote area the ambulance would have to attend, leaving Lerwick, where there are likely to be most incidents at weekends, without cover.

The source said that there were people in Shetland who would be willing to volunteer as community first responders to help the service out – some retained firemen and others have expressed an interest and training would be provided if money was available. It would also be good to have a retainer for the off-duty paramedics, in order that there was always a crew available for a second ambulance if required. “It’s all about money. They don’t look after their staff.”

Ambulance teams are paid a pittance compared with doctors, the source added. Ambulance techni­cians and paramedics receive around £24,000 per year, depending on their experience, for saving lives. They get nothing for being on call and are only paid when they go out. “But it’s not about pay, it’s about saving lives.”

One of the informants said: “I’ve never worked anywhere with such low morale. The ambulance crew exist for their patients – they can’t give up because they don’t know what they’d be replaced with. I wouldn’t be surprised if you got an answering machine when you phoned 999.”

He also criticised the out-of-hours GP service: “Sometimes patients have to plead with the on-call doctor to come to them.”

Mr Woodworth, the man at the centre of the controversy, put in a complaint about the ambulance service and an ambulance boss from Aberdeen will be visiting him at his Sandwick home today.

Scottish Ambulance Service acting chief executive Pauline Howie and head of the A&E service (North-East Division) Allan Reid are due in Shetland next month to meet health chiefs here.

Mr Woodworth said: “I hope it does some good.” He has also re­ceived a letter from Tavish Scott MSP who is arranging a meeting with the Scottish Ambulance Service to discuss Shetland’s ambulance cover.

Mr Scott said: “Shetland’s geo­graphy is especially demanding for ambulance cover. People need to have confidence that an ambulance can get to all parts of the isles when one is needed. The ambulance response times in Shetland need to be much improved.

“It’s not just a matter of meeting the Scottish Ambulance Service’s islands performance target of getting to 50 per cent of emergency calls within eight minutes, they must get to all calls in a reasonable time. They are not doing that. They must im­prove their response to the chal­lenges of the isles’ geography. If that means the crew numbers and vehicles need to be increased, then the numbers should be increased.

“A number of constituents have contacted me regarding ambulance cover. There is no doubt that concern does exist over the standard of service that the isles are receiving from the Scottish Ambulance Ser­vice. I am therefore planning to meet the chief executive of the Scottish Ambulance Service as soon as pos­sible to discuss the standards of ser­vice that Shetland should expect.

“I will make it clear to the chief executive that the recent record of the ambulance service is Shetland is not acceptable and that it needs to be improved, with extra paramedics and vehicles being provided if nec­es­sary. It is absolutely essential that the isles receive the emergency service they need.”

Despite several attempts to elicit a response to the criticisms detailed in our story this week, the Scottish Ambulance Service had not responded by the time we went to press.

• THERE is only one ambulance to provide emergency out of hours cover for the whole of the Shetland mainland although two PTVs (patient transport vehicles compris­ing one minibus and one small van, both equipped for basic needs) provide patient transport services during the week.

Saturday night, Sunday night and Monday night are the worst times to take ill as an on-call service operates, even though weekends can be the busiest time for ambulance call-outs.

• All 999 calls go to Inverness where calls are categorised to ensure “red” life-threatening cases are dealt with first, but one red call will not take priority over another. Ambulances are sent out by dispatchers and tracked by satellite.

The Scottish Ambulance Service has a target to reach 75 per cent of life threatening cases in eight minutes by 31st March. (This assumes that rural calls will never be answered in this time).

Calls deemed less urgent are passed to NHS 24 who will contact local services.

• The North Isles fare slightly better than Shetland mainland because they are equipped with VW Caravelle four-wheel drive ambulances in which the driver is trained to first responder level. A doctor or nurse will go with the driver.