1/10 Important new joint report with @AACE_org on ambulance services released today.

Report: nhsproviders.org/media/691897/r…

Blog by @daren_mochrie & me here: hsj.co.uk/quality-and-pe…

News story by ever wonderful @AliJaneMoore here: hsj.co.uk/service-design…

Quick ( 🤣) thread follows.
2/10 It’s a very good time to talk about ambulance services given the unprecedented pressure they have been under for the last two months. This is a clear warning sign that we have to address the underlying demand / capacity mismatch ambulance services face. Risks increasing..
3/10 ...Growing risk of ambulance staff burnout given constant pressure. And growing risk of harm to patients because, despite best efforts of frontline staff, demand/capacity mismatch means ambulance services can't always provide quality/speed of care they want & need to.
4/10 Our new report has three key asks for the ambulance service, which we'd very strongly endorse. Ask 1. We have to sustainably address current demand / supply mismatch in the ambulance service. For the long term. July's extra winter £55m for ambulance trusts very welcome...
5/10 ...But it's non recurrent and only a short term temporary stop gap. We believe the total recurrent revenue funding gap is around £250 million (nhsproviders.org/media/690526/s…). And it's not just revenue funding that needs sorting. It's capital and long term workforce planning too.
6/10 Ask 2. Vital that we take a strategic view of ambulance services as a key part, and potential co-orodinator, of the whole urgent and emergency care pathway. Ambulance services are not just an emergency blue light patient conveyancing service, important though this role is...
7/10 ...Ambulance services have key role in hear and treat/see and treat, to provide right care closer to home, helpfully avoiding unncessary hospital A&E trips. If we invest in this approach, it can make a huge difference for patients and streamline UEC pathway...
8/10 ...And by combining 111, 999 and local directories of services effectively, ambulance services can be a highly effective front door/entry point triage provider. And they can be a great co-ordinator on the whole pathway. But this requires investment and a strategic approach!
9/10 Ask 3. Ensuring the ambulance sector voice is much more deliberately involved in strategic decision making at national, regional, ICS and place level. Vital, for example, that ICSs fully involve ambulance services in their strategic work. Ambulance trusts cover many ICSs....
10/10 ...@AACE_org and our friends @NHSConfed have done excellent work to develop a regional commissioning board as key forum for ambulance trusts. We strongly endorse. We need ICSs and @NHSEngland Regional Directors to follow through on this idea and consistently implement.

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More from @ChrisCEOHopson

11 Aug
1/12 NHS monthly stats due out tomorrow. Although the number of covid hospital cases is significantly lower than many were predicting/fearing, the NHS is still under huge pressure due to a combination of six factors. Stats will show this tomorrow. Shorter thread (🤣) follows!
2/12 Particularly important to understand that every part of NHS is under pressure. Hospitals, ambulance, community & mental health services and general practice / primary care. Many CEOs saying that although the shape of the pressure is different, it feels as busy as Jan/Feb…
3/12 …Striking that some CEOs are saying that their trust is under the highest pressure they have ever known. Don’t measure overall NHS pressure by looking at covid-19 caseload. Vital to look at all demand and capacity pressures, particularly the latter at the moment.
Read 12 tweets
8 Aug
1/23 Health and care funding now centre stage as Govt sets 2nd half 2021/22 & longer term Spending Review settlements. Great article by @michaelsavage & @denis_campbell here: theguardian.com/society/2021/a…. My accompanying comment piece here: theguardian.com/society/2021/a…. Thread follows.
2/23 Health & care budget central to spending review, given the size of spend, so strong case to settle early. NHS budget for second half of 2021/22 must be set by end September. Increasingly likely this could be a single NHS money discussion, concluded relatively rapidly.
3/23 Decisions made here, over next two months, likely to set health and care funding for next three years. They will impact the health of our nation for a generation. So they’re very important to get right. They could also have a significant impact on the next General Election!
Read 23 tweets
27 Jul
1/25 @NHSProviders today highlighting current & future pressure NHS now facing. And, therefore, vital importance of getting NHS budget for second half of year right. Key Government decision on this due in next few weeks as NHS only got budget for first half of year due to covid.
2/25 Press release here: nhsproviders.org/news-blogs/new…. Letter to PM/Chancellor/Health Secretary and @NHSEngland here: nhsproviders.org/media/691810/2…. News coverage here:independent.co.uk/news/health/nh… and here: news.sky.com/story/nhs-as-s…
3/25 Trust leaders are telling us that, although the shape is different, the current pressures are, in aggregate, as great as they were in January. That was rightly described as the most difficult period for the NHS in a generation. Five main reasons for these new pressures.
Read 25 tweets
8 Jul
1/27 Lots of current focus on interaction between increasing levels of COVID-19 cases and NHS, in the context of relaxing restrictions on 19 July. New thread follows. Key questions to answer: what's the likely impact on NHS, can it cope and what does this mean for 19 July?
2/27 As we said a few weeks ago, vaccines have severely weakened the link between covid-19 infection and hospitalisation / mortality. Or, as we put it, for this set of variants, vaccines have broken link between infections and previously high hospitalisation/mortality rates.
3/27 So, there’s high confidence amongst trust leaders that increasing community infection rates, even to the levels we saw in January, will not translate into the levels of hospitalisation and mortality we saw in that peak. A peak that brought extreme pressure to the NHS. But…
Read 27 tweets
21 Jun
1/24 @MartinRCGP and I have highlighted the need for an Autumn covid-19 vaccination plan. Together our organisations represent almost the entire NHS frontline and we wanted to celebrate what's been achieved so far and highlight forthcoming challenges: bbc.co.uk/news/uk-575487….
2/24 There's huge focus on COVID-19 vaccinations as the NHS seeks to vaccinate as many people as possible so we can ease social restrictions. This is the latest step in an extraordinary NHS achievement. In six months our defences against the virus have been transformed.
3/24 Vaccines aren't just saving thousands of lives, they also offer a vital route back to freedoms we all miss so much. It's been a triumph of detailed planning, collaboration & commitment. Hugely ambitious in scale, speed and complexity involving tens of thousands of people.
Read 24 tweets
6 Jun
1/25 New update thread with latest on covid-19 infections and hospital admissions and what these might mean for June 21 decision on easing lockdown measures in England. Quick reminder: @NHSProviders is the voice of English NHS trusts: nhsproviders.org/news-blogs/pre…
2/25 Community infection rates rising steadily as Delta variant spreads and becomes dominant strain. In areas where community infections rates are increasing, hospital COVID-19 admission rates rising, but not alarmingly. Trust leaders telling us there are 3 consistent features.
3/25 First. Number of hospital COVID-19 admissions consistently a lot lower than in previous waves. Second. Patients admitted are, on average, younger with less requirement for critical care, more treatment in general & acute beds, lower acuity and lower mortality rates.
Read 25 tweets

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