Larrey Society calls for a national ambulance authority

The Government was urged today (16 June 2015) to create a cross-sector national ambulance authority with an over-arching pivotal role to support the integration of emergency medical and social care services.

The idea is put forward in a pamphlet to be published by The Larrey Society, the “think tank” set up to help shape future ambulance policies.

The pamphlet says the NAA would be the first step in a radical re-think but stresses that while the NHS must remain in public ownership in perpetuity it would be removed from the political agenda, leaving those better equipped to run it with an irrevocable real 5 year budget funded by a fixed ring-fenced Healthcare Tax.

The ambulance service is already structured as a self-contained arm of the NHS and the creation of a national authority would be the most important change since the NHS was launched 65 years ago and sets collaboration not conflict as the guiding principle for the nation’s healthcare economy in the 21st century.

The NAA would take over from politicians the strategic decision-making power for all patient and social care transport in England (but it might also take in Scotland, Wales & Northern Ireland) dependant on the political landscape) and hands it to a new cross-sector entity with legal empowerment to negotiate, agree and monitor: 

• A budget funded by the new Healthcare Tax, and allocated to ambulance  providers selected because their bid is commercially realistic and adequately resourced – not just the lowest in cost – to deliver a service which patients need;
• A new regime of national standards of ambulance performance, inspection and enforcement which far exceed those currently in place; this responsibility will be handed to the Care Quality Commission;
• The introduction of an authorised single national training programme for paramedic qualification;
• Planned cross-sector collaboration between ambulance providers, social care services, police & fire organisations, and industry suppliers in areas such as investment in communications technology, information sharing, operational procedures, employment terms & conditions, vehicle design and research.
• The NAA will be responsible to Monitor, the healthcare industry’s economic regulator and a non-political corporate individual with a proven track record in cultural change is to be appointed to chair the Authority;
• The organisation will comprise an individual from each of organisations such Association of Ambulance Chief Executives, Association of Chief Police Officers, British Red Cross, Care Quality Commission, College of Paramedics, Community Transport Association, Fire Brigades Union, General Medical Council, Health Care Professions Council, Independent Ambulance Association, Monitor, National Ambulance Resilience Unit, NHS England, Patients Association, Royal College of Emergency Medicine, St John Ambulance, Trust Development Authority, Unison

David Davis, Founder, The Larrey Society:  “The call for the creation of a National Ambulance Authority is a signal that genuine fresh thinking and bold action is required to ensure that the entire NHS, not only the ambulance service, is super fit for purpose for the 21st century.

“It is accepted that delivering successful outcomes from such a diversified group of organisations, each powerful in their own right, is a long shot – but what’s the alternative?”

The pamphlet cites the views of Bob Hudson,  Visiting Professor in Public Policy at the University of Durham, who in his paper  – Competition and Collaboration in the ‘New NHS’ says:

“Collaboration through the market mode is not impossible but it is unlikely. The most likely outcome is that as providers proliferate and competitive tendering becomes the norm, integration will become more difficult.

“Partnership working is a delicate plant based upon shared vision and high trust relationships and it is difficult to see large private companies focused on short-term profit, working in productive long-term relationships with the NHS and other public sector organisations.

“The alternative modes of collaboration – through hierarchies and networks – seem totally neglected……What we may witness – at best - in coming years will be guerrilla warfare as public sector commissioners and providers seek ways of working together more closely in the face of legislation and regulations that pull in the opposite direction.”

Davis added:  “The outlook is clearly alarming and the only option is to set the NHS in a new direction while retaining the principles of its founders, that it meets the needs of everyone, that it be free at the point of delivery and that it is based on clinical need, not ability to pay. The ambulance service is a good starting point.”

For further information about the Larrey Society visit www.thelarreysociety.org or to sign up to a free membership click HERE