The East Midlands Ambulance Service (EMAS) has been fined £3.5 million after missing a target on response times for the third year in a row, with previous fines amassing £7.5 million.

Each year, ambulance services across the UK are required to meet set national performance standards through the NHS.

For 2012-2013, EMAS managed to fall within the target of getting to 75% of life-threatening problems within eight minutes at 75.21%, but missed the second target.

The other target is the total number of life-threatening calls which resulted in a fully equipped ambulance vehicle, able to transport the patient in a clinically safe manner, arriving at the scene of the incident within 19 minutes, irrespective of location, in 95% of cases. EMAS achieved 91.85%.

EMAS is one of two ambulance services to miss this target, alongside the East of England Ambulance Service, and also the lowest of all the percentages achieved.

The percentage means that of the 234,120 responses made to life-threatening calls, 52 a day arrived off the target time.

EMAS said in a statement in the first month of 2013/14 the target improved already by 1.21%. EMAS also found that if they could improve the speed of just 19 calls each day by eight minutes and ten seconds, they would meet the standard.

Dr James Gray, EMAS Medical Director, said: “A tremendous amount of quality clinical care was provided to hundreds of thousands of people across the East Midlands during the 2012/13 performing year.

“I thank our clinical colleagues and those working in the backroom functions providing support to them, for their continued commitment and dedication to provide the very best care, often during traumatic and challenging circumstances.

“The speed at which an ambulance response is given to an emergency call is important. There are also other elements that are as vital when providing emergency medical care.

“Negotiations with the organisations who pay (commission) us to provide emergency services have been successful and this year, we’ve been given additional funding which will be spent on extra frontline staff. This is on top of the 140 new staff we announced in March 2013.

“Our Being the Best improvement programme will also make a significant contribution to improving performance. It covers issues such as revising our staff rotas to ensure our resource levels match demand patterns; a management restructure to improve communication and support for staff and the introduction of ambulance hubs, stations and community ambulance stations to improve the speed at which we respond to calls and helps improve the working lives of our colleagues.

“These changes and investment, together with the continual development and improvement in the quality clinical care provided to our patients puts us in a better position this current performing year.”

Under the new plans, there will be 9 hubs, 19 ambulance stations and 108 community ambulance stations across Lincolnshire.

As previously reported, Councillor Christine Talbot, Chairman of the Health Scrutiny Committee for Lincolnshire, requested a review of the plans as she believed they were “flawed.”

“Our ultimate goal is to return a dedicated ambulance service to the county,” Councillor Talbot said. “Despite the goalposts changing, and new options being introduced at the 11th hour, EMAS’ proposals still entirely fail to address how they will start meeting response time targets for our county.”

Lincolnshire County Council will be using Waddington to test local emergency services and other public sector organisations in a serious incident.

The exercise, as part of Exercise Georgiana, will take place on May 21 and 22 just off the A15 to test the council’s large scale emergency plans.

It aims to test personnel and systems of contingencies in coping, containing and resolving a major incident.

The exercise will involve services such as Lincolnshire Police, Lincolnshire Fire and Rescue, East Midlands Ambulance Service, local authorities, the Environment Agency and health agencies, plus voluntary and private agencies.

The council said the exercise will not disrupt the public, but motorists may see more emergency vehicles in the area.

The exercise runs between 8am and 9pm.

Due to a recent increase in measles cases across the country, Lincolnshire County Council and GPs are encouraging parents of unvaccinated or partially-vaccinated children to get the MMR jab.

As part of a catch-up campaign for 10 to 16-year-olds by government, Public Health England and Lincolnshire County Council are sending letters to parents.

The letters will only be sent to parents with children who are not fully vaccinated, inviting them to get the MMR jab at their local GP surgery.

It takes two doses of MMR to be fully vaccinated against measles. It is thought around 10,000 children in Lincolnshire have not received any or all of the doses.

If children have had measles in the past, they should still have the measles vaccine.

Dr Tony Hill, Director of Public Health at the County Council, said: “Measles is a very serious and highly infectious illness.

“The best way to prevent an outbreak in Lincolnshire is to ensure children and young people have had both doses of the MMR vaccine that they need.

“GPs will be writing to parents of those aged 10 to 16, as this age group has a low take-up of the vaccine and has seen an increase in cases of measles as a result. However, if anyone is unsure if they have been vaccinated we strongly urge them to ask their General Practitioner.

“If you have chosen not to have the vaccination for yourself or your child in the past, it’s not too late to change your mind and have it now. Vaccinations are safe and effective.”

Measles is a highly infectious viral illness which can be very unpleasant and possibly lead to serious complications, including blindness and even death.

The illness is now rare in the UK due to the effectiveness of the MMR vaccination, but experts believe the recent rise in measles cases is mostly because of the number of children who missed out on immunization in the late 1990s and early 2000s.

In that period, some parents stopped immunising their children due to the controversy around the vaccine stirred by a study, which was later described as “the most damaging medical hoax of the last 100 years”.

The Director of Public Health in the county has issued the Annual Report for Lincolnshire County Council assess the health and needs of local residents.

As of April 1, Lincolnshire County Council took over the provisions of a number of NHS Lincolnshire public services, including immunisation, healthy eating, tobacco and alcohol, drug recovery, sexual health, pregnancy and children’s health.

This is due to the new Clinical Commissioning Groups (CCGs), GPs and other key healthcare professionals taking responsibility for around 80% of the healthcare budget in their area.

The areas are divided into four: Lincolnshire East, Lincolnshire West, South Lincolnshire and South West Lincolnshire.

Lincolnshire County Council will also provide the four CCGs with public health guidance so they can plan services like hospital and emergency care.

As well as a current look into health challenges in Lincolnshire and what is already underway, the report outlines a number of recommendations to improve service.

According to the report, improvements could be made in the use of data for planning health treatments, better services for those with learning disabilities, better use of NHS Health Checks programme to pick up on long-term illnesses quicker and reduce childhood obesity.

Dr Tony Hill, Director of Public Health at the county council, said: “Because of the recent transfer of some services from NHS Lincolnshire to the county council, this report aims to help all health organisations to stay focused on working together.

“As we go forward, our aim remains- to improve the health and wellbeing of Lincolnshire people.”

Stats at a glance

View the Annual Report here

According to the report:

• In Lincoln, 22.2% of children in Year 6 are considered obese.
• Reception year children in Lincolnshire exhibit higher levels of obesity than the England and East Midlands average.
• Since the beginning of the NHS Health Checks programme in 2009, 50,599 people have received an NHS Health Check in Lincolnshire.
• Of those invited to attend a check within the high risk category, 82% have attended.
• NHS Lincolnshire met and exceeded the national targets in encouraging people to use the service.
• Data indicates that there are around 13,000 people with learning disability across Lincolnshire, with 2709 of these being moderate or severe.
• However, in March 2011, 1714 people with learning disabilities were known to Lincolnshire adult social care services.
• For women with learning disabilities, only 28% get cervical cancer screenings, compared to the general population’s 71% of women — 48% of women with learning disabilities do not get invitations to a screening.

Up to 10,000 Lincolnshire children between 10 and 16 are being offered the MMR jab in a new four-month long campaign.

The campaign is to avoid a potential outbreak of measles after more than 880 cases have been confirmed in the Swansea outbreak and one death.

There were only eight cases of measles in Lincolnshire during the whole of 2012, but there were five cases from January to March 2013.

Measles is a highly infectious viral illness which can be very unpleasant and possibly lead to serious complications, including blindness and even death.

The illness is now rare in the UK due to the effectiveness of the MMR vaccination, but experts believe the recent rise in measles cases is mostly because of the number of children who missed out on immunization in the late 1990s and early 2000s.

In that period, some parents stopped immunising their children due to the controversy around the vaccine stirred by a study, which was later described as “the most damaging medical hoax of the last 100 years”.

Dr Tony Hill, Director of Public Health in Lincolnshire, advised in a video: “Well over 90% of parents are immunising their children, but we do need more than that.

“It’s not just about children who are due the vaccine at the moment, but also about children who missed out in the past, right up to teenagers.

“Children would normally be immunised at about a year old for their first dose, and just before they go to school for their second dose.

“It is important for long-term protection children have two doses, although one dose gives very good protection in the short term.”

If you are unsure whether you or your children have had two doses of the vaccination, contact your GP who will have a record.

A review into the care of patients at Lincolnshire hospitals as part of the Keogh Review is set to start in June. ULHT will be one of the last trusts to be seen.

United Lincolnshire Hospitals Trust was one of 14 NHS trusts needing reviews into their high mortality rates between 2010 and 2012 after the Mid-Staffordshire Hospitals scandal.

ULHT will be one of the last four trust to be reviewed in mid-June, with the first of the trusts beginning reviews in May.

As part of the review, led by Medical Director of NHS England, Professor Sir Bruce Keogh, a team of doctors, nurses and patient representatives will visit hospitals in Lincolnshire.

Over a two to three-day period, the team will watch the hospital in action, and meet with patients, local residents, and staff.

The review looks to see how many failings there are within care and the treatment provided to patients in Lincolnshire, and establish how to improve the trust, either through extra support, recommendations or regulatory action.

After the team visit ULHT services, a special ‘risk summit’ will be held between the review team and the trust to look at improvement measures, and the results of the findings made publicly available.

Professor Sir Bruce Keogh said: “I am determined that these reviews should be about identifying solutions to any problems that may exist.

“I am interested in not just providing a diagnosis, but helping to write the prescription and provide support to these hospitals to help them improve.

“A higher than expected mortality rate does not in itself tell us that a hospital is unsafe. For example, units delivering highly complex and specialist care could legitimately have higher mortality rates.

“It is, however, a warning light that suggests further investigation is necessary.

“It is important that the mortality data warning light – which went unheeded at Mid-Staffordshire Hospitals – is checked in future. That is what this review is all about, and the lessons of Mid-Staffordshire will inform all of the NHS’s new ways of monitoring hospitals.”

Jane Lewington, ULHT Chief Executive, said in a letter to staff: “The process will be robust and challenging, but the Trust welcomes it as an opportunity to continue our journey of improvement.

“We will not compromise the safety and quality of patient care, which remain our top priority. ULHT is making significant progress, as is shown by recent positive CQC reports on both Lincoln County and Pilgrim Hospitals. But we want to do the best for our patients and know there that there is the potential to improve still further.”

Recently, two former United Lincolnshire Hospital Trust executives described the NHS as having a “culture of threats and intimidation” and not putting patient care first over targets.

The former ULHT CEO during the period and whistleblower Gary Walker and former Trust chairman David Bowles gave evidence in the Health Select Committee’s Mid Staffs NHS Foundation Trust Public Inquiry, due to the Trust’s impending review.

A number of leaked letters from consultants regarding patient care within Lincolnshire hospitals also confirmed Walker and Bowles’ accusations.

There have been numerous causes for real concern about the Tories’ attitude to our NHS since 2010, but the recent news that A&E departments across the country are at crisis point is extremely worrying. Hundreds of thousands more patients in England are now waiting longer than the benchmark four hours in A&E, with waiting times reaching 12 hours in some parts of the country.

Despite their election pledges about safeguarding what many believe is our most cherished national institution, in 2010 the Tories weakened the NHS’s existing target of treating 98% of A&E patients within 4 hours. Now, nearly three years on, due to a toxic mixture of staff cuts and a hugely wasteful ‘reorganisation’, England’s A&Es are being overwhelmed. They’re struggling in a way not seen since the bad old days of the mid-1990s.

As The Lincolnite reported, earlier this month United Lincolnshire Hospitals Trust urged people to use A&E only “if absolutely necessary” and asked GPs not to refer patients to hospitals. At the time, the North Lincolnshire Branch of the Royal College of Nursing rightly expressed concern.

In fact, over the last 27 weeks, ULHT have missed the four hour A&E standard in well over half of those weeks and 4,646 people were waiting longer than four hours for A&E treatment.

Across the whole of England in the last six months, 161,890 more people waited for more than four hours in A&E compared with the same period in the previous year, bringing the total to 582,811 people. Shockingly, at Norwich & Norfolk University Hospital, an emergency tent was set up outside to treat patients because the A&E was under such pressure.

To say this situation isn’t good enough would be a gross understatement. It’s absolutely appalling. It should serve as an urgent alarm call to us all that the NHS is under severe strain.

This strain has been caused by cuts to staff and social care budgets, as well as by the time and money wasted on an unpopular reorganisation. Since the 2010 election, almost 5,000 nursing posts have been lost from the NHS. Hospitals are continuing to make severe cuts to front-line staffing levels, with many operating below recommended levels – the Care Quality Commission have warned that 1 in 10 hospitals are failing to meet the standard on adequate staffing. Despite the Francis Report’s recommendation, following the Mid Staffs scandal, that there should be a minimum staffing level (and pressure from Labour’s Andy Burnham), the Conservative Party refused to implement this.

Deep cuts to council social care budgets mean patients can’t be discharged from hospital beds, which has a knock-on effect right through the hospital. With no free beds on the wards, A&E staff can’t admit patients and, with A&E full, paramedics can’t hand over patients. The result is long queues of ambulances outside hospitals as the pressure backs up right through the system.

For months, the NHS has been distracted by its biggest-ever top-down reorganisation. On top of this, the short-sighted slashing of NHS Direct has contributed to even greater pressure on A&Es.

All in all, a deeply unhealthy combination of pressures has meant standards of care are deteriorating across the country, including here in Lincoln, and patients are suffering as a result.

Our NHS has suffered greatly under previous Tory governments and, though depressing to say it, it’s no surprise to me that it is now suffering again. It’s absolutely vital that the Tories get a grip of this A&E crisis and bring all A&Es back up to national standards as quickly as possible. At a minimum, they should stop the job cuts and ensure there are enough staff on the ground to provide safe care.

The City of Lincoln Council is sending out messages in bottles to some city residents, but to help them, not the authority.

The Message in a Bottle Scheme was set up by the City Council, housing contractor Kier and Lincoln Lions to help elderly and vulnerable people.

Tenant Liaison Officers will give these people special bottles to be kept in the fridge, which contain details of medical conditions, personal details and emergency contacts.

A sticker is also placed on their back door, so anyone coming to help in an emergency will know they are in the scheme.

The scheme is free for anyone to join if they feel it might be beneficial to them. if successful, Message in a Bottle could be rolled out nationally.

John Bibby, Director of Housing and Community Services, said: “We are delighted to be involved in this project as it will provide peace of mind to dozens of families across the city.

“Should the worst happen this bottle, and the information in it, could give first responders and paramedics vital infomation which could save a life.”

President of Lincoln Lions Barbara Coleman said: “The Lions are very pleased to have the opportunity to work with Kier and the City of Lincoln Council in providing this potentially life-saving concept to residents of Lincoln.

“It is a very simple and cost-efficient way to assist the emergency services by making sure that they have access on the spot to all the relevant information to enable them to deliver the appropriate treatment.”

Phil Oades, Senior Operations Director at Kier said: “Kier prides itself on working closely within the communities in which we work to support initiatives and groups which improve the life of others.

“We have always seen our Tenant Liaison Officer’s and operatives being our eyes and ears as they potentially come into daily contact with vulnerable tenants in Lincoln and these are the front line staff that will be delivering the bottles.

“This potentially life saving initiative is the start of many of commitments going forward within our partnership with the City of Lincoln Council.”

The A&E at Lincoln County Hospital is now back to normal operation after a busy week that led to high demand for beds and services at the hospital.

“Lincoln and Pilgrim hospitals have now returned to normal seasonal activity levels following the period of prolonged cold weather,” United Lincolnshire Hospitals NHS Trust said in a statement.

As previously reported, the two hospitals advised people to go to A&E only if absolutely necessary throughout the week and asked GPs not to refer patients to hospitals in the period.

Linda Higginbottom, Deputy Director of Patient Services, said: “We would like to thank members of the public for cooperating with us during this busy time.”

Grantham hospital deals with norovirus

“Grantham and District Hospital is continuing to experience cases of the winter vomiting bug, norovirus and is no longer taking admissions onto the wards,” Linda Higginbottom added.

“A&E will remain open, but any patients who need to be admitted to a ward will be diverted to other hospitals.

“Ambulance services will also take patients who need to be admitted for treatment to alternative hospitals.

“Staff have also been affected by the bug, and the Trust is asking for any ULHT-employed trained nurses or healthcare support workers who are able to work shifts on medical or surgical wards over the weekend to contact the hospital directly on 01476 565232 and ask for the site duty manager.”

Lincolnshire hospitals are seeing a high demand for beds and services at Lincoln County Hospital, Pilgrim Hospital in Boston and Grantham and District Hospital.

United Lincolnshire Hospitals NHS Trust said in a statement hospital staff have opened up additional beds, and taken other actions to meet the demand for services.

They are urging people to use the A&E service only “if absolutely necessary” and asking GPs not to refer patients to hospitals in this period.

No single incident has caused this pressure, ULHT said, though no details of the nature of the incidents were disclosed.

There are also additional ward rounds so that people who are well enough to go home are discharged in a timely fashion, which then frees up beds for other patients.

“We are also working with our local commissioners to help care for patients with less severe medical conditions in community based facilities,” ULHT added in the statement.

“We are asking members of the public to help us during this busy time and only use A&E if absolutely necessary.

“If you need medical help fast, call NHS 111 24 hours a day or seek advice from your GP or pharmacist.”

“The hospitals are liaising with Lincolnshire GPs to ensure that patients not requiring hospital care are not referred to hospital during this busy time.”

Concerns over actions

Meanwhile, the North Lincolnshire Branch of the Royal College of Nursing (RCN) is concerned about ULHT is asking people not to attend A&E departments.

David Harding-Price, Branch Secretary and Council Member for the East Midlands, said: “ULHT only has three A&E departments and to in effect close all three is of real concern to my members.

“It is going to put a lot of additional pressure on the Walk in centre on Monks Road and the ambulance service. Also for many people it will increase their travel time if they have to travel further to access medical care.

“All the other hospitals in the county only have either a Minor Injuries Unit or an Urgent Care Centre so restricting the only A&E departments is reduction in service in Lincolnshire.

“Such action has to have been sanctioned by the Trust Board and we hold them responsible for the failure to ensure that there is adequate funding to maintain clinical services.”

Recovered drug and alcohol users in Lincoln have been helping tackle graffiti at a Methodist Church in order to give back to the community.

The small peer support group from Lincoln’s Drug and Alcohol Recovery Team (DART) volunteered their time to clear drug-related graffiti off Ermine West Methodist Church, after one member noticed the damage.

After getting in touch with church leader Reverend Mark Stennett, the team got to work painting over the graffiti and tidying the area.

The peer support group also offered their services if the church needed help with gardening or any other manual tasks.

Reverend Mark Stennett at Ermine West Methodist Church said: “It was a real delight having the peer support volunteers help our church after the frustrations of vandalism.

“They were ever so pleasant and they worked really hard to help us.”

One of the peer support mentors and initiator of the project, Andy, said: “As part of the work of the peer support group, we not only want to encourage people suffering with drug and alcohol problems to come forward and seek help and support them through their recovery journey.

“We also want to give back to the local communities we live in after many years of being disengaged.

“After noticing this offensive graffiti and the fact that it was related to drug culture in this way, we thought this would be a great opportunity for the group to start to offer our help and services.”

Despite objections from Lincolnshire County Council, the East Midlands Ambulance Trust (EMAS) will go ahead with plans to restructure the ambulance service across the region.

As previously reported, the plans will introduce a number of superhubs, community stations and standby points to improve response times.

However during consultations, a number of iterations were made, leading to three alterations of the plans.

Under the new plans, there will be 9 hubs, 19 ambulance stations and 108 community ambulance stations across Lincolnshire.

The decision comes despite Councillor Christine Talbot, Chairman of the Health Scrutiny Committee for Lincolnshire, requesting a review of the plans as she believed they were “flawed“.

“Our ultimate goal is to return a dedicated ambulance service to the county,” Councillor Talbot said. “Despite the goalposts changing, and new options being introduced at the 11th hour, EMAS’ proposals still entirely fail to address how they will start meeting response time targets for our county.”

Changes will not be immediate

Phil Milligan, EMAS Chief Executive, said: “The changes will be better for staff, with more support and time to care for patients – not vehicles.

“The final recommendation was created after three months of consultation, and a further two and a half months of engagement allowing our staff and the public including other healthcare providers, councillors and MPs, to have their say and help to shape our plans.

“The way we operate now is simply not delivering the performance that local people deserve and national government expects.

“The changes we have approved at our Trust Board meeting today will improve performance on life-threatening calls by nearly 4%. People suffering a serious illness or injury can also expect to receive a faster response.

“Moving to a hub-and spoke-model means that ambulances will be deployed more efficiently and will be nearer to patients. This is not all about the bricks-and-mortar of ambulance stations – many of which were built on assumptions more than 50-years old,” Phil Milligan added.

“Clinicians will be supported by Make Ready teams based at each hub and ambulance station to clean and stock our emergency vehicles, thereby allowing our skilled crews to get out on the road faster to respond to calls and ensuring that they have the right equipment with them.

“The introduction of community ambulance stations will mean crews no longer have to return to large urban-centre ambulance stations and will be less likely to be drawn away from more rural areas. Indeed, we have also announced a trial of community paramedic schemes – which will see paramedics ring-fenced to a rural area, ensuring a local presence.

“This is a five year plan and changes to our estate will not be immediate. We will use the next three to six months of the new financial year to progress our planning and implementation of the 108 community ambulance stations, twinning of the proposed existing ambulance stations and further development of the estate strategy.”

Health Minister Dr Dan Poulter visited Lincoln County Hospital on Thursday and spoke about the United Lincolnshire Hospital Trust’s part in the high mortality rates investigation and condemned gagging former health executives.

ULHT is one of 14 trusts in the country that are being investigated for higher than expected mortality rates, and the Health Minister said the review will be concluded by the summer.

Speaking to The Lincolnite, Dr Dan Poulter said: “There are a few things I have picked up on today that I will feed into those investigations.

“Sir Bruce Keogh, the NHS Medical Director who’s taking on board those investigations, is going to 14 trusts, [ULHT] being one of those trusts. It’s about looking at what factors there may be that caused the higher than expected mortality ratios, and there may well be factors there that were well out of the hospitals’ control.

“For example, what are local palliative care facilities like, are people getting the support in the community that they need when they are coming towards the end of their life, and if not, they are having to come and die in hospital, then that drives mortality ratios. That review is going to be ongoing and will conclude by the summer.”

Earlier this week, former ULHT CEO and whistleblower Gary Walker and former trust chairman David Bowles gave evidence as part of the Mid Staffs NHS Foundation Trust Public Inquiry by the Health Select Committee.

Gary Walker and David Bowles described to the panel their time at ULHT, and the problems the trust faced, particularly in 2008, explaining how he was intimidated into leaving his post, and that he agreed to a gagging order compensation worth £225,000.

“As a government we make it very clear that gagging clauses are completely unacceptable,” said Health Minister Dr Dan Poulter.

“Of course you’re sometimes going to have to have confidentiality clauses where there are issues of commercial sensitivity or patient data, but it’s never acceptable to try to gag staff from speaking out on issues about patient care. We’ve made that very clear as a government, a number of the issues happened in the previous government, but our line is [gagging orders] are completely unacceptable.”

Lincoln MP Karl McCartney accompanied the Health Minister on Thursday on his visit in Lincoln, as part of a tour of several hospitals in the East Midlands, including Newark and Grantham.

Karl McCartney said: “When we look at what’s been happening with Gary Walker, and when he spoke at the Health Select Committee, along with David Bowles, I think there’s real serious issues that need to be addressed that haven’t.

“I wrote to the chairman of the Health Select Committee and I listed a number of people I felt should be invited to talk to the committee — and that involves the previous health ministers who I think will have overseen what happened to Gary Walker — who have some serious questions to answer.

“As someone elected to represent my constituents, it’s something that concerns me and I want to know what’s being to make things better, and also who’s going to be disciplined to make sure they don’t make the same mistakes they have potentially made previously. I think that goes across the whole spectrum of different issues, not just in the health service,” Karl McCartney added.

Lincolnshire County Council’s Health Scrutiny Committee is requesting a review of East Midlands Ambulance Service’s (EMAS) new plans, as it believes them to be “flawed”.

The committee plans to write to the Secretary of State for the review after a recent meeting expressed concerns over the EMAS consultation process and response times.

EMAS proposed last year to remove the ambulance stations in Lincolnshire and install Community Ambulance Posts, Standby Points and in some areas state-of-the art “Super Stations”.

The service believes these hubs and points will result in better response times and care.

Councillor Christine Talbot, Chairman of the Health Scrutiny Committee for Lincolnshire, said: “We believe the consultation is flawed; key parties were not invited to comment, new options not consulted on, and both public and stakeholder events poorly attended.

“Despite the goalposts changing, and new options being introduced at the 11th hour, EMAS’ proposals still entirely fail to address how they will start meeting response time targets for our county.

“EMAS has not met targets for the last 21 months in Lincolnshire and this isn’t good enough. It is not acceptable for voluntary organisations such as LIVES and other emergency services, who make a valuable contribution to response times, to prop up the ambulance service.

“The committee therefore has no confidence that EMAS’ pledge of “Being the Best” will happen in Lincolnshire without considerable extra financing and will therefore be referring the matter to the Secretary of State.

“Our ultimate goal is to return a dedicated ambulance service to the county.”

Better service for residents

Lincoln MP Karl McCartney visited Lincoln County Hospital on March 21 alongside the Health Minister, Dr Dan Poulter.

He said: “I’m pleased that they’re obviously examining what the ambulance service have done, I’m not sure of the full details of the consultation project and the process that has been followed, but these consultations are in a way set down in statute, and there’s a quite easy template to follow, so I’d be surprised if they haven’t followed the process they should have if they’re been called to answer by the Scrutiny Committee at the County Council.

“I want to make sure the the service my constituents are provided with by the ambulance serve are as good as, if not better than, anywhere else in the country.

“I’ve spent some time with those working in the ambulance service in Lincoln and across Lincolnshire going out on calls etc, and I know how hard they work, but this is more management issues, and what resources are put forward for the service to ensure my constituents receive the level of service they require.”

A statement from EMAS argued that the service is dedicated to improving response times and patient care, and these plans will help.

“Our plans for Lincolnshire will improve response times. Similar plans have worked very well for rural areas in other areas of the country.

“There’s no guarantee that a devolved ambulance service for Lincolnshire would be effective. When Lincolnshire had its own service the performance targets were less exacting. Such a service would also cost more as it would need its own bureaucracy.

“In Lincolnshire we’re proposing to have four hubs, six ambulance stations and 23 community ambulance stations. This means full fleet services (mechanics to maintain and repair vehicles) will be available in four locations in Lincolnshire. Currently there are no fleet services in the county.

“Our aim is to improve response times, patient care and the working life of our staff and we believe these changes, together with the additional investment needed, help us meet these aims.”

Two former United Lincolnshire Hospital Trust executives have described the NHS as having a “culture of threats and intimidation” and not putting patient care first.

Former ULHT CEO and whistleblower Gary Walker and former Trust chairman David Bowles gave evidence as part of the Mid Staffs NHS Foundation Trust Public Inquiry by the Health Select Committee looking at high death rates on Tuesday, March 19.

Gary Walker and David Bowles described to the panel their time at ULHT, and the problems the Trust faced, particularly in 2008, and Mr Walker’s dismissal.

David Bowles described how there was a culture “to make things look good, rather than things being good”, and that other trusts in the country faced the same problems.

Too many targets

Problems centered on patient care versus targets, and how the likes of East Midlands Strategic Health Authority (SHA) were too focused on hitting targets than the welfare of patients.

Walker and Bowles described how the focus on targets put Lincolnshire hospitals and their patients at a “tipping point”.

Gary Walker described that after paying off the Trust’s debts from previous administrations and reducing waiting times by half, he then had to deal with capacity issues, because hospitals like Lincoln County were “over-full”.

He mentioned that there had been plans in place to add 100 more beds due to demand increase, but these could not happen due to lack of resources.

He described how there was a choice between meeting targets and patient capacity, and that despite applying for a capacity review with the Health Authority, he was advised not to raise it.

The committee asked why Walker did not fight to get a capacity review during his time as CEO, to which he replied the situation went “beyond needing a capacity review, as the Trust went into crisis management”.

The beds were added after Walker was dismissed from his role for alleged gross misconduct, which he argues is testament to his point.

He also accused the Health Authority of being at times heavy-handed and even bullying.

Walker mentioned that the ULHT was threatened by SHA and Lincoln County Hospital subsequently put into red alert if it did not stick to targets.

To help make hospitals safer, Walker made a decision within his role to cancel 700 operations so hospitals could focus on the high number of emergency cases, despite getting pressure outside the Trust to stick to the targets.

Scared to speak up

Even managers within the hospitals could be too target driven to look at patient safety, and staff would be too scared to speak out in fear of losing their jobs.

Bowles mentioned that he raised a complaint with the Trust’s board every time a staff complaint was raised.

During the period, there were a number of complaints from staff regarding both patient care and staff being bullied. At the time, he assured staff the Trust would protect them if the case went to be reviewed.

None of the staff were confident enough to pursue their complaints further for fear of being let go.

David Bowles said: “I feel I let everybody down.”

The committee argued that his concerns for staff had not been raised with the SHA effectively, but Bowles said he raised concerns with the SHA regarding its tone and the pressure applied to stick to targets.

Bowles mentioned he had also been bullied over his concerns around targets, and that Walker had struggled to continue his career after whistleblowing.

The pair also received emails from outside the Trust containing threats. One regarding A&E admissions said that if the Trust did not meet national targets, there would be “serious consequences”. Neither knew what these consequences would be or meant.

Gagging order

Walker was sacked over a row regarding long non-emergency waiting lists within the Trust. He was not allowed to talk about the row between waiting lists, patient care and targets until now due to a gagging order.

He described how he was intimidated into leaving his post, and that he agreed to a gagging order compensation worth £225,000.

Walker accepted the sum as his lawyer fees reached £100,000 and he grew “exhausted” of battling NHS authorities.

He also told the select committee that he was not the only executive Trust member to be given a gagging order, and many others across the country were also in the same position.

Gary Walker said: “We don’t know what’s being covered up. Public money is being used, and that’s a problem.”

Bowles concluded the two-hour meeting: “The current culture is inconsistent with care… we have to tackle the culture. We can’t change the NHS without changing the leaders. We need to stop staff being too scared to speak out.”

ULHT is one of 14 trusts currently being investigated due to high death rates after the Stafford Hospital scandal over mortality rates between 2005 and 2008.

Also read: Leaked letters show staff worries over patient care and targets balance at Lincolnshire hospitals

A new clinical mental health research unit has opened in Lincoln.

The new facility focuses on improving conduct of Lincolnshire mental health research and clinical trials, such as infrastructure and support.

Clinicians and researchers will also have one base to work together from in order to dispense trial medications for people participating in studies.

It also means a higher number of trials can take place, which will be of benefit to current and future mental health service users.

Lincolnshire Partnership NHS Foundation Trust (LPFT) Chief Pharmacist Shiraz Haider said: “I am delighted to open this new centre in Lincoln.

“In addition to helping to develop new treatments, mental health research makes a vital contribution to NHS clinical research performance.

“Bringing this expertise into one place will ensure that the trust continues to lead the way in translating the latest innovations into improved outcomes for NHS service users.”

Trust Medical Director, Dr John Brewin, added: “This opening marks yet another milestone in the development of the trust as a centre of excellence in clinical mental health research and reflects the desire, ambition and enthusiasm of our staff to be at the forefront of cutting-edge innovation for our service users.”

Smoking materials are the main cause of accidental house fire deaths in Lincolnshire, according to new figures released by Lincolnshire Fire and Rescue.

The statistics show that the number of house fires caused by smoking has decreased from 28 in 2011 to 16 in 2012, but of those fires, more are fatal.

There were 212 accidental house fires attended by Lincolnshire firefighters in 2012, compared with 365 in 2011 and 380 in 2010.

However, there were three fatalities from accidental house fires in 2012 compared to 1 in 2011, all of which were caused by smoking materials.

Overall last year, 1 in 13 accidental fires in the home were caused by smoking materials, and 14% of casualties needed more help than could be given at the scene.

Debbie Robinson, deputy community fire safety manager at Lincolnshire Fire and Rescue, said: “These accidental fires often start when people are at their most vulnerable, which is why they are so often fatal.

“Nationally and within Lincolnshire statistics show that smoking materials cause more fire-related deaths than any other domestic fires.”

“So, we are trying to encourage people to not smoke when feeling tired, especially in bed or lounging in a chair. And to remember that if they have been drinking alcohol or taking medication, they may feel drowsy,” Debbie Robinson added.

Lincolnshire Fire and Rescue advised to always use an ashtray when smoking, never smoke in bed, and always empty ashtrays before going to bed, making sure the contents are fully extinguished, like running them under a tap.

NHS Lincolnshire will no longer exist after the NHS reforms come into place on April 1, changing the way health services are commissioned across the county.

As part of new Clinical Commissioning Groups (CCGs), GPs and other key healthcare professionals will be responsible for around 80% of the healthcare budget in their area, while public health services will move to Lincolnshire County Council.

The Lincolnshire West CCG will cover 223,000 people with 37 practices including Lincoln, Navenby, Gainsborough, North Hykeham, Branston, Nettleham, Brigg, Welton, Saxilby, Ingham, Washingborough, Metheringham, Willingham by Stow, Bassingham and Scotter.

There will be three other CCGs covering the county: Lincolnshire East, including Market Rasen, Horncastle, Louth and Boston; South Lincolnshire including Stamford, Bourne and Spalding; and South West Lincolnshire, covering Sleaford and Grantham.

Edie Butterworth is the Transition Director at NHS Lincolnshire, who has worked over the last two years with organisations in the health and social care community to support the change from old to new NHS organisations.

“The four emerging Clinical Commissioning Groups in Lincolnshire will take over our role as local commissioners and have been working in shadow since 2012 to ensure they are well prepared to become statutory bodies on April 1,” Edie Butterworth said.

“GP, pharmacy, dental and optical services will be commissioned by the Leicestershire and Lincolnshire Commissioning Board Area Team, part of the NHS Commissioning Board.

“NHS Lincolnshire has achieved an incredible amount which wouldn’t have been possible without the hard work and support of all our staff, and we’re proud to leave a legacy of improving health and improving services from the last seven years,” he added.

Dr Sunil Hindocha, Accountable Officer for the Lincolnshire West CCG, said: “There are over 220,000 people living in Lincolnshire West over an area of about 420 square miles and we are committed to making sure people receive compassionate care and excellent health services that help them lead a healthy lifestyle and preventing illness.

“Our priorities for the future include reducing the differences between the least healthy and most healthy communities, helping residents to have high quality and responsive healthcare of their choice, and to continually improve health for all our population, whilst improving the quality and safety of local services even further,” he explained.

New duties for public health

Meanwhile, public health services including immunisation, healthy eating, tobacco and alcohol, drug recovery, sexual health, pregnancy and children’s health, have transferred over to Lincolnshire County Council.

Councillor Sue Woolley, Executive Councillor for health, community and housing at Lincolnshire County Council, said: “We want to make sure that people living and working in Lincolnshire lead long, healthy and happy lives by improving the health of the population and reducing inequalities.

“These changes are part of the government’s health reforms, and we are well-placed to take on these services, as we already have responsibility for many important cross-cutting services such as planning, schools and transport.

“This is an exciting time with many new opportunities already being taken to work more efficiently and effectively. We have already seen savings of more than £1 million through contract negotiations which offer improved services.”

Under the new arrangements, the council will also provide public health guidance to the county’s four new CCGs, made up of 102 GP practices, as they plan services like hospital and emergency care.

Dr Tony Hill, Director of Public Health, said: “We have been working behind the scenes for some time to make sure the transition is as seamless as possible. Many of the services are provided by community groups, charities, partnerships and private businesses and this will continue to be the case, so you can access services just as easily as you have in the past.”

The specialist stroke unit at Lincoln County Hospital has been praised in an external assessment.

The report found patients are receiving the best possible treatment within three hours, improving their recovery speed and reducing rehabilitation time.

The £195,000 unit opened last year and has led to an ‘improvement in standards’ of care which is ‘consistently patient centred’.

The external assessment was undertaken by the NHS Midlands and East Stroke Review External Expert Advisory Group (EEAG) and Lincolnshire West Clinical Commissioning Group.

The assessment took place in February 2013 at the specialist stroke units at Lincoln County and Pilgrim Hospital, Boston to assess the quality of care in line with national standards.

The report found United Lincolnshire Hospitals NHS Trust (ULHT) is ensuring that nearly all stroke patients receive a vital brain scan immediately “resulting on some of the best imaging times nationally.”

Dr Simon Leach for ULHT said: “The review team commented at Lincoln that our door to scan times were amongst the best in England.”

“The symptoms of a stroke appear F.A.S.T and spotting them quickly can mean fewer brain cells are damaged, reducing damage and disability.”

Sarah Newton, Chief Operating Officer for Lincolnshire West Clinical Commissioning Group (CCG) said: “As the NHS organisation which commissions stroke services on behalf of people in Lincolnshire, we were delighted to see the standards of stroke care being delivered at Lincoln County Hospital.

“In particular, our CCG is impressed with the hospital’s tracker system which identifies all stroke patients to ensure they’re receiving the right level of care and the seven day therapy services.

“Lincolnshire West CCG will continue to monitor the care being delivered at Lincoln’s stroke unit, in line with national guidelines to ensure people in Lincolnshire receive the best standards of care.”

United Lincolnshire Hospitals Trust says it is experiencing a higher demand in A&E across all its hospitals in the county, particularly in Lincoln and Boston.

Michelle Rhodes, Director of Operations, said: “Staff within our hospitals continue to work hard to care for patients under the additional pressure.

“By choosing an alternative NHS service that could be more appropriate for their symptoms, patients can get treated quicker whilst helping to ease the pressure on A&E departments.”

Residents are being asked to support Lincoln County Hospital by not adding to the sustained pressure on Accident and Emergency services.

“Call NHS 111 to be guided to the right health services for your needs if it’s not a life threatening emergency,” Michelle Rhodes added.

ULHT is asking patients to consider the following services before A&E:

• Self Care – can you treat aches, pains, coughs and colds at home?
• Pharmacist – Most over the counter medicines can treat allergies, constipation, cold and flu symptoms
• Walk-in centre or minor injuries unit – for treatment of minor illness and injuries, no appointment needed
• Doctor’s Surgery – ring the usual number whatever time of day or night and visit your GP
• Call 111 24 hours, 7 days – for the GP out of hours service, advice on all health symptoms and referral to a healthcare professional, if required.