Transcript of Edward Argar’s speech to #ALF2021, Tuesday 18 May 2021.
INTRODUCTION
Good afternoon and thank you to the Association of Ambulance Chief Executives for inviting me to this year’s leadership forum.
Now as the Minister with responsibility for ambulances, it is a genuine pleasure and privilege to be here because your service is such a vital part of the day to day work of our NHS.
You are always there when we need you, 24 hours a day, 7 days a week.
Just a few stats illustrate this so powerfully:
- In April 2021, last month you answered 32,973 ‘999’ calls on average per day
- On average each day in April you responded to 24,723 incidents
- And made 22,655 face to face responses every day in April just gone
And when the public think of the NHS, I am sure one of the first things they imagine is an ambulance with blue lights and sirens on its way to help someone in their moment of greatest need.
So of course, as we know, the NHS is a team, and it works so fantastically because it’s a team, and the same is true of the Ambulance service, all 42,000 of you.
And I want to recognise in that context the dedication, skills and experiences of all staff working in our Ambulance Service Trust. Whether on the front line as those first responder vehicles, or in the ambulances themselves, whether as a call handler, or assisting with patient transport, or maintaining ambulances in “make ready” hubs, or in the head offices of those trusts making sure that the systems, the finances, the estate – everything runs smoothly.
Not to mention of the course, the thousands of volunteers up and down the country who give up their time to work as community first responders or with St John Ambulance.
And actually I know, more than a team, you are a family, an ambulance service family, which is why I know you will all have felt very heavily the tragic death on duty recently of Jeremy Daw of West Midlands Ambulance Service, and indeed the tragic loss of all those in the Ambulance Service family who lost their lives during the COVID-19 pandemic – and our thoughts and prayers are with them and their loved ones.
Each and every one of you working in our Ambulance Service Trust up and down the country embody the values of our NHS – working together for patients with compassion and a shared commitment to high-quality care – and in that you have my profound admiration and thanks for the extraordinary work that you do every day of the year and every year.
COVID-19 RESPONSE
And while the ambulance service always does amazing work, day in, day out, I know you have particularly faced significant and unique challenges over the last year.
And in meeting those challenges as always you have demonstrated incredible flexibility and resilience by taking on new roles and responsibilities, learning new skills and adapting ways of working during the pandemic to meet the very specific needs of the circumstances of that pandemic.
In March last year, with a surge of over one million 999 calls and the highest number of 111 calls received on record – nearly three million – you significantly increased the number of patients treated on scene or given clinical advice over the phone.
And ambulance response times improved nationally across all six categories compared to the year before.
Considering the huge pressure, you were all under and seen across the urgent and emergency care sector, these are simply outstanding achievements.
And as I alluded to earlier, I know that you will have faced personal challenges too – many of you and your teams would have had to isolate away from your families, making huge sacrifices to keep your loved ones safe while playing a critical role in the COVID-19 response.
I know the huge emotional and physical toll working throughout this pandemic would have had on all of you.
It is because of your tireless efforts, your sense of dedication and public service day in, day out, in the face of those challenges in this pandemic that I want to say once again a huge ‘thank you’ to all staff across the entire ambulance sector for your amazing work. Not just in the past year, but every year – you truly have the gratitude of the nation.
Now today I wanted today to make some remarks around these key themes – innovation; collaboration; overcoming barriers; and perhaps most importantly protecting our people.
INNOVATION OF THE SERVICE
What you have delivered during the pandemic just shows how much you have transformed the sector in recent years through innovation, with a highly-skilled workforce delivering ever-increasing levels of care.
It is vital that patients are taken to emergency departments only when clinically they need to be. Therefore I was particularly inspired to read about the Early Intervention Vehicles designed by the East of England Ambulance Service to support elderly fall patients with a one-stop service to provide a clinical assessment, review medication and make referrals for additional care support, resulting in less than a quarter of these patients having to be taken to hospital.
Initiatives like this mean that last year, those patients who needed to be taken to hospital still were. But those patients who did not need to be taken to hospital and could be treated in other settings, whether at home or other ambulances were able to be treated in that way. And what that meant was that the number of patients transported to emergency departments across all ambulance services fell to 52% of incidents, from 57% the year before.
We need to continue to build on this fantastic progress to improve access to alternative care pathways, taking patients to the right place for their healthcare needs, whether emergency department, an urgent treatment centre, mental health support services or elsewhere.
INNOVATION – DIGITAL INVESTMENT
Furthermore, still focusing on innovation we recognise how technology and data will play a crucial role, joining up people and information across health and care systems to improve patient care.
As digitally-advanced trusts, South Central, North East and West Midlands ambulance services have already been recognised as Global Digital Exemplars.
Now building on this fantastic work, NHSX has launched a new Digital Aspirant programme, with the East of England Ambulance Service receiving £5 million to drive forward their goal of becoming paperless by 2024.
This investment is vital for ambulance staff to access the clinical information they need, and we will continue to support with the development of electronic patient records access, video consultations, and new interoperability standards between 999, NHS 111 and trusts.
INNOVATION – AMBULANCE FLEET
And finally in the sphere of innovation, we can see in the Government’s commitment to reaching net zero carbon emissions by 2050, and the NHS ambition to achieve neutrality by 2040, all parts of our NHS coming together to play their part in this national endeavour.
I was delighted to see that the West Midlands Ambulance Service has already launched their first fully electric emergency ambulance to support our “Greener NHS” campaign.
And the London Ambulance Service, with funding from the Office for Zero Emission Vehicles, aims to deliver a prototype zero emissions ambulance later this year.
This further reinforces my view that modernising the ambulance fleet is vital to achieving our carbon ambitions, and the Government will continue to look into all options to support you in this endeavour.
EMERGENCY SERVICES COLLABORATION
Turning now to collaboration, the collaboration of emergency services, we have seen improved integration across the emergency services, with police, fire and ambulance, in partnership with the military, all coming together to respond to incidents and share their resources – including from new ‘Blue Light Hubs’ built across the country.
I want on this juncture to put on record my gratitude for my local ambulance trust, the East Midlands Ambulance Service, for their support in my constituency, in the service they provide to my constituents in Leicestershire and indeed across the region.
And also for their innovation last year a new “tri-service” station opened in Coalville, bringing together the ambulance service, Leicestershire Fire and Rescue and Leicestershire Police all under one roof, and I am sure this will continue to provide benefits for the local community in the months and years to come.
COLLABORATION – FOOTPRINT CHALLENGES
We also recognise the unique challenges posed by the geographical size of ambulance trusts, the sheer number of partner organisations that you work with, and the importance of you taking the rightful place which is yours at the table in local strategic planning.
Through my Department’s forthcoming Health and Care Bill announced in the Queen’s spech, we will build on the joint working that has proved vital in responding to the pandemic, and remove the bureaucracy that can get in the way of local leaders making the best decisions for the populations they serve.
I want ambulance trusts to play a key role in these changes, as both strategic and local partners, and we will continue to engage with you to ensure the sector has a strong voice in the development of integrated care systems.
LONG-TERM CHALLENGES
Now, turning to challenges although COVID-19 has presented very specific challenges, I know all of you will recognise that there are historic issues or challenges or indeed barriers facing the sector.
HANDOVER DELAYS
One of these for example, comes in the form of handover delays and EDs. It is vital that we address hospital handover delays to allow ambulances to return to service quickly and safely.
It is fundamental to improving outcomes for patients, and we must continue to address the pressures across the whole emergency care pathway in a holistic way to address these delays, looking at what is affecting you as ambulances service trusts and also what is going on in the EDs that could be addressed to help further speed up those transfers and handovers.
This is why last winter, the Government provided an additional £450 million of capital investment to upgrade emergency departments across the country.
This has expanded waiting areas and increased the number of treatment cubicles available, along with reducing overcrowding and improving infection control, all of which has increased capacity in turn to enable more rapid handovers from ambulances.
But we must continue to go further, and we will continue to work with you and EDs across the country to understand what else can be done to further smooth the hospital handover process.
PROTECTING THE WORKFORCE
And finally, and perhaps most importantly, you have just been hearing from Prerana [Issar, NHS Chief People Officer] about our people. Our people are at the heart of the NHS, each and every one of you are the beating heart of the NHS without whom none of the amazing patient care would be possible. So, it is vital that we protect our people.
And I was shocked to read in the most recent NHS Staff Survey that a third of ambulance staff reported that they had experienced physical violence at work from patients or members of the public.
Any physical or verbal aggression against our NHS staff is completely and utterly unacceptable.
And this Government is absolutely committed to tougher sentences for those convicted of assaults on any frontline emergency worker.
And in the context I must pay tribute to my fellow MP, Chris Bryant, who first introduced his Private Member’s Bill in Parliament in 2017, resulting in now it is an act an increase to the maximum sentence for assaults against emergency workers from six months to a year.
And building on that Act, the Government’s Police, Crime, Sentencing and Courts Bill will now go even further, with a proposal to double the maximum sentence again to two years.
Sending a clear and simple message that we will not tolerate abuse towards frontline emergency workers, each and every one of you who go out every day to help people – and put your lives at risk to help save others.
FUTURE VISION
So, as we continue to make progress on today’s challenges, we are also laying a solid foundation to transform the ambulance service to meet the challenges of the future.
CONCLUSION
Now as I conclude, I must reiterate my thanks to you for the lengths you go to for patients.
Your shared purpose and tremendous dedication to making a difference every day goes to the heart of why our ambulance services are held in such high regard and affection, not just by me and the Secretary of State, but by the people of this country and why your work is an inspiration to so many.
It is always deeply humbling to me to see the amazing work you do, day in and day out, and I am incredibly proud to be the minister responsible for ambulance services and I hope to be able as restrictions continue to ease to be able to get out and meet and visit many of you in the coming months.
But in the meantime, let me conclude once again by saying thank you.
Edward Argar MP
Minister of State for Health
