Great Western Ambulance Service

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Map of the Great Western Ambulance Service's coverage

The Great Western Ambulance Service NHS Trust (GWAS) was a UK National Health Service (NHS) trust providing emergency and nonemergency patient transport services to Bath and North East Somerset, Bristol, Gloucestershire, North Somerset, Swindon and Wiltshire in the South West England region. It was formed on 1 April 2006, from the merger of the Avon, Gloucestershire and Wiltshire ambulance services. The ambulance service was acquired by neighbouring Foundation Trust South Western Ambulance Service (SWASFT) on 1 February 2013.

It was one of twelve Ambulance Trusts providing England with free Emergency medical services, and is part of the National Health Service, receiving government funding for its role.

Operations[edit]

The Trust headquarters was at Jenner House, Chippenham, Wiltshire.

The Trust had one main call handling control room ("EOC — Emergency Operations Centre") and two "dispatch centres". The main control room, the EOC at Acuma House, Almondsbury, was been recognised as a Centre of Excellence for emergency call handling and dispatch for 2006, 2007 and 2008 by the company that supplies their computer software.[1]

The EOC in Quedgeley, Gloucestershire, was also the hub for the Gloucestershire out-of-hours "urgent care" service. The emergency control centre for Wiltshire is located in the WES building in Devizes, as the Great Western Ambulance Service in Wiltshire is part of Wiltshire Emergency Services project.

In common with all UK ambulance services, the control room triages and categorises 999 calls into three categories — A, B, and C. Category A are potentially life-threatening emergencies requiring an immediate response. Category B are potentially serious but not life-threatening emergencies. Category C require do not require an emergency response and are relayed to NHS Direct, specially trained paramedics or nurses for over-the-phone advice, GP services or Emergency Care Practitioners(ECP).

Below are the performance targets the government has set out of ambulance trusts to meet.

  • to reach 75% of immediately life-threatening emergencies (category A) within 8 minutes
  • to reach 95% of non-life-threatening emergencies (category B) within 19 minutes
  • where a doctor requests an ambulance for a patient under the Doctors' Urgent Standard, to deliver 95% of patients within 1, 2 or 4 hour targets, as requested by the health care professional.

History[edit]

Formed on 1 April 2006, from the merger of the Avon, Gloucestershire and Wiltshire ambulance services, the trust had a difficult start, marked by redundancies, closure of its training centre and the threat of ambulance station closures, though in the end, only one ambulance station was closed (Newent, Gloucestershire).

This caused strained industrial relations [2] with its recognised union, UNISON, and attacks from the local media. From the date of merger, Great Western Ambulance Service struggled to achieve the Department of Health Key Performance Indicators and in 2007-2008 the Trust lost two contracts for non-emergency Patient Transport Services (PTS) to private contractors. Huge numbers of ambulance shifts were covered by private agencies.[3]

In September 2008, the Chief Executive, Tim Lynch resigned. He was replaced by an Interim Chief Executive, Anthony Marsh, from West Midlands Ambulance Service. Marsh identified a lack of operational leadership and a "competition of priorities" within management and removed two Directors (the Director of Operations and Director of Corporate Development).[4]

In February 2009, a ceremony was held to present almost 60 staff, partner agencies and members of the public with Chief Executive Commendations.

In September 2010 a specialist unit, the Hazardous Area Response Team, was established and went live after months of preparation and training.[5] This unit consisting of 32 paramedics is trained to respond to complex or large incidents involving fire, chemicals, biological or nuclear risks, collapsed buildings, cliff or heights, confined spaces, water or firearms incidents. The GWAS unit was planned to be one of the last parts of the national scheme to be established, but has already had national acclaim with high levels of activity and a dedicated base being built in Filton, North Bristol.

In summer of 2010, the regional NHS announced that after a tough competitive tenering process, GWAS had secured the major patinet transport service contract for the former Avon area, representing an estimated three-quarters of non-emergency patient journeys in the region. The new revamped service, operating 24/7, went live on 1 October 2010.

In 2010 the trust board recommended the closure of at least one county's control room, and gave the go ahead to an "Estates Review" to prepare the trust for closure of local ambulance stations.

In 2009, the new chief executive, David Whiting, previously director of operations from East Midlands Ambulance Service, was appointed as Chief Executive. He announced his resignation in November 2010,[6] having served just nineteen months, a situation the union described as "difficult".[7] The resignation came at the height of an industrial dispute as the trust attempted to adjust rota patterns, rest break configutarions and staff shift times, which caused staff to be concerned about safety and welfare of patients and colleagues.[8]

In December 2010, the Trust announced another interim Chief Executive, Martin Flaherty of the London Ambulance Service.[9] When Mr Flaherty leaves, and his replacement appointed, it will be the 5th Chief Executive in only 3 years.

At the beginning of January 2011, UNISON (the only approved union within GWAS until January, when the GMB was 'suddenly' accepted) announced the results of a ballot for industrial action. From those that voted, the result was 96% in favour of taking industrial action as a form of protest against the changes implemented during 2010.[10]

Later in 2011 plans were revealed for the merger of the Great Western Ambulance Service with South Western Ambulance Service and as of 1 February 2013, all of the former Great Western Ambulance Services' area, vehicles and staff transferred over to SWASt.[11][12]

Wiltshire Emergency Services[edit]

Great Western Ambulance Service's Wiltshire branch is a member of the Wiltshire Emergency Services (WES) project, a collaboration of emergency services in Wiltshire. The project has seen the construction of the WES building at Wiltshire Police Headquarters and the relocation of all three emergency services control centres into that one emergency control centre where information is shared instantly between the three. The project has overseen the sharing of stations at Bradford-on-Avon and Mere, and also the sharing of Wiltshire Air Ambulance and the training of Fire and Rescue crews to use defibrillators on occasions when the ambulance service is busy.

GWAS is also supported in Wiltshire by a group of volunteer doctors ('SWIFT Medics') who respond from home, in their own time, to incidents involving seriously sick or injured parients throughout the county. The doctors involved are all either senior GPs or hospital clinicians, who provide their time and expertise for free. The specially trained prehospital care doctors are able to supplement the skills of paramedics and other ambulance staff (for example with advanced decision making, administration of strong painkilling drugs, prehospital anaesthesia and certain surgical procedures normally carried out in hospital). The prehospital care doctor team receive no funding from either the government or GWAS, and rely entirely on charitable donations and fundraising to pay for their drugs, kit and training. All the doctors use their own cars and are permitted to respond with blue lights and sirens (having undergone an intensive three week police driver training course with Wiltshire Police). The team work closely with the Wiltshire Air Ambulance and the GWAS Air Ambulance. Currently SWIFT doctors are tasked to a job either by the Emergency Operations Centre in Devizes or following a direct request from ambulance personnel at the scene of a serious incident.[13]

Vehicle fleet[edit]

PTS

  • Avon: Renault Master (DCA), Ford Tourneo Connect, and Fiat Multipla
  • Gloucestershire: Renault Master
  • Wiltshire: Renault Master

A&E

  • Avon: Mercedes Sprinter
  • RRV: Ford Mondeo, Vauxhall Astra and Vauxhall Zafira but now standardising on Ford Mondeo
  • Gloucestershire: Renault Master but now standardising on Mercedes Sprinter
  • RRV: Renault Scenic, BMW 5 series, BMW 3 series, Honda CRV, Vauxhall Astra and Zafira. A new fleet of Ford Mondeos are now being introduced to the Gloucestershire fleet and will become standard as the maligned Astras and Zafiras reach the end of their operational life.
  • Wiltshire: Renault Master but now standardising on Mercedes Sprinter
  • RRV: Renault Megane, Honda CRV, Vauxhall Astra, Vauxhall Zafira, XC70, V70 and V50. Now standardising with Ford Mondeos

Special operations

  • Resilience: Land Rover Discovery 4, Volvo XC90, Iveco Daily, Land Rover Defender
  • HART: Land Rover Discovery 4, Volvo XC70, Iveco Daily, Polaris Ranger, Honda Foreman

Officer cars

  • Skoda Octavia

ASU

The latest addition to the vehicle fleet are £140,000 Mercedes Sprinter coach-built ambulances which represent a big step forward from the aging Renault Master ambulances in Wiltshire and Gloucestershire, many of which had to be removed from service when they were found not to meet modern safety standards.[14]

Air ambulances[edit]

Air Ambulance G-NDAA

GWAS has three air support units. The Midlands Air Ambulance operates from Strensham and covers GWAS northern areas. It is crewed by two air ambulance paramedics. The Wiltshire Air Ambulance operates 24/7 from the police HQ at Devizes and is crewed by an air ambulance paramedic.

The Great Western Air Ambulance is based at Filton Airfield, Bristol and operates 7 days a week during daylight hours. The MBB Bo 105 helicopter[15][16] is crewed by a specially trained Critical Care Paramedic and a senior Doctor trained in prehospital medicine. The helicopter covers the entire GWAS area and, if requested, will fly outside the GWAS boundary to assist other ambulance services. Although GWAS pay for the paramedics, vehicles, training and some equipment, the doctors all work on a voluntary basis and give their time for free.

The helicopters and their associated running costs are paid for entirely by charitable donations, receiving no funding from either government or the ambulance service. The units can be tasked to an incident either by proactive dispatch from ambulance control or by a direct request from an ambulance crew on the ground.

See also[edit]

References[edit]

  1. ^ "Great Western Ambulance Service NHS Trust". National Academies of Emergency Dispatch. Retrieved 24 November 2011. 
  2. ^ Burchall, Kevin (19 December 2006). "Ambulance staff poised to strike". This is Wiltshire. Retrieved 17 November 2011. 
  3. ^ Donnelly, Laura (21 February 2009). "NHS bosses send 'ill-trained' private ambulance crews to 999 calls". The Daily Telegraph (London). Retrieved 4 May 2010. 
  4. ^ "Fear as 999 chief takes two jobs". Express & Star. 4 September 2008. Retrieved 17 November 2011. 
  5. ^ Delivery of New Hazardous Area Response Team (HART)
  6. ^ "Ambulance boss quits top position". This is Bristol. 5 November 2010. Retrieved 17 November 2011. 
  7. ^ "Union worry at ambulance chief's move". This is Bristol. 8 November 2010. Retrieved 17 November 2011. 
  8. ^ "Risk of action over change to 999 rotas". This is Bristol. 3 November 2010. Retrieved 17 November 2011. 
  9. ^ "New ambulance boss appointed". This is Bath. 17 December 2010. Retrieved 17 November 2011. 
  10. ^ "Ambulance staff vote for industrial action". This is Bristol. 7 January 2011. Retrieved 17 November 2011. 
  11. ^ Glaister, Dan (16 November 2011). "Why South Western ambulance may rescue Great Western". The Guardian. Retrieved 16 November 2011. 
  12. ^ "Ambulance trusts to merge in South West". BBC. Retrieved 16 November 2011. 
  13. ^ "About SWIFT Medics". SWIFT Medics. Retrieved 24 November 2011. 
  14. ^ Walker, Emily (6 December 2007). "'Heavy' ambulances are unsafe". Swindon Advertiser. Retrieved 17 November 2011. 
  15. ^ G-NDAA - Great Western Air Ambulance
  16. ^ BBC News: Great Western Air Ambulance cannot land on BRI helipad

External links[edit]