Rural 999 service 'must get better'

Published on Monday 22 June 2009 22:52

MORE must be done to respond to emergency calls quicker in Scotland's most remote areas, the head of the ambulance service says.

The Scottish Ambulance Service (SAS) is now responding to more than 77 per cent of life-threatening emergencies within eight minutes.

But Pauline Howie, SAS acting chief executive, said they had more to do to improve provision in rural areas.

The issue will form a major part of the most extensive consultation ever undertaken by the service on how to improve services, launched this week.

A number of different methods – such as having more expert first-aiders in rural areas and retained ambulance staff – are being looked at in the search for ways of getting to patients faster.

But health campaigners said that some of these schemes may not be appropriate in all areas and more paramedics were needed.

The ambulance service has faced a difficult year, with the departure of former chief executive Kevin Doran and Grace Kennedy, the operations director, amid allegations of bullying and harassment.

Ms Howie said the service had now come a long way, particularly in cutting response times.

But she told The Scotsman that they knew they had more to do to on provision in remote areas.

"What we are doing is working to see what the demographics are in a particular area and what the existing clinical skills are, to match up how we can get best use of existing resources to meet the needs of the population," she said.

One scheme being tested is the use of "first responders" – expert first-aiders who are able to provide initial care before an ambulance arrives.

About 50 schemes are already operating, but more could be introduced.

Other measures being tested include using retained staff to provide cover, as well as community paramedics – staff who work in primary care when not on call-outs.

"We are getting to people faster than ever before, but roads are becoming busier. There are also issues around landslides.

"It is about making sure we can get to people in remote and rural areas even more quickly than we can at the moment," she said.

Ms Howie said "skills atrophy" – where staff lose skills if they are not used enough – meant it was not feasible to have large numbers of paramedics based in areas where they might not be needed regularly.

Dr Jean Turner, of the Scotland Patients Association, welcomed plans to increase access in rural areas, but described first- responder schemes as "the thin end of the wedge".

"If you really want to have Scotland and all its communities sustained, you don't want to give them a second-class service," she said.

Dr Turner said that more paramedics should be trained up to operate in rural communities.

She gave the example of the schemes where paramedics work in primary care when not out on calls.