We recognise the unprecedented pressures that the ambulance service is facing, and strong support is in place. A £55 million investment by NHS England and NHS Improvement will provide 700 additional staff in control rooms and on the front line to improve response times. This is alongside £4.4 million to keep an additional 154 ambulances on the road this winter. NHS 111 is recruiting an additional 1,100 staff, alongside a £250 million winter GP capacity fund to avoid unnecessary ambulance calls and visits to A&E.
Last week, the BBC reported that Shropshire had run out of ambulances, as every ambulance was queueing outside hospitals. Yesterday, the Shropshire Star reported that the West Midlands Ambulance Service had apologised that ambulance-hospital handover times were now four hours. This is happening all over the country, and people are dying waiting for paramedics. This is before the expected winter surge starts, so what is the Government’s emergency plan right now?
The Government understand that the reason for a number of these waits is related to the Covid pandemic and increased callouts, and we have stats for that. Ministers are in regular contact with NHS England and NHS Improvement about the performance of the emergency service care system, including the ambulance service. One Minister of State has meetings that track the improvement effort at all times, including in ambulance trusts. In addition, there is investment of £55 million to boost ambulance staff by more than 700 and £4.4 million to keep an additional 154 ambulances on the road. Also, we are looking at ways to stop people calling out an ambulance when they do not need to—when their calls could be handled without the need to call out an ambulance.
My Lords, it seems clear that the problem is a symptom of system pressures and will require a whole-system approach to resolve it once and for all—Covid, social care packages to help with discharges and local factors, and the fragility of the NHS infrastructure going in to the pandemic. The Minister has explained some of the short-term emergency plans literally to save lives, but in the absence of an NHS workforce strategy, how will the Government produce a system-wide resolution of this matter?
The noble Baroness makes a very important point: we should be looking at this in a systemic way. In fact, I did my PhD in a department of system science, where you look at problems in a holistic way—rather than analysing individual problems, you look at the whole system. We found odd unintended consequences. For example, a friend forgot his inhaler, could not get one from the chemist, could not get one from the A&E and, in the end, had to call out an ambulance. There are a number of times when ambulances are called out needlessly, and that is on top of the pressures we are already facing due to Covid. We are tackling the backlog, which, hopefully, will also reduce ambulance waiting times.
My Lords, is the Minister aware that every ambulance service in the country is currently on black alert? The problem goes both upstream, into the community, and downstream, into the hospitals and social care. What are the Government doing to decrease the number of older people being blue-lighted into A&E because they cannot get the social care services to keep them safe in their own homes?
The noble Baroness makes a very important point. We are all aware of the difficulties in different parts of the system. We have invested £450 million to upgrade A&E facilities in more than 120 separate NHS hospitals ahead of last winter, and this is being used to boost the physical capacity of A&E through expanded waiting areas, increasing the number of treatment cubicles, reducing overcrowding, et cetera. This is alongside an additional £1.8 million to place more hospital ambulance liaison officers at the most challenging acute trusts to help address the long delays, to reduce ambulance queueing and to get crews back on the road quickly.
My Lords, the Northern Ireland Ambulance Service and its personnel hold a special place in the hearts of the people there because of their bravery, selflessness and professionalism during 30 years of terrorist violence. With Northern Ireland currently registering the highest Covid infection rate in the UK, the ambulance service is now facing a new challenge, with waiting times trebling and some patients having to wait for up to six hours outside emergency departments to be admitted to hospital. What assurance can the Minister offer the people of Northern Ireland that Her Majesty’s Government are aware of this problem and will offer all possible support to local Ministers to help solve it?
I thank the noble Lord for raising that point and making people aware of the challenges in Northern Ireland. As he will be aware, health is a devolved issue, but we are very much aware of the challenges in all four of the devolved Administrations. If he would write to me with extra information, I should be happy to pass it on.
My Lords, it is estimated that nationally, a quarter of patients in beds are clinically ready to leave hospital but cannot do so due to problems of discharge—particularly a lack of available care in the community. With fewer available beds, ambulances cannot discharge patients to a bed, leading to a lack of ambulances and paramedics available to deal with other emergencies. What plans do the Government have to deal urgently with the problem of discharge to help the NHS get through the winter?
All noble Lords have raised important points about the pressures on different parts of the system. In taking a systemic overall view, the Secretary of State is holding regular “pressure” meetings and looking at the key metrics in getting those pressures down. He is also looking at how we can tackle things systemically from within, including discharge issues. We are looking at how to improve on discharges to make sure that there is enough space, thereby continuing to ensure not only that elderly patients are back in their homes as quickly as possible, but that we reduce the length of time that others have to wait for ambulances.