The trust:
London Ambulance Service NHS Trust is one of the largest and busiest ambulance services in the world, with a staff headcount of more than 7000, serving a city of approximately nine million people.
The challenge:
The trust is working hard to embed its values - caring, respect and teamwork - at the heart of all it does, so staff can feel confident in recommending it as a good place to work and to be treated as a patient. It is also addressing "silo working" through close collaboration with community and mental health colleagues, getting the right care to patients while reducing hospital conveyances. We saw a real commitment to ensure equity of access for all patients, whatever their situations and needs.
Delivering:
The trust has an outstanding educational programme, notably paramedic apprenticeship training with the University of Cumbria, with two purpose built centres offering full simulation. Its advanced paramedics programme offers a career structure up to chief paramedic, with increasing autonomy and prescribing opportunities, which helps keep people in the service. There has been a conscious push to develop teams and promote a wider sense of connection through a dispersed workforce. The trust has also invested in a secure and safe medicines management process, providing assurance for staff and patients.
Julian says:
Coming from a hospital leadership background this was a great opportunity for me to see close up the amazing work carried out by our ambulance service colleagues. I was immediately struck by the sense of pride and commitment to serve patients whenever and wherever they need help. It was great to see the deployment of new zero-emission vehicles, including bicycles, motorbikes, cars and (coming soon) ambulances that allow paramedics to move freely through the capital’s congested streets.
I am a great believer in the transformative effect of a good working culture, and I was delighted to see the priority that Daniel and the trust leadership have devoted to values and behaviours, developed and owned by the whole staff team. I am sure the emphasis on team working across the service, the focus on inclusivity and listening, allowing colleagues to choose their rota patterns, and the promotion of staff wellbeing, will reap rewards. One colleague told me that in more than 30 years with the service he had never seen such a commitment to staff wellbeing. Unsurprisingly, sickness rates have fallen dramatically.
The visit was a reminder to me of the complexities of medicines management across so many sites and the evident determination to secure, monitor and closely manage the distribution of medicines, with different levels of access to colleagues working at different grades. I know this can be a big challenge for ambulance services, requiring a lot of planning and investment. LAS has rightly made this a priority.
It was fascinating to see at close hand the emergency operations centre, witnessing the calm professionalism of the call handlers and the seamless steps from the initial response and triage through despatch and delivery supported by clinical expertise and smart application of technology. Seeing the real-time images fed through to the control room from cameras across the city was a graphic reminder of the connection between staff at their desks and the wider community they serve so well.
Seeing the work of LAS was enjoyable and uplifting, but I am certainly under no illusions about the scale of the challenges and problems they face in common with so many colleagues across the NHS. The strain of the pandemic, the relentless demand through the winter, the desire to deliver a better service for patients – these are very much in evidence. There are also real challenges around mobilising the access, insight and skills, that ambulance trusts in London and elsewhere can bring to bear in the new system-based landscape.
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