Paramedics are railing against an order from emergency service chiefs to end the trust's ambulance cleaning contract. The frontline workers say the decision will see them delayed from going to their next 999 call because they have to stop and clean the vehicles themselves after dropping a patient off at hospital.
The order, set out in a letter from North West Ambulance Service (NWAS) bosses to staff - leaked to the Manchester Evening News - will bring an end to a cleaning provision in place since the beginning of the pandemic. The trust says that the contract with the external cleaning company is 'unaffordable', costing more than '£3 million per year', reads the letter.
The contracted cleaning company was brought in 'at the height of the pandemic to increase crew availability and improve cleanliness', according to NWAS. An ambulance would come to hospital and, while paramedics took their patient inside the hospital and completed necessary paperwork, cleaning staff stationed outside A&E would scrub down the ambulance.
Paramedics say the service not only ensured that their potentially Covid-19 contaminated vehicles were thoroughly safe both for themselves and their next patient, but saved them vital minutes, allowing them to get back out on the road to their next emergency quicker.
The move to end the cleaning provision has sparked fury within NWAS, with paramedics also telling the M.E.N. they are concerned that:
- Paramedics will be under such time pressure to get to their next call that the cleaning 'will not be done to the same high standard'
- Lacking cleaning supplies at hospitals mean crews will have to spend time driving back to an ambulance station 'which could be miles away'
- Taking away the cleaning service will be a 'blow to morale', as it provided a precious break for paramedics after a distressing emergency scenario
- The policy comes as the number of 999 calls are 'ramping up again' in the face of 'another Covid wave'
'This is unaffordable'
From April 1, the cleaning provision, provided by JPR Solutions Ltd, will be brought to an end, says NWAS. The 'difficult decision' has been made as bosses say they 'realise how disappointed frontline crews will be'.
The letter to NWAS staff reads: “We have made the difficult decision that now is that right time for emergency department vehicle cleaning support to come to an end based on a comprehensive cost-benefit analysis. We realise how disappointed frontline crews will be with this decision, however it was always intended to be a temporary Covid-19 measure which does come with significant cost implications for the trust of over £3 million per year.
“This is unaffordable once the Covid-19 supplemental funds are significantly reduced from April 2022."
"'We know this will disappoint a lot of staff' but basically tough luck," one North West Ambulance Service paramedic blasts to the M.E.N, who says the patient getting in the confined ambulance space after a potential Covid case would be 'safer' after the thorough clean.
"The cleaning is to an excellent standard and importantly took a small amount of pressure off an already exhausted workforce.
"It gave us a little bit of time to do a safeguarding referral, or finish paperwork, or speak to patients' family members, or to clean ourselves and our personal equipment. And most importantly to try and process whatever horrific situation you have just dealt with in order to be OK to go to the next job."
'The downtime this will cause will be crippling'
The implications of revoking the cleaning service will also impact on the quick turnaround of ambulances at hospitals. Instead of being able to get back out on the road once they have finished with a patient, paramedics will have to take crucial minutes to clean that they could be spending at their next emergency, they say.
“It’s going to have an impact on our turnaround times because we’re going to have to do the cleaning ourselves," explains paramedic and trade union leader Jeff Gorman.
The downtime - the amount of time crews spend off the road - 'this will cause will be crippling', adds the other paramedic, who wishes to remain anonymous.
Infection and prevention control (IPC), however, remains a 'top priority', according to the trust. "Work will be ongoing to monitor the cleanliness of vehicles and consider the introduction of A&E cleaning flexibly at times of peak demand," adds the letter.
Yet, paramedics say that hospitals often do not have equipment NWAS staff can use, and ambulances only carry 'minimal cleaning equipment'. "We always used to have mops and buckets available at the hospital, but because of the IPC regulations now, we can’t use that equipment - and if it is that bad, you’ve got to go to the nearest station," says Mr Gorman.
“That’s not so bad if you’re at Manchester Royal Infirmary, because you’ve got an ambulance station directly opposite. But in some places like Wigan, it could be a 15-minute drive before you get to the station. And if the ambulance is in that bad a state, they’ve got to make themselves unavailable [to response to any 999 calls]."
The experienced paramedics have also been left shocked by the trust 'not consulting them' before going ahead with the decision, suggesting that 'on the whole, the trust does communicate with us'. "From a trade union perspective, we would have said we don’t support it, it’s not right, and we need to try and find something else," Jeff Gorman tells the M.E.N.
Two years of severe ambulance service pressures - and more to come
The decision to end cleaning measures comes after an acutely pressured two years for North West Ambulance Service. At times throughout the pandemic, the most serious category 999 calls have been at 'unprecedented levels'.
The huge demand has also seen the families of some NWAS patients criticise the service. They have claimed their relatives would 'still be alive' had paramedics not been so rushed off their feet that they took 'hours' to arrive at an emergency.
NWAS has issued several orders to cope with the sheer volume of emergency reports, including pleas to the public 'not to call' unless they were in life-threatening condition. In October, the service brought in a policy for paramedics to leave patients at hospital after 15 minutes in an attempt to curb ambulance handover times at A&Es.
The region's health lead, Professor Kate Adern, shared with the M.E.N. earlier this week that Greater Manchester is now undergoing another wave of Covid-19. Paramedics say they will struggle to keep up with the highest degree of cleaning - as 'every respiratory patient is classed as a potential Covid job until proven otherwise', which only happens after they are reviewed in hospital.
"Prior to Covid, we did the cleaning ourselves. But [999] activity during Covid and fairly recently has been quite dramatic," says Mr Gorman. "[Now] it won’t be done to the same quality, because I’ve been in the back of an ambulance and they’re on the radio saying ‘how long are you going to be? We’ve got a job waiting for you.’ That’s the pressure you’re under."
North West Ambulance Service response
In response to the Manchester Evening News , Director of Operations for North West Ambulance Service (NWAS) Ged Blezard said: “As part of our response to COVID-19, we temporarily employed JPR Solutions Ltd to provide vehicle cleaning support outside emergency departments to increase ambulance crew availability.
“Limiting the spread of the virus remains a top priority for us as we enter the recovery phase of the pandemic. We have strengthened our infection prevention controls, including a team of practitioners who offer specialist knowledge and provide assurance that in-house processes meet the gold standard test for cleanliness.
“JPR Solutions Ltd will continue to work with us to provide deep clean services, as they did so prior to the pandemic, and we thank them for their incredible service during what has been an extremely challenging time.
“We are fully aware of how hard all our staff have worked over the last two years and we’re proud of the incredible resilience shown in the face of extreme pressures. The wellbeing of our workforce remains of the utmost importance to us. In light of recent pressures, a number of measures that were introduced during the pandemic will continue, including improving health and wellbeing resources available to staff and access to support.”
Frustrated paramedics, frustrated families
The cleaning contract debate marks another challenge for NWAS, as some members of its workforce have been left reeling while the region approaches yet another Covid wave they will have to work through. The stretching of paramedics only paves the way for more frustration on all sides, sighs the second paramedic.
"Late last year and early this year we had an unprecedented amount of calls. It was insane. NWAS covers a very large area and everywhere was slammed. Things have eased slightly but are slowly ramping up again.
" We have turned up too late when we have been over run with calls and taken the rightful angry frustration of the family members who know if we could have got there a bit quicker something could have been done."
