A Report of Peoples Experience
of West Midlands Ambulance
Services
Contents
Page
1. Executive Summary 3
2. Reason for Report 4
3. Regional Context 4
4. Method 5
5. Findings 5
5.1 The initial call 5.2 Vehicle arrival time 5.3 Staff and equipment 5.4 Unstructured questions
6. Conclusions 11
7. Recommendations 11
8. Follow up 11
9. References 11
Appendix 1 - WMAS Survey Sep 2014
Appendix 2 - Ambulance chiefs hit back at cuts claim-Solihull Observer, Chris Smith Wednesday 10 July 2013 Updated: 11/07
1. Executive Summary 1.1 Introduction
Healthwatch is the consumer champion network for health and social care services as set out in the Health and Social Care Act 2012.
Healthwatch works at a local and national level, it is a statutory body and a key feature of the function of the Health and Well Being Board. Healthwatch Solihull will listen to all views and enable local voices to be heard by taking them to policy makers, commissioners,
stakeholders, providers and regulators. This report is independent and is reflective of those views.
‘Healthwatch Solihull exists to ensure that there are improvements in health and social care services for local people by providing a voice for local people that influences decisions and increases choice.’
1.2 Key Findings
Base on the survey of 35 people we found:
51% of the calls were made by a caller other than the patient.
80% of people believed that the call taker listened to all of the details carefully 43% of people for the attendance vehicle response time very acceptable, 43% found it acceptable and 14% fairly acceptable with no one indicating unacceptable or very unacceptable response times.
97% of people rated the attending staff as very professional with 3% as a little improvement necessary and no one recording unprofessional.
Additionally 68% of people stating that were “very satisfied” with the service received, 26% found it satisfactory, 3% fairly satisfactory and 3% unsatisfactory with no one recording very unsatisfactory.
The overall responses to the unstructured questions allowed for a narrative to briefly understand the specific events and possible impact especially in the individual cases where the service had been less than satisfactory. These generally reflected the tone of the structured questions.
1.3 Recommendations
For Healthwatch Solihull to continue to engage with West Midlands Ambulance senior staff to monitor progress of the community ambulance station deployment throughout the borough. For West Midlands Ambulance to actively keep the boroughs residents informed about the deployment of the community ambulance stations through the media and key organisations and evidence the improvements in service and outcomes as a result.
2. Reason for this report
Following newspaper reports in the second half of 2013 regarding the closure of Solihull ambulance station Healthwatch became aware that people were becoming concerned about a perceived reduction in service. To understand the full context of the reports and ensure people were more fully informed Healthwatch Solihull put on a public event in November 2013 where the regional manager of WMAS presented the “Transformation” project including the “Make ready” hub in Erdington and the “Dynamic deployment” of double manned
ambulance and fast responder vehicles in the borough.
It was reported (2) … that “Instead of two stations in the borough of Solihull, the other being
in Chelmsley Wood, the trust will end up with five - at Solihull Fire Station and four new bases in Chelmsley Wood, Shirley, Dorridge and Olton.”
“These community ambulance stations will be smaller but placed in statistically the places where we are most likely to get calls which means we can respond to them more quickly. “When available, ambulances will standby at any of these five stations.”
In this context Healthwatch Solihull and other stakeholders were advised about the planned positioning of the community ambulance stations providing several local vehicle bases in the borough. Healthwatch Solihull continued to hear individual concerns and in the light of difficulties locating community ambulance stations Healthwatch Solihull ran a second event in June 2014 focussed on the Knowle, Dorridge and Bentley Heath area which is at the
furthest point from The Hub and experiencing difficulties obtaining permissions to locate the local facility. Healthwatch Solihull has continued to engage with the WMAS and now received an update advising that planning permissions are granted to locate a double manned
ambulance at Knowle and work will soon commence to locate a crew at Solihull Hospital. Healthwatch has therefore undertaken a brief survey of people’s experiences of West Midlands Ambulance services to provide a person centred perspective for presentation to Joint Health Overview and Scrutiny Committee.
3. Regional Context
West Midlands Ambulance serves a population of 5.36 million people covering an area of more than 5,000 square miles made up of Shropshire, Herefordshire, Worcestershire, Staffordshire, Warwickshire, Coventry, Birmingham and Black Country conurbation.
The West Midlands is full of contrasts and diversity. It includes the second largest urban area in the country (Birmingham, Solihull and the Black Country) yet over 80% of the area is rural. It is the second most ethnically diverse region in the country after London.
West Midlands Ambulance Service responds to around 3,000 '999' calls each day. They employ approximately 4,000 staff and operate from 16 new fleet preparation hubs across the region and a network of over 90 community ambulance stations. (1)
4. Method
A survey was constructed to gain peoples experiences and satisfaction using similar criteria to the WMAS Emergency Patient Survey with additional opportunity for people to tell us how the service worked for them and service improvement suggestions as a simple story/narrative. A variety of establishments were identified as having a potential for repeated or regular requirement for ambulance services. These were located in the north and the south of the borough including residential homes, sheltered housing, Warden controlled housing, private individuals living at home unassisted, learning disabled and Dementia support and carers support groups. The majority of people surveyed were senior citizens however we have also sought to include younger people and specifically approached organisations supporting all age groups.
Response times is often raised as a concern by people. It is understood that the response times / priority following a call may differ dependent upon the assessed risk (ie if a GP or suitably qualified professional is present then attendance may be a lower priority than where a vulnerable person in alone) therefore the acceptability of the time for a vehicle to arrive was used as the criteria for people’s views and is more helpful than stating the actual times in this context.
A total of 35 surveys were completed by either the patient or caller. The survey is attached in Appendix 1
5. Findings 5.1 The initial call
51% of the calls were made by a caller other than the patient. In the majority of these cases the caller was a professional based in a sheltered housing/supporting living or care home environment. It is logical to assume therefore that the professional will have made similar calls in the past and hence able to assess by experience the response of the call taker. Our survey shows and 80% yes to the question 4 (Q4 Did the ambulance call taker listen to all your details carefully?) with only 1 person stating no. The remaining answers stating “can’t
5.2 Vehicle arrival time
The key issue for many people is the length of time it takes for an ambulance (or paramedic) to arrive on site. As stated above It is understood that the response times / priority following a call may differ dependent upon the assessed risk (ie if a GP or suitably qualified
professional is present then attendance may be a lower priority than where a vulnerable person in alone) It is also possible that unless the caller is consciously measuring and
recording time that an inaccurate figure of the actual time may be stated. The acceptability of the time taken is therefore a more suitable measure for a vehicle to arrive and was used rather than stating the actual times in this context. The graph below shows 43% of people for the attendance vehicle response times very acceptable, 43% found it acceptable and 14% fairly acceptable with no one indicating unacceptable or very unacceptable response times.
5.3 Staff and equipment
We also found that people viewed the overall cleanliness of the equipment, professionalism of the staff, respect for dignity offered by the staff all rated highly in people’s opinion with 97% of people rating the attending staff as very professional, 3% as a little improvement necessary with no one recording unprofessional. Additionally 68% of people stating that were “very satisfied” with the service received, 26% found it satisfactory, 3% fairly satisfactory and 3% unsatisfactory with no one recording very unsatisfactory.
The overall tone of the unstructured questions when relating to the staff / on site attendance is largely appreciative and satisfied. Comment such as the ones below illustrate this.
“Dispatcher very helpful and understanding, ambulance crew efficient, caring and supportive.” And “Particularly well, I fell and fractures my femur. A paramedic arrived within 5 minutes, checked details and called an ambulance which also arrived very quickly.” The statements illustrating unsatisfactory service seem to relate to the use of volunteer responders with less scope to make on site medical decisions.
“Fell at around 1.00pm, left at 3:30ish An 88 year old resident at our independent
retirement complex had fallen outside (summers day).it was clear to me as a first aider & manager that her ankle /foot was in the wrong position. 2 calls before volunteer emergency responder. He then had to wait for an ambulance to come and assess for them to say she needed hospital.”
“send people out who are able to make decisions about the need for further treatment & implement them. Waste of time for 2nd crew needing to come out and re-assess.”
5.4 Unstructured Questions
I addition to the structured questions we also asked two unstructured or open questions. These were:
Q17 Please tell us how you think this service worked for you and Q18 What do you suggest could be done to make this service better?
The overall responses to these questions generally reflected the tone of the structured questions however it was then possible to briefly understand the specific events and possible impact especially in the individual cases where the service had been less than satisfactory. All the collected comments are listed in the full survey printout in Appendix 1 attached. Comments such as “Very ill and ended up in intensive care” and “The pain I was in from a water infection. I don't think I would have got to hospital without their help.” Illustrate the vital importance of the service.
The following is an extract of the comments from people who received a less than satisfactory service (in part).
The comment below relates to a situation after the closure of Solihull Ambulance station and we believe illustrates the concerns people had (or possibly still have) that without the
about possible delays in ambulance / responder arrival times whether or not response times have altered compared with before the Solihull Ambulance Station closure.
“I thought the service worked well but on some occasions it was a little slow when they shut down the ambulance station. It did take longer for ambulances to get here as they came from Bartley Green / Handsworth.”
“After the paramedic crew arrived, had to wait 2 hours for an ambulance due to more serious cases taking priority. This happened twice, and sure everything could be done better.”
“Fell at around 1.00pm, left at 3:30ish An 88 year old resident at our independent
retirement complex had fallen outside (summers day).it was clear to me as a first aider & manager that her ankle /foot was in the wrong position. 2 calls before volunteer emergency responder. He then had to wait for an ambulance to come and assess for them to say she needed hospital.”
“send people out who are able to make decisions about the need for further treatment & implement them. Waste of time for 2nd crew needing to come out and re-assess.”
6. Conclusions
6.1The survey responses show a high level professionalism and care of the ambulance crew and staff as viewed by the patient or caller.
6.2The earlier publicity about ambulance station closure may still be causing some people to be anxious about possible delays in ambulance / responder arrival times whether or not response times have altered compared with before the Solihull Ambulance Station closure.
6.3There was some frustration where a paramedic or volunteer attended site to then have to further call an ambulance.
7. Recommendations
7.1 For Healthwatch Solihull to continue to engage with West Midlands Ambulance senior staff to monitor progress of the community ambulance station deployment throughout the borough.
7.2 For West Midlands Ambulance to actively keep the boroughs residents informed about the deployment of the community ambulance stations through the media and key organisations and evidence the improvements in service and outcomes as a result.
8. Follow up
8.1 For Healthwatch Solihull to repeat this survey shortly after the deployment if the completion of the deployment of the community service stations throughout the borough.
