Ambulance Response Times (Local Reporting)

I beg to move,"That leave be given to bring in a Bill to require ambulance services to provide more accessible and localised reports of ambulance response times; and for connected purposes." I thank all those Members across the House who have sponsored the Bill. I am sure that they would wish to join me in recording our gratitude to all those who work on the front line of our ambulance services for their valiant and valuable work on our behalf. My Bill would help to bring greater transparency and proper accountability to bear on the performance of ambulance services across England, in an effort to assist ambulance trusts and primary care trusts in addressing deficiencies and variability in their current service, and to improve outcomes for patients. The seeds of the Bill were metaphorically sown in the town of Nantwich in my constituency, almost two years ago. In the face of what were called "operational decisions" by the North West Ambulance Service to downgrade and deskill the service provided by community first responder volunteers in Nantwich, a local campaign erupted in opposition, not least because to the local community the value of community first responders in helping to reduce response times and save lives by plugging the gaps that mainstream operations were unable to fulfil was all too apparent. Two years on, the campaign continues apace, testament in no small part to the unstinting commitment to his local community demonstrated by Nantwich community first responder Gavin Palin and to the resolve of local councillors in fighting for a better service. This drawn-out saga has also raised serious doubts about the current performance standards required of ambulance trusts across England as a proper measure of outcomes for patients. Following the review of ambulance performance standards in July 1996, the categorisation of calls according to clinical urgency was introduced, whereby category A calls—those deemed immediately life-threatening—should receive an emergency response within eight minutes in 75 per cent. of cases. Category B calls—those classed as serious but not immediately life threatening—should receive a 19-minute response in 95 per cent . of cases. Category C calls—those neither immediately life-threatening nor serious—should be met through locally determined standards. Given that the number of ambulance call-outs has risen by over 100 per cent. in the past 10 years to 7.48 million in 2008-09, we should recognise that the national performance targets are robust, but rightly so. However, the 1996 review also recommended that those standards should be based on health authority rather than ambulance service areas, as that would mean that standards could be related to smaller areas. That recommendation was not implemented, and so we remain in a regional rather than local response time system of performance accountability, despite the fact that the number of ambulance service areas has been reduced from 37 in 1996 to just 13 today. The report went on to say that there was a risk that the needs of smaller localities within larger geographical areas could be neglected. That is exactly what has happened in my constituency and neighbouring constituencies in other parts of the north-west and beyond. Regional targets are distorting and disguising enormous local variations within a region, where local performance can be patchy all the way through to grossly substandard. If we take response times for 2008-09, the percentage of category A incidents that resulted in an emergency response arriving at the scene within eight minutes in the north-west region was 74.3 per cent., just below the national standard. Yet when the data are broken down into more localised figures, the picture is very different. For Central and East Cheshire PCT—it serves my constituency—the percentage drops to 65.2 per cent. For the CW5 Nantwich postcode, it falls further to 52.1 per cent. For the CW3 Audlem postcode, which crosses the border into the constituency of my hon. Friend the Member for Eddisbury (Mr. O'Brien), the percentage is just 14.3 per cent. or fewer than one in five life-threatening cases. Even taking into account the inherent geographical difficulty of reaching more rural areas than urban areas, those are unacceptable responses. Without extracting the information through freedom of information requests, as I have done, the public have no meaningful way of establishing how their local service is performing and, in turn, as set out in the 1996 report, local communities are not provided with the freedom to adapt forms of response to local services and patterns of service such as the community first responders whom we have in Nantwich. Such locally focused information should not have to be made public through the costly FOI process. Regional figures are already published and the North West Ambulance Service was able to respond within 24 hours to my FOI request for local response times, based on the fact that it already holds the information on its database. A senior North West Ambulance Service manager has told me that this information is available at the push of a button, so let us see it published online, on a monthly basis, by primary care trust and postcode area, at minimum cost. Where the call targets are missed by a significant margin, let us have an explanation as to why. That is already provided in Wales, so that people can identify the gaps and fill them by improving the local service through partnerships between the public, the voluntary sector and the emergency services. The North West Ambulance Service and its chief executive, Darren Hurrell, are starting to understand the benefits of that approach. In the likely event that this Bill does not become law, I therefore hope that these proposals will form part of the common practice across the North West Ambulance Service and the other 12 ambulance trusts in England. I recognise that response-time requirements are not enshrined in primary legislation, and this mechanism of introducing new requirements on ambulance services may not be the most adept way of achieving my aim. Indeed, I am also acutely aware that there is a question as to whether response targets are an effective measure of patient care and outcomes, as what matters for the patient is not just the speed of response, but what level of medical attention is received on arrival, in transit and in hospital, and the quality of after-care service. I accept that fully, but I hope that my Bill will begin to address the absence of proper local accountability across the ambulance service and, in doing so, help to improve the outcomes for patients, wherever they happen to live. I commend this Bill to the House. Question put and agreed to. Ordered, That Mr. Edward Timpson, Mike Penning, Mr. Stephen O'Brien, Graham Stringer, Mr. Ben Wallace, Geraldine Smith, Alistair Burt, Mr. Frank Field, Mr. Tobias Ellwood, Paul Rowen, James Duddridge and Mr. Lindsay Hoyle present the Bill. Mr. Edward Timpson accordingly presented the Bill. Bill read the First time; to be read a Second time on Friday 12 March and to be printed (Bill 55).