Paramedics taking tens of thousands of days a year off sick with stress

Paramedics are taking tens of thousands of days a year off sick with stress, as growing numbers of 999 calls add to the pressure on NHS ambulance services.

The number of days being lost to paramedics having time off work because they are struggling with stress, anxiety or other mental health conditions is rising, official figures show.

Statistics have revealed that paramedics working for seven of England’s 10 NHS regional services have been signed off sick with such ailments for 183,962 days in the last four years.

In all, 35,872 days were lost for that reason in 2013-14; that went up to 41,412 in 2015-16. Figures for the first nine months of 2016-17 suggest last year’s total will be even higher.

Paramedics and health unions claim staff shortages, pressure to meet 999 response targets, routinely long shifts lasting up to 15 hours and the emotional toll of dealing with sick patients and their families are behind the trend.

There is concern that stress leave is exacerbating the existing pressures on ambulance services’ ability to respond fast enough to the increasing number of emergency calls at a time when vacancies and early retirement are widespread.

“Paramedics provide life-saving care, often in stressful circumstances, but the blue lights flashing right now are for the ambulance service. It is unacceptable that such high levels of stress are now seen as part of normal life for ambulance staff,” said Tim Farron, the leader of the Liberal Democrats, who obtained the figures under freedom of information laws.

“The things paramedics see and have to deal with on a daily basis must keep people up at night. We need to do more to care for those who care for us”, he added.

The London ambulance service has lost the most paramedic days through stress. It lost 11,911 days to it in 2013-14 but that rose to 12,215 in 2015-16 and then again to 14,447 in the first nine months of 2016-17 alone.

The South-East Coast ambulance service’s figures rose from 5,659 to 6,366 figures, and the South West’s from 4,162 to 5,228, over the same period. Only the West Midlands service saw a significant fall in its numbers in that time.

“Ambulance services are haemorrhaging staff, and struggling to hire new recruits. That puts extra pressure on those left behind with crews having to work very long shifts,” said Alan Lofthouse, Unison’s national ambulance officer, who is a former paramedic.

“Rising demand on 999 services means patients wanting not just emergency treatment but also medical care as they can’t see their GPs. Overstretched A&E departments with long waits to hand over patients, abuse and threats of violence from motorists, relatives or under the influence casualties. It’s no wonder ambulance staff are having to take time off for stress.”

The true figures for England as a whole will be a lot higher as the North West, Yorkshire and South Central ambulance services did not provide any figures.

A survey of ambulance staff undertaken by the union Unite last year found that 89% of ambulance staff said that morale and motivation in their workplace was falling and 88% identified stress as the main reason for that. In the same poll 91% of the 362 ambulance crews questioned said their workloads were growing and 85% said they worked beyond their contracted hours.

Meanwhile, Labour claims NHS England’s plan to significantly relax the requirement on hospitals to treat 92% of patients waiting for an operation within 18 weeks may be illegal.

Labour has challenged the health secretary, Jeremy Hunt, to set out the legal basis for dropping a commitment on waiting times that is enshrined in the NHS constitution.

The move, announced on Friday, prompted widespread criticism from medical groups.

Paramedics taking tens of thousands of days a year off sick with stress

Paramedics spend 500,000 hours outside busy A&Es, say auditors

Paramedics last year spent 500,000 hours outside hospitals with a patient in the back of their ambulance because A&E staff were too busy to accept them, an official inquiry has revealed.

That was the equivalent of 41,000 12-hour ambulance shifts being taken up with waiting instead of crews being able to attend to other emergencies, according to a report by the National Audit Office.

Ambulance crews are meant to take no more than 15 minutes to hand over a patient to A&E staff and another 15 minutes to prepare their vehicle to get back on the road. “Each failure to meet this standard results in a poor experience for the patient and a delay in an ambulance crew being available for a new emergency call,” the report says.

Last year just 58% of ambulances transferred their patient within 15 minutes and 65% were ready to leave a quarter of an hour later.

All but one of the 10 NHS regional ambulance trusts are breaching 999 call response targets, services are desperately short of paramedics and funding has not kept pace with a surge in the number of patients who need an ambulance.

The NAO report says: “Ambulance services are finding it increasingly difficult to cope with rising demand for urgent and emergency services. Introducing new models of care has helped but there are signs of stress, including worsening performance against response time targets.”

Ambulances are meant to arrive at the scene of 75% of Red 1 and Red 2 calls within eight minutes. Red 1 calls involve life-threatening emergencies such as patients who have suffered a cardiac arrest, are not breathing and do not have a pulse. Red 2 calls are less immediately time-critical but involve events such as a heart attack or stroke. Green 1 calls have a target of 20 minutes.

In 2015-16 the West Midlands ambulance service was the only one of the 10 trusts in England to meet the three main targets, the NAO found.

The NAO flags up a 10% vacancy rate for paramedics, and ambulance trusts’ difficulties in retaining staff, as obstacles to tackling what it describes as “significant challenges”.

It says the ageing population, growing number of patients with alcohol or mental health problems and lack of health services outside hospitals all help to explain the rapidly growing demand for care. The number of calls to ambulance services and transfers from the NHS 111 telephone advice service rose from 7.9m in 2009-10 to 10.7m in 2015-16 – an average year-on-year increase of 5.2%.

Phil McCarvill, deputy director of analysis at the NHS Confederation, which represents NHS trusts including ambulance services, said underfunding elsewhere in the health and care system was a key reason ambulance trusts were under pressure.

“Our highly skilled and dedicated ambulance personnel are working incredibly hard to make sure people get the right care where and when they need it, but they are having to respond to unprecedented demand for health and care services,” he said.

“If we are to relieve the current pressures on ambulance services, we also need to see the right balance of resources going into community, primary care and social care.”

Norman Lamb, the Liberal Democrats’ health spokesman, said: “The health secretary says he wants to make the NHS the safest healthcare system in the world, but these figures show patient care and safety is being severely compromised.

“When thousands of patients are stuck outside A&E departments, ambulances can’t get to other emergencies on time. People suffering from serious conditions such as a stroke will be left with serious disabilities and other life-long problems, and there is a serious risk of lives being lost because emergency calls are delayed.”

Case studies

Rachel, Newcastle upon Tyne: “I was ordered an ambulance by NHS Direct due to a suspected brain haemorrhage. My boyfriend offered immediately to drive me to A&E but they insisted on sending an ambulance, and he was told to wait outside ready to receive the paramedics. Forty-five minutes later we were still waiting, and when we were able to speak to someone we were told that it was in the system but hadn’t been dispatched yet.

“We drove to hospital and were seen immediately. Given that we offered to drive from the outset, it was an unnecessary delay and, had the ambulance arrived, would have been an unnecessary journey.”

Paul Baggaley, Newark: “I came across a pedal cyclist lying in the road after falling off his bike on a slippery surface. A young carer stopped with us and called for an ambulance after five minutes of convincing him that he needed to be seen by hospital. He had injuries and a broken helmet after cracking his head on the road. After coming back to his senses he informed us of two spinal operations he had suffered so we didn’t move him. We kept him warm with blanket and kept him talking.

“After 20 to 30 minutes I rang 101 for police assistance to help with traffic. They arrived in 15 to 20 minutes. We stayed 20 minutes then had to leave. After we had done what we had to do, we came back past that way and still no ambulance. He was lying on the cold ground for over an hour.

“The East Midlands ambulance service is the poorest performing service in the country and things seem to be worst where we are because we are 23 miles from the nearest A&E and so ambulance service is continually stretched.”

Paramedics spend 500,000 hours outside busy A&Es, say auditors

NHS paramedics to get pay rises of at least £4,400

Paramedics are set for pay rises worth at least £4,400 from the Department of Health and NHS Employers amid trade unions’ concerns that their members were not being paid properly for their life-saving work.

About 12,000 of the health workers – who are trained in emergency medical care and first aid, but not to the level of a qualified doctor – will be affected by the agreement, which will increase starting salaries from £21,909 to £26,302.

Under the terms of the deal, most paramedics, including ambulance crews, will move up the pay scale. However, union leaders have warned that the change may not be enough to staunch a steady drain of workers leaving the ambulance service.

While Christina McAnea, the Unison union’s head of health, backed the new pay deal, she added: “The banding issue alone may not solve the drain of paramedics from the ambulance service, but it will certainly make it a little easier for trusts to hold on to experienced staff.”

The pay rise comes as the UK faces a critical shortage of paramedics, which has left at least one trust paying £30 an hour for agency staff – almost double the rate given to staff workers – and another seeking permission from immigration officials to poach 250 workers from Australia and New Zealand.

Paramedics have reported working under tremendous pressure as a result of increasing demand and a healthcare system battered by cuts. Many say they continue working well past the end of their 12-hour shifts, and rarely get meal breaks. At the end of 2015, a survey of 3,200 paramedics, commissioned by the GMB, Unison and Unite unions, found that three-quarters said they were planning to quit the NHS.

The DoH said the deal had been the result of several years’ negotiation between government officials and unions to thrash out how best to recruit and retain ambulance staff. It goes hand in hand with plans to modernise the role of paramedics, including expectations that they will carry out more treatment at the scene of emergencies, and take patients to medical centres other than hospitals, a spokesman said.

He added that 2,200 more paramedics had been recruited since 2010, and the number of training contracts had been increased by 60%.

Jeremy Hunt, the health secretary, said: “In recognition of their increased responsibilities, we have agreed to look at rebanding around 12,000 paramedics where their job description matches the requirements of the new band six profile, moving them up the pay scale and making sure we are able to better recruit and retain paramedics in the future to ensure patients will continue to get the very best care.”

Sharon Holder, national officer of the GMB general trade union, said: “GMB has campaigned for many years to ensure all ambulance staff receive fair pay. This agreement is a step in the right direction.

“The GMB is pleased the Department of Health has finally realised paramedics need to be paid properly.”

• This article was amended on 9 December 2016 to correct the assertion that the government accepted paramedics were not being paid enough. The Department of Health says this is not the case.

NHS paramedics to get pay rises of at least £4,400

Paramedics to be skilled as GPs

Controversial proposals will see already overstretched paramedics provided four months education to become GPs.

Below the programs the paramedics will see sufferers out-of-hours, prescribe medicines and carry out appointment, the Everyday Mail has reported.

Up to 800 paramedics will be capable to qualify for the new function of an independent prescriber.

The proposals have been announced by NHS England.

It comes amid a shortage of GPs and the paramedics would be stationed in neighborhood surgeries.

The programs, which will be run at universities, could start subsequent yr.

• Calls for much more paramedics as NHS 111 service denies sufferers ambulances

Katherine Murphy, chief executive of the Patients Association, informed the paper it would location “massive extra responsibilities” on paramedics.

Dr Chaand Nagpaul, chair of the British Medical Association’s GP committee, extra: “We must not compromise patient care through short cuts and quick fixes.”

Last month an investigation by the Telegraph revealed that patients who call the NHS 111 helpline are becoming denied ambulances.

The head of the Commons Overall health Choose Committee has urged the NHS to secure a lot more paramedics.

Dr Sarah Wollaston stated the undercover probe highlighted “the essential dilemma of unfilled paramedic vacancies” as she named on Jeremy Hunt, the Well being Secretary, to prioritise staffing numbers nationwide.

She explained it was only appropriate that the “serious allegations” manufactured by this newspaper have been investigated.

The 111 service was set up as a non-emergency option to 999 to relieve strain on the well being technique, like A&ampE departments. Get in touch with centre personnel are anticipated to dispatch ambulances if individuals describe symptoms of a significant illness.

Nonetheless, amid a shortage of paramedics, contact handlers are getting put underneath pressure not to send out ambulances at particular occasions.

Paramedics to be skilled as GPs

Volunteer paramedics face street visitors prosecution despite "seeking to do good"

Lady Justice Rafferty, sitting with Mr Justice Jay in London, mentioned she was saddened that medically skilled volunteers “seeking only to do good” had been efficiently constrained.

On Oct 14, 2012, the two men attended an accident at 8.17pm involving a car and motorcycle on the outskirts of Bury.

They recognized themselves to police as Hatzola Quickly Response personnel and have been allowed to give health care care just before an NHS ambulance arrived eight minutes later on.

The two men have been then told they would be reported for utilizing “blues and twos”.

At their original trial, District Judge Richardson was told that the Hatzola crew originated in America about 40 many years ago with the objective of saving lives. It has since spread to Britain.

It aims to give emergency very first help cover in defined locations, such as Salford and components of Bury, mainly but not exclusively for the Jewish neighborhood. In Salford there are 20 Hatzola members, ten of whom are skilled paramedics, such as Mr Issler and Mr Bamberger.

Their typical response time is “under two minutes”, compared with 7 to 10 minutes for NHS ambulances, the court was informed.

Their massive vehicles can carry health-related products, including defibrillators, oxygen and neck braces, as effectively as dressings and some medication.

Judge Richardson stated Hatzola’s 24-hour-a-day care was funded by voluntary contributions from the Jewish neighborhood.

“I discovered Hatzola to be a responsible, devoted and public-spirited organisation with properly-qualified and motivated operatives, of whom the defendants were two,” he stated.

He acquitted each men of the traffic charge, saying their cars had been getting “used for ambulance purposes”.

But the High Court judges ruled on Wednesday that his choice was incorrect. They agreed “with regret” that the appeal must be allowed.

Mr Justice Jay stated road traffic legislation did not supply an exemption for “first responder” voluntary organisations such as Hatzola to escape the restrictions on the use of “blues and twos”.

Edited by Andrew Marszal

Volunteer paramedics face street visitors prosecution despite "seeking to do good"