RADICAL changes to the provision of the ambulance service in Hampshire could herald "a good time for Alton" - but not in the eyes of frontline crews. Hampshire Ambulance Trust managers are upbeat about plans which will see regularisation of rapid- response vehicle cover in Alton and a change of location to provide a more "fit for purpose" ambulance station. And they believe amalgamation with the Thames Valley Ambulance Trust will facilitate the streamlining of management, allowing more money to be ploughed back into frontline services. But the joint shop stewards' committee (JSSC), representing ambulance crews, has a different view. Union members believe the loss of 24-hour rapid- response cover in Alton could prove fatal, and that the new ambulance station may be located in the wrong place. They fear amalgamation with Thames Valley could serve to compromise ambulance cover, especially in the rural areas of Hampshire. It is a view supported by Hampshire County Council, which told the government that the residents of Hampshire would be best served by a stand-alone service. Hampshire and Thames Valley is just one of the mergers proposed by the Department of Health, which is seeking to construct 11 large, integrated ambulance trusts following the boundaries of regional government offices. HCC opposed the merger, pointing out that it would fly in the face of the move to make service delivery more local. In the county's view it could also result in delayed response times because of an inevitable loss of local knowledge, be expensive to implement, add another layer of bureaucracy and cause difficulties in the running of non-emergency patient transport services. But with the merger due to take effect from July 1, the ball is now rolling and words of caution appear to go unheeded. The head of operations for Hampshire Ambulance Service, Andy Roughton, is aware of the unrest change can wreak among local communities but, he assured, "this could be a good time for Alton". Referring to Alton's rapid-response vehicle (RRV), he said that until now it has been operated on an "ad hoc" basis by a member of staff, but that this situation is to be regularised with the introduction of a new roster. This is expected to operate from 7 am to midnight and when it is not in operation, Mr Roughton said the county would maintain out-of-hours emergency response from outside the area. "We operate on a county level so although Alton has an ambulance station, the vehicles stationed there move about as part of a dynamic process designed to give 999 cover where it is needed. An empty area will have another vehicle moved into it," said Mr Roughton. He added: "If the RRV is off duty, we can move another into the area if the workload requires a presence." He also flagged up a joint initiative with St John Ambulance, due to be launched tomorrow (Saturday) to train first responders to provide emergency cover prior to the arrival of an ambulance. The JSSC vice-chairman, ambulance paramedic Graham Leggat, does not share Mr Roughton's optimism. The union man points out that at present Alton's RRV is manned on a 24-hour basis by a trained paramedic, who answers emergency calls at any time of the day or night and covers any gaps at the Alton station. "That man has worked hard to provide emergency cover for the people of Alton - and believe me, Alton desperately needs that cover. "Another RRV could be 30 or 40 minutes away in Basingstoke or Portsmouth, which is too far in an emergency. Alton's RRV can get there in five minutes." And, while not decrying the first responder scheme, Mr Leggat feels their skills will not match those of a paramedic, who is able to administer drugs and start time-critical treatment at a much higher level. On the proposed relocation of Alton's ambulance station, pending redevelopment of the existing Albert Road site, Andy Roughton confirmed the trust's intention was to keep a site in Alton and that it was currently investigating several options. The new site would need to be located on a good road network, provide garaging for new vehicles, which are now too big for the existing station, and more modern facilities for staff. Graham Leggat questioned the merit of keeping a station in Alton when there are rumours that Petersfield ambulance station may close. He believed Whitehill/Bordon would provide a more central venue. Referring to the impact of the proposed merger with Thames to create a South Central Ambulance Trust, Mr Roughton explained that the concept is to provide a better, more cost-effective service. Although the name of the trust will change and management resources will be pooled, this should release funding for frontline services. "At the end of the day, we (the trusts involved) have all got ambulance resources to provide the best level of care we can. If we continue to put resources where demand is, service provision should be unaffected by the change." He added: "The NHS has very good managers and members of staff, all of whom are dedicated to providing first class patient care. We are there for the patients and they are our number one priority." Sceptical of a scheme that is untried, Graham Leggat said union members were concerned that one joint-control centre will be lacking in local knowledge, causing problems for the direction of ambulance crews. There is real concern that ambulances will be directed away from Hampshire to more densely populated areas of the South Central Trust, leaving rural areas with inadequate cover. Having struggled back to being the third most highly rated trust in the country for performance, Hampshire crews fear that response times could suffer under the new regime and that their position at the head of the pack will be lost.
