New ambulance service for London

A new Intermediate Care Ambulance Transfer Service was announced today  by Medical Services for hospitals in central London.

Interview with Joe Sheehan, Managing Director, Medical Services

Q:  Is this new service related in any way to Medical Services’ corporate reorganization into a limited company with its own board of directors?

A:  Not entirely, we do have a clear 5 year expansion programme. However, with all plans there is a need to remain flexible and meet new demands. This is one of those occasions.

Q:  What is the background of the new service?

A:  There is a growing demand, particularly late in the day and during the night, for a responsive ambulance service to transfer patients between hospitals, clinics and other locations for further care. In September last year we saw this demand rise with additional requests from London Trusts. The new service is essentially an enhancement of what we have already been providing locally to individual hospitals. Now in a much more planned and organized way we are providing a service covering all of Central London and available to Trusts 24/7 

Q: Are Medical Services staff properly trained for this work?

A: Absolutely. Our company training programmes are continuous and we have also been conducting special courses for crews for the new service.  The entry level grade for transfer ambulance crews will be the BTEC First Person On Scene qualification with an additional module in cardiac monitoring but will be replaced by the forthcoming BTEC HDU qualification. We have started to pair this staff with our EMT crews already in place

Dispatch and control staff has also undergone additional training to prepare for taking telephone requests for this service. Unlike Patient Transport, but similar to the 999 service, a criteria based system, with an underlying clinical algorithm will be in place to ensure we undertake journeys that match our skills, equipment and our ability to move patients efficiently and safely.

We think we are the first independent provider to reach the stage where we can do this. It clearly reduces risk. We have voice and data recordings of all journey requests and we are able to review this data to improve quality

Q:  Have you recruited extra staff for the new service?

A:  Yes, because the company is continuing to grow we have constant need for new people and I see no let up in our recruitment requirement.

Q: Do you have sufficient up to date vehicle resources?

A: We continuously invest in our fleet and have recently placed orders totaling over £3 million on new vehicles. By next winter we will have 80 ambulances and vehicles per shift to provide the 60 minute response time across London for transfers. This will be supported by the existing PTS fleet.

Q:  How will the new service be operated?

A:  Calls are handled by staff using computerised CBD systems to make sure the patients we are requested to transfer are suitable for intermediate care or whether they need Paramedics or Nurse/Doctor escorts. We have had the system in place for over a year but the crucial function of signing off a suitable algorithm took a lot of work.  We also work to very high clinical governance standards based on those in place within the NHS

Q: Have you needed to bring in outside specialists to help create the new service?

A: All the research, planning and training has been carried out from within our organisation, especially David Ellis, the former regional chief of the Welsh Ambulance service who is a director of our company.

Q:  Do you plan to expand the service outside central London?

A: Our immediate plan is to gradually introduce the new service to hospitals within central London and later extend it to cover the M25 area within about a year.

Q:  Who provided this intermediate care transport service in the past?

A: London Ambulance Service

Q:  Isn’t your new service competing with LAS?

A: No. We are not providing an emergency service to the public, far from it. LAS provide Londoners with a world class ambulance service with great skill and dedication.

I have the difficult task holding on to our best crews, many of whom aspire to continue their training and become qualified paramedics working for LAS. ICATS is a support service providing hospitals with an Intermediate Care Ambulance Transfer Service which is available 24/7 on demand across the patch.

Q: Have you had any criticism that the new service is privatization by the backdoor?

A: If there are any such comments they would certainly not be justified. The new service fills a gap left by LAS. It might be argued, with some justification, that LAS have been available all night and week-ends covering transfers for all London trusts that would be done by hospital PTS services during the day. The ICATS service will be available to fill that gap.