Annual Review Q & A
The Annual Public Review was held in Glasgow on 13 October. Below are the answers to questions which were asked at the meeting.
- What steps are going to be taken to improve the reliability of patient transport? My experience, as a dialysis patient, is that transport is late or doesn’t turn up at all and I have now stopped using the patient transport service for this reason.
- I would like to know what the main drivers are for overtime?
- Is there a planned overtime budget which is being exceeded due to staff shortages, absence, seasonal factors, etc?
- When I look at the recruitment pages on the website the majority of jobs for ambulance crew the salary is in the £15K to £18K range.
- I would expect these employees depend on overtime and shift allowance to boost their income. If overtime gets cut back is there likely to be a negative effect on morale and attrition?
- How is management going to reduce the overtime costs taking these factors into account?
- How does the Ambulance Services make themselves available to individuals within the community who are Deaf and use sign language as their chosen form of communication? Text calls may be a useful tool, however consultation with Deaf people in setting up such a service, would provide much/necessary information.
- Are many Ambulance Service personnel able to use sign language and have they completed Deaf Awareness training?
Question
What steps are going to be taken to improve the reliability of patient transport? My experience, as a dialysis patient, is that transport is late or doesn’t turn up at all and I have now stopped using the patient transport service for this reason.
Answer
The Scottish Ambulance Service is currently leading a review of transport to renal services across the West of Scotland in conjunction with the seven NHS territorial Boards providing renal services to the area. This work has been commissioned by the West of Scotland Regional Planning Group and will bring forward recommendations by March 2010. Those proposals will recognise the continued increase in demand for renal services and any option to further develop the existing dedicated renal transport service.
Glasgow has 14 dedicated renal vehicles operating, including weekends, five of which are just for the Beatson activity. The demand for renal transport is currently being reviewed to assess whether more dedicated vehicles are required for Glasgow and Lanarkshire. Monthly hospital liaison meetings are also in place and weekly monitoring of area service office planning and resourcing is ongoing.
We saw an improvement in the timeliness of pick up for appointment across Scotland in the last year, up to 71 percent within 30 minutes between January and March 2009. In many areas, we have dedicated transport arrangements for renal patients and other specific conditions and we will continue to develop this more tailored solution.
We have a set of criteria in place for determining eligibility for ambulance transport and we also have the facility for GPs and hospitals to book journeys directly onto our system without the need to make a direct request to our staff. However, we are aware that these criteria are not consistently applied and this can lead to issues with over–booking of resources and unfortunate cancellations.
The rate of cancellations by Scottish Ambulnce Service is extremely low, currently less than 1 percent of all journeys booked. However, almost 10 percent of journey booked are cancelled by hospitals or clinics, sometimes with less than 24 hours advance notice. We often do not receive notification of cancellations or that patients have made alternative arrangements to travel in sufficient time to alter planned journeys and therefore ‘abort’ around 7 percent of all journeys at present. This means that an ambulance will arrive to pick up a patient who is not there and as a consequence, we may have had to cancel another journey.
We are working with our colleagues in the NHS to reduce the level of aborts and cancellations and improve the efficiency of the Patient Transport Service and improve communication and planning. We have also extended the availability of Patient Transport Service resources to evenings and weekends in many areas to better match the times of clinics and appointments.
We have also carried out extensive consultation with patients to better understand what their experience of the current service is and also in developing our future strategy. That consultation has shown us that there is a lack of understanding of the role of the ambulance service and what alternative transport provision is available both amongst patients and colleagues in the NHS. We recognise that there is a need for greater integration with our NHS partners and with transport providers to better co-ordinate transport to healthcare and we are actively working to develop the service.
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Question
I would like to know what the main drivers are for overtime?
Answer
The Ambulance Service is a 24/7 organisation and as such shifts require to be covered to ensure there is a full resource across Scotland. In addition with Double crewed vehicles there requires to be both crews available to allow that resource to be deployed.
In all A&E areas there are relief staff who are employed to ensure there is 24/7 cover. This provides cover for annual leave, a 4 percent sickness rate, training leave and a small amount of other leave, such as court attendance. Overtime is worked therefore for unexpected absences or vacancies that exceed the amount of relief cover available.
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Question
Is there a planned overtime budget which is being exceeded due to staff shortages, absence, seasonal factors, etc?
Answer
Yes there is a planned overtime budget that represents 4.6 percent of the pay budget.
It is being exceeded due to high sickness levels especially in July and August. The requirement for additional resources at peak occasions such as football matches, the Edinburgh festival, pay weekends where alcohol is a significant factor. In one division higher than expected vacancies are also contributory factors.
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Question
When I look at the recruitment pages on the website the majority of jobs for ambulance crew the salary is in the £15K to £18K range.
Answer
The salary you describe is probably that of an Ambulance Care Assistant not of an Ambulance Paramedic or Technician and only reflects basic pay. Staff receive additional payments for such things as; unsocial hours, on- call and call outs. The average salaries of Ambulance Care Assistants are: £20,300, Technicians are: £28,500, Paramedics are: £38,500.
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Question
I would expect these employees depend on overtime and shift allowance to boost their income. If overtime gets cut back is there likely to be a negative effect on morale and attrition?
Answer
We appreciate that staffs that are willing to work overtime shifts especially those at short notice, however the salaries paid to staff should not require them to be dependant on overtime. The attrition rate for the service is extremely small and therefore morale would not appear to be an issue. Staff will wish to balance their home and work lives and therefore excessive overtime is not a good balance.
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Question
How is management going to reduce the overtime costs taking these factors into account?
Answer
Management work with staff to ensure that all shifts required are covered through permanent staff or relief staff. Data is provided to identify where shifts are covered on overtime and managers take steps to reduce their dependence on overtime. Unfortunately as a 24/7 service that has to manage peaks in demand and ensure that all areas of Scotland are adequately covered overtime will be a requirement in the foreseeable future.
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Question
How does the Ambulance Services make themselves available to individuals within the community who are Deaf and use sign language as their chosen form of communication?
Text calls may be a useful tool, however consultation with Deaf people in setting up such a service, would provide much/necessary information.
Are many Ambulance Service personnel able to use sign language and have they completed Deaf Awareness training?
Answer
Communication is the skill that underpins pre-hospital clinical care in terms of the reassurance staff are able to provide to patients and also the history that they are able to obtain to make an appropriate diagnosis.
Emergency SMS messaging has now been introduced nationally across emergency services including the Scottish Ambulance Service. This service is designed to ensure that disabled people who are deaf, deaf blind, deafened, hard of hearing or speech impaired have immediate access to the 999 system by a means which supports their personal needs. This service is only accessible to users who have registered and offers a similar but enhanced functionality to the Type Talk/Text Relay services which have been operating for some time.
At present all ambulance vehicles have Tip Cards in them developed in conjunction with the Royal College of General Practitioners (Scotland) and Fair for All – Disability. These cards provide a quick reference guide for staff in terms of the most appropriate way of communicating with patients or carers who may have a disability including those who are deaf.
A few Scottish Ambulance Service staff are able to use British Sign Language and consideration is being given as to how further training for staff in this area can be provided to further support deaf awareness training.
Work is currently underway to improve communication tools via cab based terminals in ambulances. This includes the use of signs, symbols and pictures to assist where communication support may be required.
Where there is a need for additional assistance for deaf people employed by the Scottish Ambulance Service, the appropriate equipment and materials are provided. Every effort is made to ensure individuals have the necessary equipment to enable them to fulfil the requirements of their role.
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