OPPOSITION TO THE PROPOSED RECONFIGURATION

OF EOCS IN THE WEST MIDLANDS

as presented to the Board 25th July 2007.

If Hereford and Worcester EOC and Shropshire EOCs are disbanded, the West Mercia locality will have no representative control. That effects a population of 722,500 and an area of 1512 square miles. This will undoubtedly undermine public confidence in the NHS in general and West Midlands Ambulance Service in particular. At Hereford and Worcester EOC we believe the issue is not just about a building and 28 jobs in E + U alone. It’s about the diverse communities in our area. This Trust rightly wants to be seen to be meeting targets but hasn’t truly considered the impact of these closures on vulnerable members of the public.

All points of reference quoted refer to the draft document. 4.1 in the proposals refers to the public expecting 999 calls to be answered quickly. Press Officer Murray McGregor made the claim on radio and television last week, that calls will be answered more quickly than ever before under the proposed changes. Where is the evidence for this? This may hold true for the populace of Birmingham Black Country but certainly not for that of Hereford and Worcester who can expect a slower service and had better get used to finding themselves on hold in a queuing system when they in future dial 999. A postcode lottery will come into play whereby the people in the BBC will gain from these proposals but at the expense of those in Herefordshire and Worcestershire.

“Our vision” in section 5 fails to recognise that not all patient locations are standard addresses. When you get, as we regularly do, the call, “I’m visiting the area and am on the Malvern Hills but don’t know where,” local knowledge is invaluable. Postcodes don’t always match and then it’s useful to know there are 2 Kingtons, one in each county, 2 Kinnersleys, one in each county, that Leominster has a letter “o” in it and that Edwyn Ralph is a place not a person. Local knowledge saves seconds, sometime minutes, sometimes lives. Local knowledge Hereford and Worcester employees could take to the BBC control room would be ever decreasing as those employees tire of the travelling time spent to and from work each day. These new vacancies would be filled by people from BBC - you’d never again recruit from Hereford and Worcester. The time would come when not a single H + W person would work in the BBC control room. The consultation document makes reference to call takers not needing local knowledge as crews will have it. Not necessarily so. A paramedic said only yesterday, and I quote, “I rely on control to direct me to incidents.” Crews don’t necessarily work where they live eg those on permanent relief. Crews in our locality are mobilised to strategic standby points - a Leominster crew might clear at Hereford County hospital and then be the nearest response to a 999 call at pen Craig near Ross on Wye. Hardly their patch. SatNav systems are brilliant when they take you straight to the door of where you want to be. Sometimes they send crews entirely the wrong way wasting valuable time.

This section also states “crews will remain based exactly the same locations as now.” That’s a very specific claim. For how long is that be guaranteed? At an Extra-ordinary trust Board Professional Executive Committee Meeting (held in public) 7th March 2006

http://www.worcestershirehealth.nhs.uk/, Wyre Forest District Council supported the proposal that the then Hereford and Worcester Ambulance service should merge with that of West Midlands with 3 provisos, 2 of which were:

“retention of Bransford Control Centre”
“ambulance service management on a district basis”.

Were any time constraints built into this agreement? Were any penalties attached for if it failed to happen?

If the argument is that circumstances have changed due to being under the auspices of a different Chief Executive Director, then the previous statement that “crews will remain in exactly the same locations as now”, would only be worth the paper it’s written on as long as Anthony marsh continues in his present post.
The table on page 8 is very selective in its listing of advantages and disadvantages. Hereford and Worcester has only on thing going for it according to this table and that is that there’s room to expand. Correction, there’s loads of room to expand. Unlike both Leamington Spa and Millennium Point, there’s also extensive car parking - 42 spaces and room for more. Another advantage is that the property’s owned outright and therefore not subject to tenancy restrictions. But perhaps it’s biggest asset and one not deemed worth bringing to the Board’s attention, is its location. Birmingham is a prime terrorist target, probably second only to London. Anthony Marsh has stated on more than one occasion, that it’s not if a terrorist attack occurs, but when. Given this expectation coupled with the fact that H + W EOC presents an extremely low risk terrorist target, why is anyone even considering axing this site?

The figure of £150,000 is quoted for ARP. The figure for installing it at BBC and Stafford appears not at all in these proposals.

We’ve had very selective costs outlined. And possible savings that could be made but there appears to be no provision made for the travelling expenses for 4 years for the employees of H+W and Shropshire EOCs. This must amount to some £400,000 - £500,000 yet such a significant sum appears not at all in these proposals.

Can Mr Marsh explain how the decision was reached to retain Leamington Spa EOC with its lack of extra seating, lack of extra car parking and its difficulty in recruiting staff as indicated by current vacancies? They are to be applauded for their consistent delivery of meeting new performance targets but are the figures being held up by Coventry being such a densely populated city? How do these figures stack if you take Coventry out of the equation? The population of Coventry is 306,000. Worcester is 94,300 and Hereford is just 50,154. It’s very, very rare for H + W to miss a 999 in either city, The biggest reason we miss 999 calls is distance. Insufficient regard is given to the extreme rural nature of our area. Although it seems money was not an issue when choosing the future EOC sites, it does appear to be the issue when we raise the question of why Bransford should close. Has the possibility of merging H + W with Shropshire been considered? West Mercia is a bigger area than Coventry + Warwick. With an expected increase in 999 calls of 6-7% per year, has keeping all present controls and making them all fit for purpose - because all this isn’t about money - been considered? H + W have space to extend. The last thing tax-payers, health ministers, PCTs, in fact anyone at all would want, is to fund these reconfigurations then discover 5 years down the line the new EOCs are again unfit for purpose.

In the technology stakes we do lack the answer phone message on the 999 line letting Jo Public know he’s in a queue. H + W don’t have that. We just answer the phone. Nor do we have the tape 999 callers are routinely told to listen to detailing what to do next. At Hereford and Worcester we rely on verbally grappling with callers if needs to, to stay on the line and listen to the advice initiated by the AMPDS system all West Midlands EOCs use and to prepare for the arrival of the emergency response. BBC callers probably hang up as soon as the tape starts playing . Crews probably arrive to find doors still locked, no-one looking out for them , and the Doberman still on the loose hindering arrival at the patient’s side. At H + W call takers ensure callers are prepared for crew’s arrival. It all saves time. And sometimes that extra time saves lives.

It’s disturbing that the Board is being expected to consider proposals based on very selective information. How can a larger control centre be more resilient to failure when it stands to reason there’s just more of it to fallover? A wider spread of EOCs offers a lower risk of failures affecting more than one centre.

There are 3 case studies mentioned in the document. Jump ahead to this time next year when we’re all at MP, fallback facility Stafford. Dirty bomb if Merry Hill Shopping Centre. Massive exacuation including MP EOC. Staff unable to get to Tollgate EOC due to traffic chaos - all major routes grid-locked.

Wouldn’t it be great to have H + W EOC 33 miles away from merry Hill, fully functioning and staff able to get there?

The management of West Midlands Ambulance Service have ahd 11 and ½ months to draw up these proposals. In H + W we’ve had just 3 days, working around shifts to formulate our objections. At Thursday night’s meeting virtually all questions raised were unable to be answered by the management present due to information not being disseminated from above. Every statement and statistic in the proposals need s investigating minutely as in the days between the draft being published 20th June and the Information and technology Business case Report being published 22nd June, H + W EOC seem to have lost 5 control staff. A head count confirmed the original figure of 28 is indeed the correct figure. The Board needs to be fully confident that every fact and figure can stand up to public scrutiny. At the end of the consultation period, if it goes ahead, the people of H + W need to know the decision was reached on the consideration of immaculately researched facts.

At H + W we feel unable to commend the proposals in the draft document as we feel the information within is too low on established facts and too high on wishful thinking.