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Ambulance targets: Plan for longer times in England revealed Ambulance targets: Plan for longer times in England revealed
(35 minutes later)
Target times for ambulances to reach some seriously ill patients could be lengthened, the BBC has learned.Target times for ambulances to reach some seriously ill patients could be lengthened, the BBC has learned.
A leaked NHS document includes plans to change the response time for some Red 2 patients - those with "serious but not the most life-threatening" conditions - from eight to 19 minutes in England.A leaked NHS document includes plans to change the response time for some Red 2 patients - those with "serious but not the most life-threatening" conditions - from eight to 19 minutes in England.
It said the plans had been approved by Health Secretary Jeremy Hunt, subject to approval by ambulance trust bosses.It said the plans had been approved by Health Secretary Jeremy Hunt, subject to approval by ambulance trust bosses.
The Department of Health said no decisions had been made. The government said no decisions had been made. Labour has demanded answers.
"The secretary of state would only agree to proposed changes that improve response times for urgent cases," it added in a statement. Shadow health secretary Andy Burnham has written to Mr Hunt asking him to urgently answer a number of questions about the plans. He also accused the health secretary of rushing through the proposals without proper parliamentary scrutiny.
Shadow health secretary Andy Burnham told the BBC Mr Hunt had urgent questions to answer, adding: "We need to hear from the health secretary today." The Department of Health said nothing had been decided but Mr Hunt would "would only agree to proposed changes that improve response times for urgent cases".
One ambulance service director criticised the plans - which it is proposed would be brought in within weeks - saying they were about "political expediency rather than patient safety".One ambulance service director criticised the plans - which it is proposed would be brought in within weeks - saying they were about "political expediency rather than patient safety".
The document, drawn up by the Association of Ambulance Chief Executives (AACE) and dated 16 December, said NHS England had "explicitly stressed" the plans were confidential.The document, drawn up by the Association of Ambulance Chief Executives (AACE) and dated 16 December, said NHS England had "explicitly stressed" the plans were confidential.
Details of the proposals "should not be disseminated beyond the group" involved in the discussions, it added.Details of the proposals "should not be disseminated beyond the group" involved in the discussions, it added.
The document said there were existing plans for changes "after the general election" in May.The document said there were existing plans for changes "after the general election" in May.
But it said Prof Keith Willett, of NHS England, made an "urgent request" for discussions due to "unprecedented demand" on health services - and now the "target for implementing these changes is the first week of January 2015".But it said Prof Keith Willett, of NHS England, made an "urgent request" for discussions due to "unprecedented demand" on health services - and now the "target for implementing these changes is the first week of January 2015".
AnalysisAnalysis
By BBC home affairs correspondent Sally ChidzoyBy BBC home affairs correspondent Sally Chidzoy
A whistleblower leaked the memo to the BBC because of serious concerns over patient safety, fears the plans were rushed at the height of winter when the service is under unprecedented pressure, and anger over the secrecy involved.A whistleblower leaked the memo to the BBC because of serious concerns over patient safety, fears the plans were rushed at the height of winter when the service is under unprecedented pressure, and anger over the secrecy involved.
To many in the service, the general ideas are good - but there this concern it should have been a more thoughtful exercise where time was taken to consult widely and the public was involved in the process.To many in the service, the general ideas are good - but there this concern it should have been a more thoughtful exercise where time was taken to consult widely and the public was involved in the process.
Paramedics say response times distort their ability to treat patients because they have to chase the clock.Paramedics say response times distort their ability to treat patients because they have to chase the clock.
They say some illnesses such as strokes, should be moved up a category.They say some illnesses such as strokes, should be moved up a category.
The target for these changes was early January, according to the document, but it seems unlikely the proposals will now go ahead by then.The target for these changes was early January, according to the document, but it seems unlikely the proposals will now go ahead by then.
One ambulance service director, who asked not to be named, told the BBC: "This is being done for political expediency rather than patient safety and it's being done with the full blessing of Jeremy Hunt.One ambulance service director, who asked not to be named, told the BBC: "This is being done for political expediency rather than patient safety and it's being done with the full blessing of Jeremy Hunt.
"This is being pushed through with limited consultation with the chief executives and the health service as a whole. "This is being pushed through with limited consultation with the chief executives and the health service as a whole."
"There has been no consultation with the wider health system, which is required when you are making such a major change which could impact on patient safety."
Call types:Call types:
There are no plans in the document to change the response targets for Red 1 patients - those with life-threatening conditions where response time "may be critical", such as heart attacks and serious bleeding.There are no plans in the document to change the response targets for Red 1 patients - those with life-threatening conditions where response time "may be critical", such as heart attacks and serious bleeding.
The national target is for ambulance trusts to reach 75% of Red 1 patients within eight minutes, and 95% within 19 minutes. The time starts as soon as an emergency call is connected.The national target is for ambulance trusts to reach 75% of Red 1 patients within eight minutes, and 95% within 19 minutes. The time starts as soon as an emergency call is connected.
Red 2 targets are currently the same, except that the "clock start" can be up to 60 seconds after a call is connected.Red 2 targets are currently the same, except that the "clock start" can be up to 60 seconds after a call is connected.
The changes proposed in the AACE document for current Red 2 situations are:The changes proposed in the AACE document for current Red 2 situations are:
The Red 2 category includes conditions such as strokes and fits, but the document does not say which conditions would be put in each of the new categories.The Red 2 category includes conditions such as strokes and fits, but the document does not say which conditions would be put in each of the new categories.
Lower grades of call-out - known as "Category C" and "Hear and treat" - are dealt with by locally agreed targets.Lower grades of call-out - known as "Category C" and "Hear and treat" - are dealt with by locally agreed targets.
The document said the proposed changes could bring "substantial improvements".The document said the proposed changes could bring "substantial improvements".
One line in it said ambulance trusts would be able to cut the number of fast-response cars being used in favour of deploying more double-crewed ambulances.One line in it said ambulance trusts would be able to cut the number of fast-response cars being used in favour of deploying more double-crewed ambulances.
The AACE document acknowledges that details of the new response arrangements have not had the "breadth of exposure that would normally be expected".The AACE document acknowledges that details of the new response arrangements have not had the "breadth of exposure that would normally be expected".
Mr Burnham said: "This has all the hallmarks of a panic move and suggests Jeremy Hunt's only solution to the A&E crisis is to give up and move the goalposts. 'Full apology'
"Rather than getting ambulance response times back up to established standards, it looks like he is running up the white flag. Mr Burnham demanded answers, telling the BBC: "We need to hear from the health secretary today."
"The situation in the NHS is now serious and Jeremy Hunt is failing to provide the leadership it desperately needs. He said he had called Mr Hunt to the Commons on Thursday, to tell MPs his plans for ambulance services over the winter "and he made no mention of it at all".
"While there may be a case for reviewing these rules, this is not the way to do it. It is nothing short of dangerous to make a snap decision at the start of the most difficult winter in the NHS for years." In his letter to Mr Hunt, he wrote: "If you do not have an acceptable reason for withholding information about your decision from Parliament, I suggest you should prepare to make a full apology to the House at the first opportunity after it returns from recess."
Mr Burnham had earlier said the plans had "all the hallmarks of a panic move".
"While there may be a case for reviewing these rules, this is not the way to do it. It is nothing short of dangerous to make a snap decision at the start of the most difficult winter in the NHS for years," he said.
What is your experience of the ambulance service? You can email haveyoursay@bbc.co.uk. If you are willing to speak to a BBC journalist, please leave a contact number.What is your experience of the ambulance service? You can email haveyoursay@bbc.co.uk. If you are willing to speak to a BBC journalist, please leave a contact number.
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