A view from the frontline – Keighley ambulance service...

by Unite regional officer Terry Cunliffe

Emergency crews at Keighley, who serve a population of  about 100,000 were recently given four days to accept revised rotas from management which they believe will be unsafe for patients, as well as unworkable and unhealthy for staff to maintain a decent family life outside of work.

The proposals include runs of eight shifts in a row which means working 84 hours on the run with just six hours rest, plus forced 'end of shift' overtime which, due to the high volume of emergencies, frequently happens.

Meal breaks are also being reduced to 30 minutes during a shift. Staff will have just three weekends off in every 10 giving them little quality time at home with children and families.

Daytime cover has been increased at times when it isn't needed and evening cover reduced.

This is directly putting the patients at risk due to poor allocation of resources when the demand needs it.

Every day heralds disarray and 'panic management' as crews find themselves away from area covering Bradford or Leeds where they can more easily achieve the government targets. Reaching the targets rewards the service with money, not achieving those carries penalties.

Staff are increasingly concerned that it is becoming a 'postcode lottery' - those in the cities getting far more ambulances than the outer towns and rural areas that often don't have an ambulance in area at all,  as they are sucked into the big cities and no other resource is available to take their place. This happens daily and is due to money saving issues.

Our members don't have enough vehicles to deal with the volume of work they are now faced with and after the introduction of the new 111 system, that was designed to relieve the burden on the ambulance service, now feeds staff with far more emergencies than ever - leaving the service stretched, under staffed and struggling to provide ambulances to patients that genuinely need them.

Many emergencies generated by 111 do not require an ambulance, but will be allocated one anyway and so will dispatch an ambulance simply to 'cover their backs'!

The response car staff, who initially attend an emergency (and achieve the target) are then often waiting for an hour or more for an ambulance crew to back them up leaving patients waiting for definitive hospital treatment.

Some conditions, such as a stroke or a heart attack, require a patient is properly treated within an hour or it puts their life at risk. This is no longer happening due to the lack of ambulance resources and the waiting times.

It is also leaving staff vulnerable to verbal abuse from patients and families who are unhappy their relative has to wait for an ambulance to take them to hospital.

Our members can no longer rely on a fleet of spare vehicles to replace ones that break down, so are constantly struggling to maintain a full fleet.

Lives are being put at serious risk. The balance of skill mixes amongst staff has recently altered for financial reasons and the service now has far too many lesser skilled emergency care assistants who do not have the skills to deal with anything other than minor problems. This is leaving the full responsibility on the shoulders of the one qualified crew member on board and, therefore, there is considerably more stress on that one individual.

Keighley has one response car, sometimes two, which are also frequently sent away from their home town and deployed in Shipley or Bradford to maintain the required targets.

For most of the day, Keighley ambulance station is empty and the area is totally devoid of ambulance cover. This is extremely worrying to staff, who also have loved ones that live in the area and are, therefore, at serious risk, should they need emergency care.

Staff have been told to accept the shifts within the next two weeks or they will be imposed in any case.

Staff feel these rotas have not been properly thought out, nor consideration given to the amount of cover actually needed. They are detrimental to the welfare of staff and do not allow a decent quality of home life away from work.

Staff are extremely stressed and frustrated in the knowledge that many weekends and night shifts will remain uncovered, as colleagues are off sick though fatigue and stress.

They are also concerned about the quality of time they are now going to have with families on their days off. The lack of consideration and care that managers show our members and imposition of a new and very flawed rota will only exacerbate the current problems.