- Trust holds ‘very early discussions’ about community first responders driving ambulances
- Senior paramedic says ‘desperate’ plans raise major patient and staff safety risks
- Trust also says it is considering use of ‘other emergency services and the military’ to plug staff shortages
East of England Ambulance Services Trust is also considering drafting in the military to cover staff shortages.
Its senior leadership said it wanted feedback from its community first responder volunteers on what it said were “very early discussions” for how they could be further utilised, including as driving standard 999 ambulance vehicles, an internal email seen by HSJ said. This is believed to be unprecedented in the NHS.
The volunteer community first responders would only be used in “low acuity patient” cases.
The trust, which is one of the worst performers in the country on the most urgent response times, also told HSJ it would consider the use of “other emergency services and the military” this winter to plug its well-known capacity gap. It said it would be criticised if it was not considering such drastic measures.
But a senior paramedic at the trust told HSJ they were “absolutely horrified” by the proposal for volunteer ambulance drivers, even for low acuity patients, as these could deteriorate, a view they said was shared by their colleagues at other trusts.
The source said it showed how “desperate” the trust was ahead of next winter. They raised concerns that similar problems to those experienced last winter, when “significant” response delays led to patient harm, could be repeated.
Community first responders are lay people who receive five days “intensive” training to give basic but often critical support before paramedics can get to the patient.
An email to staff from local managers sent this week said: “[The senior leadership group want] to obtain feedback from CFR groups on the potential utilisation of CFRs in supporting double crewed ambulances and attending low acuity patients where the CFR could then potentially drive qualified crew members and patients to the appropriate receiving acute or appropriate care home.
“This option does require the driving licence holder to also hold C1 on their licence [which allows the holder to drive vans up to 7.5 tonnes].”
It is not known how many CFRs hold a C1 licence. But local paramedics told HSJ that their concerns about safety and governance still applied where CFRs hold a C1 licence.
The senior paramedic, speaking to HSJ on condition of anonymity, added: “Does it pose a risk to patient safety? Without a doubt. What happens if the patient suddenly deteriorates and needs to be blue lighted to hospital?
“The paramedic in the back can’t do it. They need to be attending the patient. The staff are very against it. As a paramedic you want to be working with someone who is qualified and knows what they are doing.
“I have never heard anything like this in all my years. CFRs fulfil a very important role in their respective communities, but they should be there in their communities, not on frontline ambulances.
“I told colleagues at other trusts about the plans and they were absolutely horrified.”
Under separate existing plans, the trust is planning to employ 330 additional staff and 160 additional emergency ambulances.
In a statement to HSJ the trust said volunteers had been supporting patient care for over 20 years adding: “Many people who volunteer and work in patient transport services bring previous skills and knowledge that can contribute in a different way to the delivery of services during times of extreme service pressure.”
It said CFRs could be sent to non-injury fall patients and stressed: “This is information gathering on the proposed two options, therefore should the majority of CFRs agree this is something [the trust] should potentially take forward, further detailed discussions would need to be held to ensure all the relevant governance, training and patient safety aspects are addressed.”
It claimed the use of volunteers was widespread in countries such as Canada, the USA and Australia adding it was “common place” for volunteers to staff emergency ambulances.
The statement said: “While our long term plan is delivered, it is imperative that the trust consider every alternative to maximise existing and alternative resources to support our patients across the winter period.
“In doing do, the trust will consider the use of volunteers, other emergency services and the military. Indeed, the trust would rightly be criticised for not doing so.
“Despite multiple reviews in recent months, the trust’s processes have been deemed sound with no recommendations for change from any organisation.”