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GPs fear rise in home visits as struggling ambulance trust cuts service

An ambulance trust on the south coast is cutting its paramedic home visiting service from the end of March, leaving GPs to take on more visits themselves.

The South East Coast Ambulance Service NHS Foundation Trust (SECAmb) has been subcontracting paramedics to practices across the southeast to take on home visits.

But GP leaders said the ‘excellent service’ is being suspended because the trust received an ‘inadequate’ CQC rating for not answering 999 calls within the five-second target.

After a routine inspection last September, the ambulance service was noted as ‘the worst performing trust nationally’ for failing to answer 999 calls on time.

The report said: ‘Trust performance was as low as 95% within 80 seconds during March 2016.’

It added that between April 2015 and March 2016, 67.3% of emergency calls received a response within eight minutes – the national target is 75%. 

The CQC report said this meant SECAmb was the fifth-worst performing, out of 11 ambulance trusts in England, for emergency response times to life-threatening situations during this period.

Dr John Allingham, medical secretary of Kent LMC, said the service was struggling to hit the targets with GPs ‘stealing their paramedics’.

He said: ‘There aren’t enough paramedics either and we’re all fishing in the same pond, so the paramedics that run the 999 ambulances are the same ones that do our home visits for us; the paramedic practitioners.’ 

By subcontracting paramedics from the ambulance trust, practices do not have to handle sickness or holiday cover, while vehicles and equipment are also supplied by the trust.

Dr Allingham said: ‘An area like I work in Dover, our town couldn’t support enough paramedics to provide a cover that would meet things like sickness and maternity leave, so every time someone goes home sick or goes on holiday there would be no one on duty.’

He added that the service was ‘very good at avoiding admissions’ and cutting the service ‘means more after evening surgery visits and going home late’.

Pulse reported last November that NHS England recommended CCGs introduce a local enhanced service to incentivise GPs to do more urgent home visits, where there isn’t a system already in place.

Dr Allingham, however, said he had not heard any talk of introducing such a LES in Kent. 

A SECAmb spokesperson said: ‘Unfortunately, due to capacity and the demand placed on the Trust’s services, we were unable to extend this contract.’

He added that the contract was ‘for a pilot period’ and due to finish at the end of March.