********* UNDER STRICT EMBARGO UNTIL 00:01 THURSDAY, 16 DECEMBER 2021 ********* Temporary meal break changes coming in the New Year for ambulance crews to reduce delays to patients

NEAS has been at REAP level 4, the highest status of operational alert, since July due to increased demand on the services and similar pressures felt across the region’s hospitals causing delays in handing patients over and being unavailable to attend further patients in the community. This has resulted in some patients waiting several hours for an ambulance response.

One of the actions in force during REAP level 4 is to make as many ambulance crews available to respond to patients as possible. This means clinical staff working in non-patient facing roles making themselves available and non-essential training being cancelled so the Trust can focus on patient care.

A recent review of meal break arrangements over a three-day period found emergency crews could potentially be unavailable for nearly 60 hours due to the travelling time associated with returning to their base station for their breaks – equivalent to being able to respond to 37 additional incidents a day.

The review also looked at scheduled care crews, who mainly transport patients to and from pre-planned appointments but regularly provide support to their emergency colleagues in transporting patients to hospital who do not require clinical interventions en route to hospital, thereby freeing up an emergency ambulance to respond to another patient. The review found they were unavailable for just over 7.5 hours each day due to the current meal break arrangements.

NEAS is therefore introducing a temporary measure in the New Year to try and improve this whilst it continues to operate at the highest level of escalation.

The change, which comes into effect on Monday, 3 January 2022, until 31 March 2022, will see ambulance staff being asked to stand down for a break at hospital or their nearest ambulance station rather than return to base. In return, staff will receive a £5 payment for each break they take away from their base location.

The decision comes just a week after the Board of Directors heard that harm is being caused to patients because of ambulance delays.

The Association of Ambulance Chief Executives (AACE) also recently published a report on the harm caused to patients who wait to be transferred to hospital care.

Vicky Court, deputy chief operating officer, said: “We are making these temporary changes to reduce the risk of patients being harmed by ambulance delays. The safety of patients and our staff is our top priority and the evidence is overwhelming that making this temporary change will allow us to see more patients quicker and reduce the potential harm that occurs when there are long waits for an ambulance.

“This is not a permanent change. It will only last over winter up to the end of March while we continue to experience the enormous pressures upon our service.

“In a bid to try and avoid these delays, crews are often sent late for their breaks, impacting on their health and wellbeing, so we think this temporary measure will also improve the wellbeing of some of our staff who have not been able to take a proper break for several hours because the distances they have to travel back to their base location.”

Ambulance crews work shifts lasting between 10-12 hours and are usually stood down by the NEAS dispatch team to travel back to their base station for their two 30-minute breaks. This time is protected and means they are unavailable to respond to patients. However, when taking into account the distance crews need to travel to return to their base station – sometimes taking up to an hour – this can lead to crews being unavailable to respond to patients for much longer than 30 minutes, which can result in delays for some patients.

The review, which looked at six stations for emergency crews and five scheduled care crews over a three-day period, found:

• Emergency vehicles travelled more than 1,180 miles to return to base for a break when they could not be diverted to an emergency incident – and average of nearly 400 miles each day across these six stations
• The time taken to return to base for a break was almost 32 hours – an average of 10.5 hours each day.
• If this average is assumed across the whole service, it would equate to nearly 60 hours of travelling time.
• This is equivalent to having enough ambulance crews to respond to 37 additional incidents in a day.

• Patient transport vehicles travelled more than 800 miles to return to base for a break when they could not be diverted to an emergency incident – and average of 270 miles each day across these five stations
• The time taken to return to base for a break was just over 23 hours – an average of just over 7.5 hours each day.
• If this average is assumed across the whole service, it would equate to nearly 24 hours of travelling time.

These changes mean members of the public will start to see more ambulance crews in public buildings during their rest breaks and are reminded that they should not be disturbed while resting.

You should always dial 999 in an emergency.