NHS0005

 

Written evidence submitted by St John Ambulance

 

Background

St John Ambulance has always supported the NHS during periods of high demand, such as winter pressures, heatwaves, flooding, and – most recently – as part of 1.6 million hours of support during the coronavirus pandemic. Our support for the NHS includes emergency ambulance provision, alongside volunteering in hospitals, and administering vaccinations, as well as providing further community-based activities that reduce pressure on NHS services.

 

Our ambulance operations include paediatric transport services, neonatal transport, bariatric transfers, end of life transport, renal dialysis transport and surge support to the NHS, working under contract to many NHS hospital and ambulance trusts across the country. We believe expansion of St John pre-hospital care and community resilience will help relieve more pressure on health systems by supporting people needs before they become NHS Patients, thereby helping to reduce the NHS Backlog and waiting times.

 

St John Ambulance’s role in emergency ambulance response

Since August 1, 2022, St John Ambulance has been commissioned formally by NHS England (NHSE) to provide the nation’s ambulance auxiliary service in a four-year contract to add resilience to NHS ambulance trusts treating and transporting patients across the country whilst helping to reduce ambulance waiting times.

 

The contract sees St John people provide:

 

St John volunteers include healthcare professionals, such as doctors, nurses, and paramedics, who gain valuable experience of treating patients in different settings by giving their time to St John in a variety of roles, including on board our ambulances. St John co-ordinates with NHSE and the Association of Ambulance Chief Executives (AACE) to ensure we can provide the optimal support as the nation’s Ambulance Auxiliary.​​​​​​​ This ensures the NHS has certainty that St John Ambulance can deliver, by scaling up surge capacity during times of significant pressure such as the recent Heatwave and forthcoming winter pressures.

Professor Sir Stephen Powis, NHS Medical Director said: “This new agreement with one of our longest partners is a welcome addition as the NHS does everything it can to boost capacity ahead of what is set to be another difficult winter.

In recent evidence to the House of Lords Public Services Committee, Health Minister Will Quince MP stated that in supporting NHS Trusts, the government should not be afraid to use other experts in the field such as St John, which is providing the 5,000 hours of surge capacity”

Our clinically trained volunteers bring their lifesaving skills to provide support in several areas to alleviate demands on the NHS.

St John Ambulance’s regulated services (ambulance operations and Homeless Service in Sussex) are overseen by the Care Quality Commission (CQC). Following inspections this summer, three out of five services have been rated Good, with Outstanding features. At the time of writing, final CQC inspection reports are due for the other two, but the drafts both rate St John as ‘Good’, meaning our ambulance operations are of high quality across the country.

             

Our Ambulance Operations

As a leading supplier of ambulance services in England, St John Ambulance transports around 100,000 people to hospital every year and responds to emergency calls, including caring for patients at home without conveying them to hospital. Our services include paediatric transport services, neonatal transport, bariatric transfers, end of life transport and surge NHS support.

 

St John Ambulance crews support the NHS by:

 

A crucial part of delivering health resilience through the Ambulance Auxiliary is to ensure it is reflected within the national resilience architecture, to deliver effective emergency preparedness through representation within the emergency planning of Integrated Care Boards. Greater integration of the Ambulance Auxiliary and voluntary sector into these structures will enable NHS trusts to access the necessary expertise to reduce waiting times and pressure.

 

Our asks of Government

We are asking the Department of Health & Social Care and Cabinet Office to deliver:

Our Community Operations

 

Falls Services

St John provides two 24/7 mobile response falls services in London and Wolverhampton to support the elderly and frail in their own homes. Every year, 1 in 3 people over 65 suffer a fall, which can cause serious injury and even death. According to NHSE, the costs from hip fractures alone are £6 million a day or £2.3 billion a year.

 

Our falls services provide a high level of care to residents, both clinically and non-clinically. 90% of dispatches are managed by St John to discharge at scene without needing an ambulance and calls are responded to in 20 minutes. As noted in the Fuller Stocktake Report, we believe ICBs must establish clear onward referral processes into existing support pathways utilising community first responders in line with guidance underpinning NHSE Winter Resilience plans, and the DHSC Plan for Patients’.

 

To strengthen collaboration between emergency services, St John is asking to be added to the Directory of Services within NHS Pathways as an end-point provider. This ensures falls calls are handed on by ambulance services to St John where our services operate to boost NHS capacity, avoid unnecessary callouts, and enable providers to expand falls services.

 

Night-Time Economy support

Our Night-time economy (NTE) provision offers safe spaces in town and city centres, focused on Friday and Saturday nights including London, Birmingham, and Newcastle. These are times when alcohol intoxication and related issues are at their most prevalent and increase pressure on emergency services.

 

Our teams ensure patients receive prompt care and treatment under the supervision of a qualified healthcare professional. Where a patient does need to go to hospital, St John will take them and where 999 calls are received St John can attend. The greatest impact is on ambulance services, where that can be up to 13% reduction in calls and 19% reduction in ambulance responses required where these services are active.

 

Our NTE provision covers 20 locations, commissioned by local authorities, NHS ambulance trusts, Police & Crime Commissioners. Strengthening collaboration between NHS Trusts and the voluntary sector will ensure local organisations can contribute clinical expertise to reduce pressures on the local NHS whilst maximising provision to support pre-hospital care.

 

Covid- 19 Response

St John Ambulance stepped forward to serve in the biggest peacetime deployment of our- almost 150-year history. Our volunteers have delivered over 1.6 million hours of service to support local communities and the NHS, this includes:

 

Professor Anthony Marsh, National Strategic Advisor for Ambulance Services said:

Without your volunteers and staff, the country would not have been able increase the number of resources that we have been able to deploy. This has relieved pressure on the 999 services and ensured we have been able to save as many lives as possible” 

 

St John continues to support the work of the NHS Volunteering Taskforce to bring together expertise from across health, social care, and the voluntary sector to build on the incredible achievements of people who stood up to support their NHS and local communities.

 

We believe it is important to build on the innovations developed during the pandemic, to create a legacy of resilience for the NHS and communities, through greater integration of the voluntary sector into the architecture of national and local emergency planning. This would deliver a public-voluntary sector partnership that should be central to future public sector workforce planning to reduce waiting times and improve outcomes for patients.

 

St John Ambulance youth programmes

St John has a proud tradition of engaging young people in health volunteering. 2022 marks a special year for St John as the charity celebrates our ‘year of youth’ representing 100 years of supporting young people through our youth programmes. Amongst these programmes is NHS Cadets. Announced in 2020, the programme focuses on supporting disadvantaged young people to consider volunteering and an NHS career. NHS Cadets aims to attract young people undecided on their career path and those from marginalised backgrounds.

 

Young people meet in groups of 20-30 through term-time, one evening per week. Over the course of 36 weeks, young people take part in a series of 90-minute sessions delivered by experienced project teams. Topics are geared towards personal development, mental health, volunteering, and healthcare knowledge. In partnership with local NHS trusts, we offer two pathways running over 12 months: 

 

Supporting NHS volunteering and careers are key parts of the programme. Each NHS trust and region has its own workforce needs, so where possible we aim to tailor the experiences of Cadets to give them exposure to the career areas where there is a particular local need. 4610 cadets will have signed up with 61 NHS trusts supporting the programme’s delivery.

 

The programme is equally funded by St John and NHSE, however buy-in and non-financial support from NHS trusts is key to the roll-out so Cadets can gain hands-on exposure to volunteering in the NHS. For the NHS, this represents an investment in the future NHS workforce, and we are calling on NHS England to continue funding the programme after 2022.  

 

Additional Information:

St John Ambulance’s 2021 Impact Report & Annual Report

Video: https://www.youtube.com/watch?v=E9RoG1jQA4o&t=8s

Document: https://www.sja.org.uk/globalassets/documents/what-we-do/2021-impact-report/annual-report-and-accounts-2021-sja.pdf

 

Care Quality Commission reports:

https://www.cqc.org.uk/location/1-9475977147

https://www.cqc.org.uk/location/1-211025821

https://www.cqc.org.uk/location/1-7920985955

 

House of Lords Public Services Committee Inquiry ‘Designing a public services workforce fit for the future St John Ambulance Written evidence:

https://committees.parliament.uk/writtenevidence/106721/html/

 

Home Affairs Select Committee evidence on St John Ambulance’s night-time economy support (written and transcript of oral): https://committees.parliament.uk/oralevidence/3295/html/

 

November 2022