The risks of ring fencing ambulance resources | from an anonymous Oppo

We recently received this anonymous message, submitted via our website. We emailed WAST just to see if they wanted to respond, but, as yet, we have not had any correspondence back from them. 

“Hi, I would appreciate it if you treat this message as anonymous.

I work for WAST and it has recently come to my attention that certain resources are being ring fenced which, in my opinion isn’t in the best interests of our patients, the public.

I don’t believe this to be common knowledge, but I could be wrong, so I thought I’d share it with you in case you wanted to inform your followers.

The following information I believe to be correct but have no proof.

Since December WAST has tried to bring in ring fencing as follows:

initially all RRV’s were only being dispatched to red calls irrespective of how many calls stacking.
This then changed to the last RRV in the locality being ringfenced for red calls.

In the last few weeks it has again changed to prioritise P1 stations so that the last resource in a P1 station is only sent to red calls.

The downside to this is smaller stations may only have one resource operating from there.

So as an example, an amber 1 call such as a stroke, epileptic seizure or MI won’t have the nearest ambulance sent, but one from the next closest non P1 station which in rural areas could be 30 minutes at best and hours later at worst.

Frontline staff and control staff are equally unhappy, but our hands are tied.

The only exception to this seems to be if control pass the call on to clinical desk they can override the ring fencing and allow an ambulance to be dispatched.

I don’t know the reasons for this as I haven’t found anything posted internally or externally.

Perhaps to enable WAST to have the figures they need to present to the Welsh Government for an increased budget?

I know if a member of my family were affected by this I would be devastated!”

UPDATE: We received the following response from Richard Lee, Director of Operations for Welsh Ambulance Service Trust ( @acascw ) : 

“During times of increased demand the Trust has agreed escalation procedures to ensure that our sickest patients receive the fastest response possible. Like all ambulance services we have geographical deployment plans which distribute resources across our Trust to standby locations assigned different levels of priority based on call volume.

 Within our plan at higher levels of escalation we ensure that we have available resources at all of our priority one cover points. These are the locations where we are most likely to receive a red call. This is not about meeting targets but getting to the sickest patients first. Our RED category in Wales is designed to only include patients with immediately life threatening conditions such as cardiac/respiratory arrest, ineffective breathing, choking and severe bleeding. 

Clearly in the example quoted by your contributor it sounds like these escalation arrangements could have been managed differently. We are working hard to provide the best service that we can and we review all processes including how we manage escalation based on feedback such as this”.