Continuing problems faced by ambulance service, by local democracy reporter Daniel Mumby

HEALTH bosses in Somerset say they are doing all they can to recruit and retain paramedics, to ensure residents can be treated swiftly and safely.

The South Western Ambulance Service NHS Foundation Trust (SWASFT) operates ambulances across the south west, serving more than five million people and covering an area of more than 10,000 square miles.

The trust has been struggling over the last few years to respond to 999 calls swiftly, with people often facing long waits for ambulances and then being held in queues outside hospitals.

Health officials have been using a variety of measures to address these issues, using retired personnel on flexible contracts and recruiting from as far afield as New Zealand.

The issue was debated in detail at a meeting of Somerset County Council’s adult and health scrutiny committee, held in Taunton earlier this month.

Councillor Fran Smith – who represents the Taunton South division – asked, “Why is it so difficult to recruit and retain paramedics in Somerset? I was in a road accident last year and was helped by paramedics. Some of them were temporary workers or were hired privately – they said it seemed more beneficial than being employed by the NHS.”

Steven Boucher, the ambulance service’s county commander, said that Somerset was competing for the same, small pool of graduates as other NHS trusts – meaning they had to rely on other means of recruiting and retaining staff.

He told the committee, “Recruiting in Somerset has been challenging. We are working really hard to retain our workforce levels and recruit – our turnover level is around ten per cent, which is people moving into other roles rather than just leaving.

“We do contract some agency crews – they choose to work for agency crews because their terms and conditions are different, and therefore their pay may be different. Some people do retire and come back on zero-hour contract part-time – it benefits them to have flexibility.

“We recruited from New Zealand three years ago and I am looking to recruit from abroad again.

“There are only so many graduates coming out each year – we’re all competing for the same people.”

Response times in Somerset have lengthened over the last 18 months as a result of the long-term effects of the coronavirus pandemic and pressures on acute services during the winter.

The average response time for category one cases (those needing “an immediate response to a life-threatening condition”, such as cardiac arrest) is currently ten-and-a-half minutes.

This is an improvement on December 2022 (where the average wait was 14 minutes), but still far above the seven-minute “mean standard” response time.

For category two cases (conditions which “may require rapid assessment and/ or urgent transport”, such as a stroke or chest pain), the average waiting time is just under 38 minutes.

Again, this is an improvement from December 2022 – when the average wait was two hours and 14 minutes – but is far above the desired average of 18 minutes.

Councillor Graham Oakes (who represents Yeovil East) said the ambulance service needed to change the way it operated to reduce waiting times.

He said, “The handover problem [at hospitals] is a short-term issue which is diverting you from the bigger problem – which is your system isn’t working. It wasn’t working prior to Covid.

“I had to lie on the floor for four hours next to someone who had fallen down the stairs. I had a constituent who waited 20 hours for an ambulance.”

Steven Boucher replied, “There is the Covid factor – the deterioration aligned to the Covid period, but it’s not all linked to that.

“We’re not achieving category one targets across the region or country. We need more investment to improve our response to patients.”

Councillor Christine Lawrence – a former portfolio holder for public health and well-being – praised the fortitude of paramedics and said lessons learned from the pandemic needed to be comprehensively applied.

She said, “It can’t have been easy queuing up outside of a hospital for hours in order to deliver patients. We often forget how stressful it would have been.

“This has been pressure from all angles from a very long time, and that’s worrying because people can only give out so long. What is it that we’re going to do to make people feel settled and look to the future with confidence?

“What is it that we’re going to be starting to do, so that if something like Covid happens again, we can deal with it in a better way?”

Steven Boucher responded, “Our absolute focus is to make sure we have enough capacity at all times to get an ambulance to people quickly – and before that, to make sure we have enough capacity to answer 999 calls.

“We’re trying to ensure that people are handed over as quickly as possible to get out crews back onto the road.”