999-men question priorities of mercy service

Since the fire, ambulance staff have claimed a lack of paramedics is symptomatic of an emergency service in crisis.

Assistant news editor ADRIAN WORSLEY visited Lancashire Ambulance Service headquarters to put ambulance crews' concerns to bosses.

AS the horrific drama of the fatal house fire in Hapton became apparent to ambulance crews at the scene, an altogether different version of events was being played out 20 miles away at ambulance headquarters.

Flashing up on screen as an 'amber' or Category B emergency, the tragic events at Lancaster Drive were followed by control room staff at Broughton, near Preston.

'Persons reported' told the control room that three people - in this case Louise Waddington, 11 and her sisters Hayley, 10 and Gemma, seven - were reported trapped in a house fire.

Also recorded in a visual log of the terrible events of the night of Friday, February 6, is confirmation that only one paramedic attended what quickly became a triple fatal fire.

Four technicians and one trainee technician also manned the three ambulances that were at the scene in under eight minutes - the government target for Category A emergencies.

But it is this shortage of paramedics at one of East Lancashire's worst tragedies that has prompted many staff, including members of the Ambulance Service Union, to question the priorities of Lancashire Ambulance Service.

A regional spokesman for the ASU, which was formed in 2000 and now boasts 210 members out of a 450 plus workforce in Lancashire, said the fact the Hapton tragedy was classified as an amber - instead of a red - incident symbolises what is currently wrong with the service.

He said: "How can three children die in a house fire and that be classified as an amber job?

"It should have been red, or Category A. The service has lost sight of what it is all about. There is no point in meeting government targets if you send the wrong resources.

"Why do we have targets for getting to emergencies, but no set standards on what to do when we get there?"

In a bid to answer this and other concerns from union members, the Lancashire Evening Telegraph spoke to Lancashire Ambulance Service's director of human resources Peter Cooney.

These are his answers:

QHow often do ambulances leave stations without a paramedic?

AWe are currently six down on the number of paramedics we should have in East Lancashire. Therefore, ambulances do sometimes go out without paramedics. We have around 19 ambulances in East Lancashire as well as 71 paramedics and 86 technicians, who operate on a shift system. The current problem is caused by the recent recruitment of 50 trainee technicians, which is more than usual. Therefore we're playing catch-up until they are trained as technicians, then paramedics.

QWhat kind of training do technicians have?

AContrary to what some people think, technicians are not just paramedics' mates. In fact, the two roles are largely interchangeable.

Our technicians have to undergo a 10-week training programme in advanced First Aid, trauma and support. They are taught how to lift patients, administer drugs orally, carry out defribulation and emergency resuscitation. They then complete a three-week driving course.

After that they have a 12-month probation period, working under the supervision of a paramedic. When that's finished they are assessed to see if they are suitable to qualify as a technician.

To become a paramedic they then have to complete another year as a qualified technician and a 12-week course, including eight weeks in school and four on placement in an A&E department.

Paramedics are then trained in cardiac care, intubation - supporting breathing my inserting a tube down the throat - and administering IV drugs. The similar skills in the two roles are reflected in the amount of money it costs to train them - £7,000 per technician and £8,000 per paramedic. Also, in the respective salaries - £21,578 for technicians and £22,693 for paramedics.

QIf technicians are so highly trained, why does the government recommend every ambulance has a paramedic?

ABecause they have extended skills, particularly in cardiac areas. They can also prescribe a wider range of medicines without GP's permission.

QDo you classify life-threatening jobs as less urgent to meet government targets?

AAbsolutely not. The category of each job is set in stone by the computer system we have in the control room. For instance a caller says there is someone trapped in a house - that is automatically declared a Category B job when it's typed into the system. We are set targets. We have to reach red incidents in eight minutes and amber jobs in 19 minutes, but we would never manipulate incidents to achieve that.

QCan ambulance trusts alter the category of jobs?

AYes, but only to add more Category A incidents to a list that already contains around 45 jobs, many of them cardiac related. We cannot, under any circumstances, downgrade incidents to Category B at our own discretion. It simply can't be done.

QAre there occasions when ambulance crews don't cover nearby incidents because they are waiting for more serious jobs?

AYes, that does sometimes happen. There are parts of our operational plan that protects our ability to respond to Category A incidents, and that can include reserving some vehicles. If we had all ambulances responding to every call irrespective of seriousness, what do you have in reserve if there is a major trauma?

So, it might be the case that one ambulance on its way to a Category B job could pass a parked ambulance waiting for a Category A incident.

QUnions claim morale is at rock bottom. Is this true?

AIt is a major strength of the service that ambulance crews are usually from the local area so they end up serving their own communities, sometimes even their own families.

It's not surprising therefore that ambulance staff genuinely want improvement - they are not raising issues for the sake of it.

However, some if them cannot understand why central decisions are made. They can't see the bigger picture.

QIs deploying three ambulances with only one paramedic acceptable?

AI was disappointed that this was the case during the Hapton fire.

I am not happy that we are a number of paramedics down at the moment, but that doesn't mean we have abandoned our standards.

AS the horrific drama of the fatal house fire in Hapton became apparent to ambulance crews at the scene, a different version of events was being played out 20 miles away at ambulance HQ.

Flashing up on screen as an 'amber' or Category B emergency, the tragic events at Lancaster Drive were followed by control room staff at Broughton, near Preston.

'Persons reported' told the control room that three people - in this case Louise Waddington, 11 and her sisters Hayley, 10 and Gemma, seven - were reported trapped in a house fire.

Also recorded in a visual log of the terrible events of the night of Friday, February 6, is confirmation that only one paramedic attended what quickly became a triple fatal fire.

Four technicians and one trainee technician also manned the three ambulances that were at the scene in under eight minutes - the government target for Category A emergencies.

But it is this shortage of paramedics at one of East Lancashire's worst tragedies that has prompted many staff, including members of the Ambulance Service Union, to question the priorities of Lancashire Ambulance Service.

A regional spokesman for the ASU, which was formed in 2000 and now boasts 210 members out of a 450 plus workforce in Lancashire, said the fact the Hapton tragedy was classified as an amber - instead of a red - incident symbolises what is currently wrong with the service.

He said: "How can three children die in a house fire and that be classified as an amber job?

"It should have been red, or Category A. The service has lost sight of what it is all about. There is no point in meeting government targets if you send the wrong resources.

"Why do we have targets for getting to emergencies, but no set standards on what to do when we get there?"

In a bid to answer this and other concerns from union members, the Lancashire Evening Telegraph spoke to Lancashire Ambulance Service's director of human resources Peter Cooney.

These are his answers:

QHow often do ambulances leave stations without a paramedic?

AWe are currently six down on the number of paramedics we should have in East Lancashire. Therefore, ambulances do sometimes go out without paramedics. We have around 19 ambulances in East Lancashire as well as 71 paramedics and 86 technicians, who operate on a shift system. The current problem is caused by the recent recruitment of 50 trainee technicians, which is more than usual. Therefore we're playing catch-up until they are trained as technicians, then paramedics.

QWhat kind of training do technicians have?

AContrary to what some people think, technicians are not just paramedics' mates. In fact, the two roles are largely interchangeable.

Our technicians have to undergo a 10-week training programme in advanced First Aid, trauma and support. They are taught how to lift patients, administer drugs orally, carry out defribulation and emergency resuscitation. They then complete a three-week driving course.

After that they have a 12-month probation period, working under the supervision of a paramedic. When that's finished they are assessed to see if they are suitable to qualify as a technician.

To become a paramedic they then have to complete another year as a qualified technician and a 12-week course, including eight weeks in school and four on placement in an A&E department.

Paramedics are then trained in cardiac care, intubation - supporting breathing my inserting a tube down the throat - and administering IV drugs. The similar skills in the two roles are reflected in the amount of money it costs to train them - £7,000 per technician and £8,000 per paramedic. Also, in the respective salaries - £21,578 for technicians and £22,693 for paramedics.

QIf technicians are so highly trained, why does the government recommend every ambulance has a paramedic?

ABecause they have extended skills, particularly in cardiac areas. They can also prescribe a wider range of medicines without GP's permission.

QDo you classify life-threatening jobs as less urgent to meet government targets?

AAbsolutely not. The category of each job is set in stone by the computer system we have in the control room. For instance a caller says there is someone trapped in a house - that is automatically declared a Category B job when it's typed into the system. We are set targets. We have to reach red incidents in eight minutes and amber jobs in 19 minutes, but we would never manipulate incidents to achieve that.

QCan ambulance trusts alter the category of jobs?

AYes, but only to add more Category A incidents to a list that already contains around 45 jobs, many of them cardiac related. We cannot, under any circumstances, downgrade incidents to Category B at our own discretion. It simply can't be done.

QAre there occasions when ambulance crews don't cover nearby incidents because they are waiting for more serious jobs?

AYes, that does sometimes happen. There are parts of our operational plan that protects our ability to respond to Category A incidents, and that can include reserving some vehicles. If we had all ambulances responding to every call irrespective of seriousness, what do you have in reserve if there is a major trauma?

So, it might be the case that one ambulance on its way to a Category B job could pass a parked ambulance waiting for a Category A incident.

QUnions claim morale is at rock bottom. Is this true?

AIt is a major strength of the service that ambulance crews are usually from the local area so they end up serving their own communities, sometimes even their own families.

It's not surprising therefore that ambulance staff genuinely want improvement - they are not raising issues for the sake of it.

However, some if them cannot understand why central decisions are made. They can't see the bigger picture.

QIs deploying three ambulances with only one paramedic acceptable?

AI was disappointed that this was the case during the Hapton fire.

I am not happy that we are a number of paramedics down at the moment, but that doesn't mean we have abandoned our standards.