The man responsible for the day-to-day North-east ambulance operations has admitted recent pressures on services has been the worst in his three decades working in emergency care.
The North East Ambulance Service has faced criticism in recent months after a number of stories revealing long waits for an ambulance.
In one case a 101-year-old woman was forced to wait six hours for an ambulance, despite living just one mile away from James Cook University Hospital in Middlesbrough.
Before Christmas, the operational service was raised to level four of six – indicating severe pressure.
Paul Liversidge is chief operating officer for NEAS.
As a former paramedic with 31 years in the service, he has spoken in depth about the pressures facing the service in an interview with The Gazette.
Mr Liversidge is responsible for overseeing the control room, the 111 control centre, the emergency care and Patient Transport Service (PTS) of the NEAS.
Pressure on services
He says one of the main differences he has noticed is the growth in the demand for the service – often resulting in staff working longer hours than they should and going without breaks.
He said: “First of all, the expectations in respect of our emergency services from the public has changed.
“People used to call if it was an emergency, whereas now it more urgent type care.
“The expectations of the public now means access to emergency care seems to be a first thought, rather than people thinking of using other community services available to them.
“The population demands have also changed, we have more elderly people and people with illnesses such as mental health.
“However, it’s hard for me to pinpoint an exact reason why this period, as I would honestly say, has been the worst I have experienced while being in the service.”
Waiting times
More than a third life-or-death ambulance calls in the North-east took longer than eight minutes to arrive in December.
Of Category A Red 1 calls – the highest-priority blue-light calls, resulting in an emergency response – the proportion arriving within eight minutes was 62.4%.
For Category A Red 2 calls – slightly lower priority but still emergency blue -light calls – 66.4% arrived within eight minutes in December.
The target is for 75% of these calls to be responded to within eight minutes.
Mr Liversidge believes the situation with hospitals is one reason behind the pressures affecting NEAS.
He said: “The acute level has gone up, putting more pressure on us responding in eight minutes.
“During winter we have seen a 10% increase in activity and hospitals have been under intense pressure.
“This means we are getting to hospitals and there are no beds so we are having to wait in car parks, meaning we can’t get out into the community.
“It’s a problem with the whole system in the whole region.”
Teesside services controlled from Tyneside
A new strategy aimed at improving waiting times has been drawn up. From now on, people over 65 who have had a fall will be classed as priority.
Lower priority cases, known as G2 and G3 – which have suffered the most this winter – will also see a change.
Any G2 cases who have waited for an hour will be put to the top of the list and G3 cases who have waited two hours can be expected to be responded to within 20 minutes
Being a regional service, with its central base in Newcastle, concerns have been raised that Teesside suffers from a poorer service.
But Mr Liversidge denied this is the case. He said: “The changes and issues across the service are the same.
“We have the control room in Newcastle but each of the three dispatch desks works independently with their resources.
“Having said that, we don’t stick strictly to the boundaries, so if we have a closer ambulance from over the boundary we will send it rather than waiting around.”
“We do look at regional standards and, as there are 12 clinical commissioning groups (CCGs) in the North-east, we try to equal out the pressures in the area.
“Regional standards are the same, which is how we can assure that everyone gets the same care.”
Private ambulances
Spending is another issue which has dominated the news, especially regarding private ambulances.
In October it emerged money spend on them quadrupled to almost £3m.
Mr Liversidge said: “There is a national shortage of paramedics by more than 2,000.
“We have seen a gap in the workforce, so in the mean time we have employed third-party employers, such as St John’s Ambulance and The Red Cross.
“That plan is in place to help us to get back to the level of service we need to be at. At the end of the day, I have said to my board, we are better off having this help than not having it.”
The future
Mr Liversidge does believe that the worst is over and the service is on the up again. He said: “We have got through this difficult period and we are on the up and everything is starting to get back to normal.
"Already over the weekend we have seen a 10% decrease in activity, and response times are getting back to the levels they should.
“The staff over the last few months have worked non-stop from start to finish and continue to do so.
“The care for patients has never wavered and staff have done their best in difficult times. It was the worst time and I would like to say it can not get any worse.
“We have looked at a lot of the issues over the past months and put things in place to hope avoiding them in the future.”
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