East Midlands Ambulance fined MILLIONS for missed targets

Ambulance service fined millions for missed targets as it struggles with a debt crisis.
Ambulance service fined millions for missed targets as it struggles with a debt crisis.

Nottinghamshire’s troubled ambulance service is millions in debt due to fines for bad performance and cuts to finance, the Chad can reveal.

Amid the revelations that East Midlands Ambulance Service (EMAS) has been in talks with another service for help, it emerges that bosses forfeited revenues to the tune of £8 million for the year.

EMAS finances

- £145 million total annual budget

- £2 million spent on training alone in 2014/15

- £101,206 Director of Operations salary last year

- £11.9 million year-end deficit

And after the service blamed rising demand for it’s crippling deficit - we can reveal that paramedics actually suffered cuts due to being penalised for dips in performance.
Penalties are incurred as part of the NHS’s ‘Payments for results’ tariff which withdraws funding for not hitting patient targets, effectively fining EMAS for not responding to as many people.

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Last year the service lost £1.2 million in fines and £3.5 million in ‘activities reduction’ according to its finance report, despite receiving 45,348 more calls than the previous year.

But although EMAS initially claimed the service “experienced unavoidable extra costs due to responding to a significant increase in life-threatening emergencies,” it emerges that paramedics actually conveyed 9,600 fewer people to hospital than it planned for, and the number of patients treated on-site was actually lower than the previous year, by 248.

Overall the service responded to 20,000 fewer patients than it budgeted for and the report also highlighted the chronic cost of handover delays at busy hospitals, which cost EMAS in excess of £3 million.

Richard Wheeler, Director of Finance at East Midlands Ambulance Service, said: “We have received £4m less income from Commissioners than we expected and £1m from new business expected in the year.”

“It has cost us an additional £4m due to a combination of additional resources required given the growth in life threatening emergencies and additional costs in training and providing operational cover for new staff.”

The Service announced this week it had suffered a £12 million deficit for the year and was forced to take out loans.

EMAS has had some of the worst performance statistics in the country, with the number of Red 2 calls reached within eight minutes falling from 97 per cent in 2008-09 to 70 per cent in 2014-15.

The revelations have been described as a ‘catch-22’ which has been bringing down EMAS’s funding for years, and only serves to put greater pressure on paramedics.

And this week there was speculation that EMAS’s finances were so dire they were considering a merger with West Midlands Ambulance Service.

An EMAS spokesperson vehemently denied this: “The BBC incorrectly quoted West Midlands Ambulance Service ad our statement still stands – we’ve not asked for a merger, and we don’t want a merger” they said.

Chairman Pauline Tagg added: “I have been having discussions with NHS Improvement to explore opportunities to streng-
then our leadership arrangements.

“One of these options has involved talking with West Midlands Ambulance Service about the possibility of their Chief Executive, Dr Anthony Marsh, working with EMAS to support us with these challenges.”

The revelations have been described as a 'catch-22' which has been bringing down EMAS's funding for years, which only serves to put greater pressure on paramedics.

EMAS has had some of the worst performance statistics in the country, with the number of Red 2 calls reached within eight minutes falling from 97 per cent in 2008-09 to 70 per cent in 2014-15.

Its financial report said there was a loss of income as a direct result of 'Calls, Hear and Treat' activities falling back below planned levels, and in one month they fell two per cent below target.

In it's worst month of the year, EMAS was in negative results for all categories of performance - 'calls', 'hear and treat', 'see and treat' and 'see and convey'.

The Service announced last week it had suffered a £12 million deficit for the year and was forced to take out loans.

Richard Wheeler, Director of Finance at East Midlands Ambulance Service, added: “Nationally the NHS has to save £22 billion by 2020/21.

“We have achieved our Cost Improvement Programme savings target in 2015/16 achieving efficiency savings of £6.4 million. However, we have experienced unavoidable extra costs due to responding to a significant increase in life-threatening emergencies and we have also been required to provide extra crews in certain areas to compensate for delays in handing over patients from our ambulances at busy hospitals.

“This means an increase in costs through having more of our highly skilled staff responding to a 999 call every 35 seconds.

“We are not unique in seeing demand increase and many other organisations within the wider health system are in a similar financial position.

“However, we are committed to protecting our frontline services and we will continue to invest in both people and vehicles so we can deliver improved quality to the communities we serve.”

Factbox

- 29,874 hoax calls made for a paramedic in 2011-2015.

- 6 hours, 14 minutes is the service's record for longest emergency call for the end of last year. EMAS said: "This related to a Green 2 categorised call involving a patient in the Nottingham area, and the delay was due to there being no available resources and extremely high demand on the service at the time." The longest non-emergency call for the period was 15 hours and 50 minutes.

- 956 visits were made to Midlands prisons in 2014/15

- Seven break-ins were made into EMAS ambulances last year including instances of drugs stolen, and even a litre of heating oil.