The London-based Ambulance Service NHS Trust has been placed into special measures following sub-par financial performance.
This is the first example of an ambulance service being placed into this emergency status.
The decision follows the recommendation of inspectors, with slow vehicle response times highlighted as a particular concern.
This particular NHS trust serves an estimated 8.6m people in the capital and has been performing “poorly” since March 2014.
Meanwhile, the cost of housing in London is seemingly impacting significantly on the potential of the service to recruit paramedics.
Prof Sir Mike Richards, chief inspector of hospitals, explained his decision. “I am recommending that London Ambulance Service be placed into special measures, because I believe that this is the step necessary to ensure this vital service gets the support it needs to improve. The trust has been performing poorly on response times since March 2014. This is a very serious problem, which the trust clearly isn’t able to address alone, and which needs action to put right.”
The inspection of the NHS trust was carried out by the Care Quality Commission, with the organisation having commenced the report back in June.
Poorly trained staff became evident during the inspection, while a lack of equipment was also conspicuous.
The Care Quality Commission was further alarmed by an apparent culture of harassment and bullying that was endemic within the trust.
Commenting on the findings of the Care Quality Commission, the Chief Executive of the trust offered some contrition.
Dr Fionna Moore, stated: “We would like to apologise to Londoners and say how sorry we are that we haven’t come up to the standards they should expect of us and we are working really hard to address those issues.”
While assessing the trust, the aforementioned Prof Richards acknowledged that patients often received good care once they had arrived at the hospital.
Clearly recruitment issues were a major part of the issues facing the trust, and despite the fact that 167 new members of staff have been recruited, this looks to be an ongoing issue.
Indeed, until 2014 the trust was ranked as the best performing service in the country for dealing with emergency category A calls.
The GMB union defended the trust against accusations of incompetence.
GMB union national officer, Rehana Azam, said: “The underlying problem is a shortage of staff. There is a seriously high vacancy rate in the LAS and other ambulance services. We are pleased the CQC identified this and perhaps now it can be addressed in full. As a result of staff shortages, existing staff have had to shoulder more responsibility.”
As it becomes more obvious that funding is a massive issue in the NHS, similar problems to the London-based trust are likely to emerge on a regular basis.
A ruling by the European Court of Human Rights could affect the daily working life of healthcare professionals across the UK.
The new ruling states that travelling from home to first client, patient or customer and home from the last one at the end of shift, should be considered as working time to be paid for by employers.
Unions that have been campaigning for the decision have welcomed the initiative by the European Court of Justice, which will have an impact on workers who travel on a regular basis in a wide variety of industries.
This legislation had been particularly strongly lobbied for by GMB, the union for British Gas, AA, meter readers and home care workers, and the union has naturally welcomed the European court judgement.
Speaking on the subject, Kathleen Walker Shaw, GMB Europe Officer, said “GMB welcomes today’s judgment by the Court of Justice of the European Union as important confirmation that the journeys made by workers without fixed or habitual place of work between their homes and the first and last customer of the day constitute working time.”
Aside from those carers who regularly provide care to people in their homes, the decision could also have a significant impact on GPs.
Central to the court’s decision was the fact that workers are generally facing more changes in their working practices and environment, and journeys made to and from work are often not the choice of the employee.
The Court of Justice acknowledged that in many cases workers were forced to take on new working patterns that were significantly detrimental to them, and that they should receive some form of remuneration for this time and inconvenience.
It was also noted in the court decision that the verdict of the European Court was in line with the Working Time Directive and its principles.
The Working Time Directive provides all workers with the right to a minimum 28 days of paid holidays each year, a 20-minute rest break after six hours work, and rest of at least 11 hours in any 24 hours. Restrictions are also legislated for regarding evening work.
Commenting on the importance of the Working Time Directive, Shaw added:
“The Working Time Directive is not ‘red tape’ as the CBI asserts. It was brought to combat the dangers of excessive hours to workers and the public. It is not only workers without fixed and habitual places of work who will benefit from this judgment today, but all workers in Britain and the EU.”
With David Cameron having announced his intention to introduce a seven-day working culture in the NHS, the decision made by the European court may impact significantly on healthcare workers all over the country.
It would seem that healthcare professionals will have to show increasing flexibility if these plans come to fruition, and there will be a relief among many that they can at least count upon claiming journeys at the beginning and end of the day as paid work.
The British Medical Association has frequently warned that it is not uncommon for junior doctors to work 100 hour weeks.
Members of the GMB are seeking assurances that managers who submit resignations will not receive compensation.
There are concerns among the trade union that golden handshakes or other forms of pay-off could be offered to resigning managers, damaging trust in the NHS.
The hierarchy of the GMB has made it clear that members believe managers being rewarded for what are deemed “dismal failures” should be considered completely unacceptable.
Speaking on behalf of union members, Gary Palmer, GMB Organiser, pointed out that members were far from happy with current managerial proposals.
“Concerns that any further management who resign could receive golden handshakes, has resulted in GMB members calling for complete clarity around NHS money funding any potential pay-offs in rewarding such dismal failures by those entrusted to manage the NHS Trust on our behalf,” Palmer asserted.
In addition to the concerns about the managerial culture in the NHS, GMB members are also calling upon East Sussex Healthcare NHS Trust to clarify a particular issue.
There have been strong rumours that the Trust will be placed into special measures potentially as soon as later this month.
East Sussex Healthcare NHS Trust includes both the Conquest and Eastbourne District General hospitals.
Should this move come to fruition, it would represent just a six-month gap since the Care Quality Commission (CQC) graded the Trust with an inadequate rating.
The CQC found that there were significant failures in the quality of care offered by the trust, with hospitals failing to deliver adequate service in a number of key areas.
It was noted that hospitals under the care of this trust were particularly culpable with regard to the critical area of safety and management.
And it is thought that this played a major role in the resignation of Chief Executive Darren Grayson earlier this year.
Speaking passionately on this issue, the aforementioned Palmer outlined the strength of feeling on the matter within the membership of the GMB union.
“GMB members and staff are shocked and understandably angry that not only have the Trust management put patients and services at risk to a point that placing the Trust into special measures could be required to finally turn things around, but that those responsible for the troubles at the Trust, namely the senior management team including Stuart Welling, could potentially be recipients of substantial NHS pay offs if they choose to resign as a result,” Palmer stated.
With the issue clearly provoking strong feeling among NHS staff in the region, this would seem to be an issue that will run and run in the coming months.
GMB, the union for care home staff, has supported a warning from Britain’s biggest providers of care homes for the elderly that cuts to public funding for residents are potentially damaging and homes will close if the situation does not improve.
The warning that the system is in crisis comes from Four Seasons, Bupa and HC-One – the three largest operators in the UK’s £24bn care home market – and has been made amid growing concerns about health and social care funding ahead of the general election in May.
According to data compiled by Age UK (the UK’s largest charity for older people) the Government cut its spending on care homes for the elderly by nearly a fifth between 2010 and 2014.
Chai Patel, chairman of HC-One, said the cuts “risked damaging our health and social care system irreparably.”
However, the Department of Health has said it had taken steps to protect social care services by giving an extra £1.1bn to councils.
“GMB support the warning from the three operators that the system is in crisis”, said Justin Bowden, GMB national officer for social care. The repeated warnings from GMB that Southern Cross would collapse were ignored again and again by government.
“Warnings that the entire care sector is in a slow motion collapse, albeit for different reasons to Southern Cross, are falling on the same deaf ears. If we are not prepared to learn the lessons of history, we are destined to repeat them.”
It is expected that demand for care home places will increase over the next 50 years, with the number of over-65s forecast to rise from 10.6m in 2010 to 16.1m in 2035.