As the case studies in this report show, the ambulance sector is contributing substantially across a number of ICSs towards delivery of key NHS priorities in transforming care navigation and ensuring people are treated in the right place at the right time. We have focused on its role in driving integrated care from the access points, deploying innovative workforce models and transforming services using digital approaches. This is important both for the continued implementation of the long term plan and the task of recovering care backlogs as we move through the next phase of the COVID-19 pandemic.
This is all within the context of rising demand for services and additional workforce pressures. With appropriate support, recognition and investment, there is potential for the sector to do even more.
AACE and NHS Providers are therefore calling for:
Policy alignment, ensuring the voice of the ambulance sector is involved in strategic planning and decision-making at national, regional, ICS and place level. This includes:
- continued meaningful engagement with the ambulance sector at national and regional levels on evolving ICS guidance and moving ICSs to statutory organisations, joined-up workforce planning, population health management, service design and commissioning
- wider promotion of the rotational paramedic model, in a measured way, as part of the ongoing reform of the GP contract to support the development of PCNs
- the involvement of the ambulance sector in policy developments for primary care and social care which will impact the urgent and emergency pathway.
Greater recognition of the ambulance sector's role as providers of UEC, with many care episodes being concluded, either on-scene or over the phone, without the need for onward referral, and as care navigators, ensuring people are treated in the right place at the right time. This includes:
- recognition from national and local delivery partners that the ambulance service can play a more significant role in integration of UEC provision across larger footprints, bringing the benefits of economies of scale and prudent use of scarce workforce resources, whilst supporting local, place-based care and working closely with a wide range of partners including primary care, social care, the voluntary sector and other trusts
- acknowledging that, through working with multiple ICSs, ambulance trusts will have a unique insight into health inequalities across regions and the impact of potential reconfigurations in services, and the best practice approaches that could be scaled up
- specific recognition of the important contribution of the paramedic workforce and the need for flexible workforce models in the next iteration of the People Plan.
Whole system investment to build on learning from the pandemic, to match the ambition set out in the long term plan, and to address historic underfunding, in the form of:
- dedicated mental health funding from government, the national bodies and via ICSs, as part of the MHIS, reaching the services that need it most
- a long term, fully costed and funded, workforce plan in the next CSR that takes into account the needs of the ambulance sector
- a multi-year NHS capital settlement in the CSR, in line with NHS Providers' #RebuildOurNHS campaign asks, to unlock capital investment to support further digital transformation and specific fleet requirements (for example, to support mental health initiatives) in the ambulance sector.
With these measures in place, the ambulance sector’s role in COVID-19 recovery and delivering the long term plan can be developed to its full potential, to the benefit of the whole health and care system and the patients it serves.