Now ambulance companies call for specialised patient services

Wednesday, 13 November, 2013

Commissioners must rethink NHS contracts, urges ISS

On the day NHS England proposed 2-tier A&E departments the independent ambulance industry today (12 November 2013) called for the introduction of specialized innovative ambulance services.

The Independent Ambulance Association, the leading trade organization for ambulance companies regulated by the Care Quality Commission, in a 16-page report for Parliament entitled “The Vital Link” urges commissioners to:

 -       Split large contracts into smaller lots;

-       Create innovative specialist services for emergency mental health, falls and bariatric patients;

-       Encourage more co-operation between providers;

-       Share framework agreements;

-       Focus more on quality than price;

-       Use the right service for the job.

The IAA also wants commissioners to award contracts which promote quality of outcome, recognize the value of plural providers and the fact that private providers are often cheaper than in-house ambulance trusts.

The report, the first of its kind published by the independent ambulance sector, also:

  • Dispels myths about independent ambulance companies
  • Calls for the closing of the loophole in the law which enables unregistered ‘cowboy’ companies to provide ambulance cover at public events;
  • Seeks the tightening the DVLA system which enables unregistered ambulance companies to unfairly claim exemption from vehicle excise duty.

The IAA says the independent ambulance companies make a vital 24/7 contribution to the nation’s healthcare economy and the NHS could not cope without their support, such as taking vulnerable patients home from hospital to easing the pressure on NHS emergency services at times of peak demand.

Yet there are still unjustified myths about the independent companies.

In dispelling the most frequently reported one, the report argues that they are not solely motivated by profit; many were started by former NHS executives who are passionate about their work and operate in a highly competitive market with low margins.

The companies are often mentioned in a negative light in relation to the cost to the NHS when trusts release figures about overspend which includes an element of private contractors.

The report says: “The simple fact is that private contractors are usually cheaper than providing the same service in house by the NHS trust. Independent companies are not bound by the standard NHS pay and conditions rates under Agenda for Change, so aren’t paying for an NHS pension or other benefits, so using a private contractor is the better value option.”

To critics that claim private ambulance training and quality standards of patient services are not as high as their NHS counterparts, the IAA points to the largely unknown fact that both sectors are regulated and monitored by the Care Quality Commission on exactly the same basis.

During inspections since the start of registration in 2011, independent providers have shown consistently high standards of care. The CQC report on inspections in 2012 found that almost all independent providers were providing good care and treatment, and treating patients with respect

Referring to what it describes as “The Event Problem” the IAA says that the Department of Health and CQC have subverted the legislation and have publically announced that providers operating ambulance services only within the confines of an event site should not register.

As a result event organisers who are seeking the cheapest quote are hiring unlicensed operators who have never had their standards checked, who often employ staff with no criminal records check and who can have inadequate qualifications.

In its vision for the future, the IAA says it wants a market where “NHS, independent and charity services can compete fairly for all types of ambulance work, in an environment which encourages high standards of patient care, exemplary safety records, and good value for money for NHS commissioners and other buyers of ambulance services.

“This vision would support higher levels of training and a raising of standards across the whole industry, supported by initiatives such as free movement of staff between providers, and recognised standards for commissioners of ambulance services”

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