FOI 25-315 Reduced On-Call Initiative
Freedom of Information Request
- Reference
- FOI 25-315 Reduced On-Call Initiative
- Request Date
- 23 Jul 2025
- Response Date
- 08 Aug 2025
- Information Requested
During the on call reduction programme, what was the criteria for removing on call from stations (or not removing it)
and how many stations removed on call as a result? If a station did not remove on call, what were the reasons? If
there is still on call in SAS, how do you manage fatigue- Response
During the on call reduction programme, what was the criteria for removing on call from stations (or not removing it) and how many stations removed on call as a result?
The Scottish Ambulance Service has a National On-Call Working Group that meets up as part of the Scottish Ambulance Service On-Call reduction programme. When ring-fenced funding is available to reduce or remove on call working, discussions take place looking at a range of factors including available funding
from Territorial Boards (part funding in provided for Thurso and Wick), demand during the in hours 'on shift' time and out of hours 'on-call' period, on call location, neighboring ambulance locations, inter hospital transfers (Broadford in Skye and Oban were good examples with increased numbers of Inter Hospital Transfers to Inverness and Glasgow), on call hours and on-call days and any other relevant factors such as an Island location.
There was no new ringfenced recurring funding made available to the Scottish Ambulance Service to reduce or remove on call working during 2024/25, so the National On-Call Working Group did not meet, but the demand profiles and risk assessment was reviewed. Good progress has been made in reducing on call
hours across Scotland over previous years through:
• the national on-call working group to date and
• the indirect benefits in reducing on-call hours that came from the Scottish Ambulance Service’sDemand and Capacity programme
Since the National On-Call Working Group was established, 44 new ambulance posts have been introduced to reduce or eliminate on call working across Scotland. Aviemore 5 new posts, Broadford 4 new posts, Portree 5 new posts, Dufftown 3 new posts, Fort William 2 new posts, Golspie 2 new posts, Kirkwall 2 new posts, Wick and Thurso 9 new posts, Campbeltown 7 new posts, Oban 3 new posts and Rothesay 2 new posts. Taking the average cost of a new ambulance post at £60,000 per annum this equates to investment of around £2.64m On-Call working has been removed in the following ambulance locations - Thurso, Wick, Golspie,
Broadford, Portree, Aviemore, Dufftown, 1 x 24/7 ambulance in Kirkwall 1 x 24/7 ambulance in Lerwick, Oban and Campbeltown.The Demand & Capacity Programme increased ambulance resource availability across Scotland with only the North and West Regions with remaining On Call locations. This programme has had a positive impact, with 11 ambulance locations in the North Region now having reduced on-call hours resulting in 161 doublecrewed ambulance hours per week being converted into shift time. In the West Region, 5 ambulance locations now have reduced on-call hours resulting in 50 hours of on-call per week being converted into shift time.
We have also seen benefits to on-call locations with increased ambulance availability in neighboring ambulance locations. There are a range of other Service wide initiatives which are having a positive impact on fatigue in On-Call
locations, this will vary in different areas with different levels of impact
• Clinical Response Model and enhanced triaging at point of call through the National Integrated
Clinical Hub has reduced the number of ambulance responses.
• Our ambulance crews attend and treat patients safely at scene with referral on to appropriate
pathways of care where required avoiding onward transport to Emergency Departments.
• Collaboration with IJBs and Territorial Health Boards around whole system redesign
• Digital Solutions – NHS Near Me, Virtual Wards, etc
• Delivery of care as close to home as possibleWe are currently progressing the reduction in the working week programme. Any indirect benefits of this programme in reducing on call hours have still to be quantified. We remain committed to looking at ways to reduce on-call hours and remove on-call working.
If there is still on-call in SAS, how do you manage fatigue.
The Service monitors and maintains compliance with the working time regulations, in relation to both average hours worked per week and compensatory rest.
There is still on call working in 20 ambulance locations in the North Region (Alford, Barra, Barvas, Benbecula, Bettyhill, Daliburgh, Dunvegan, Fort Augustus, Gairloch, Grantown-On-Spey, Kingussie, Kinlochbervie, Kyle of Lochalsch, Lairg, Lochcarron, Lochinver, Mallaig, Strontian, Tarbert in the Western Isles, Ullapool) and 12 ambulance locations in the West Region (Lochgilphead, Tarbet, Kirkconnel, Mull,
Langholm, Dalmellington, Thornhill, Inveraray, Arrochar, Islay, Millport, Maybole).
Scottish Ambulance Service staff who undertake on call working and are called out during the on-call period are able to book off fatigued to ensure they are appropriately rested. The Scottish Ambulance Service triages all ambulance calls to ensure the most appropriate response is provided to patients based on
clinical need. For some patients an ambulance response may not be required. These calls receive additional clinical triage through the Integrated Clinical Hub staffed by GP’s, Advanced Practitioners and Paramedic Clinical Advisors to enable safe and appropriate referral on to a pathway of care which negates the requirement for an ambulance response.
