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| Version 1 | Version 2 |
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| Ambulances target times for some patients could be lengthened | Ambulances target times for some patients could be lengthened |
| (about 4 hours later) | |
| Labour has stepped up attacks on the health secretary, Jeremy Hunt, after it emerged that target times for ambulances to reach some seriously-ill patients could be lengthened. | Labour has stepped up attacks on the health secretary, Jeremy Hunt, after it emerged that target times for ambulances to reach some seriously-ill patients could be lengthened. |
| A leaked 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 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 proposals have been approved by Hunt, subject to confirmation from the medical directors of 10 ambulance trusts. | It said the proposals have been approved by Hunt, subject to confirmation from the medical directors of 10 ambulance trusts. |
| The Department of Health said “no decisions have been made” and Hunt would only agree to plans that improve response times for the most urgent cases. | The Department of Health said “no decisions have been made” and Hunt would only agree to plans that improve response times for the most urgent cases. |
| The current target is for an emergency vehicle to reach those in life-threatening situations within eight minutes. | The current target is for an emergency vehicle to reach those in life-threatening situations within eight minutes. |
| According to the leaked memo, drawn up by the Association of Ambulance Chief Executives, NHS England has agreed in principle to relax the maximum ambulance wait for some Red 2 incidents, which include a range of serious problems including strokes and seizures. | According to the leaked memo, drawn up by the Association of Ambulance Chief Executives, NHS England has agreed in principle to relax the maximum ambulance wait for some Red 2 incidents, which include a range of serious problems including strokes and seizures. |
| The only higher category is Red 1 – immediately life-threatening incidents such as cardiac arrest, choking and major bleeding. | The only higher category is Red 1 – immediately life-threatening incidents such as cardiac arrest, choking and major bleeding. |
| The changes would see about 40% of Red 2 incidents move to a 19-minute response target while the proposed date for implementing the plans is the first week of January, the report states. | The changes would see about 40% of Red 2 incidents move to a 19-minute response target while the proposed date for implementing the plans is the first week of January, the report states. |
| Andy Burnham, Labour’s shadow health secretary, wrote to Hunt on Sunday to demand immediate answers on the plans and ask why parliament was “treated with contempt” three days after he signed them. | Andy Burnham, Labour’s shadow health secretary, wrote to Hunt on Sunday to demand immediate answers on the plans and ask why parliament was “treated with contempt” three days after he signed them. |
| He said: “Jeremy Hunt was dragged before parliament last Thursday to answer questions on NHS winter planning but treated it with contempt. It is outrageous that he decided to keep MPs and the public in the dark about a decision he had already taken and one which will have far-reaching implications across the NHS. | He said: “Jeremy Hunt was dragged before parliament last Thursday to answer questions on NHS winter planning but treated it with contempt. It is outrageous that he decided to keep MPs and the public in the dark about a decision he had already taken and one which will have far-reaching implications across the NHS. |
| “Patients are already waiting hours on end for ambulances to arrive. People will struggle to understand how, in the middle of a crisis, it makes sense for the government to make a panic decision to relax 999 standards and leave patients waiting even longer. | “Patients are already waiting hours on end for ambulances to arrive. People will struggle to understand how, in the middle of a crisis, it makes sense for the government to make a panic decision to relax 999 standards and leave patients waiting even longer. |
| “This leak leaves Jeremy Hunt with extremely serious questions to answer. He must do so today. | “This leak leaves Jeremy Hunt with extremely serious questions to answer. He must do so today. |
| Burnham added: “The NHS is in a dangerous position and crying out for leadership. Jeremy Hunt must start providing it or make way for someone else who will. | Burnham added: “The NHS is in a dangerous position and crying out for leadership. Jeremy Hunt must start providing it or make way for someone else who will. |
| “Labour has been warning the government all year about the growing crisis in A&E but it failed to act.” | “Labour has been warning the government all year about the growing crisis in A&E but it failed to act.” |
| A Department of Health spokesman said: “We have given ambulances an extra £50m this winter to ensure the service remains sustainable and the secretary of state agreed that NHS England should investigate a proposal from the ambulance services themselves to see whether the service they offer the public could be improved. | A Department of Health spokesman said: “We have given ambulances an extra £50m this winter to ensure the service remains sustainable and the secretary of state agreed that NHS England should investigate a proposal from the ambulance services themselves to see whether the service they offer the public could be improved. |
| “No decisions have been made and the secretary of state would only agree to proposed changes that improve response times for urgent cases.” | “No decisions have been made and the secretary of state would only agree to proposed changes that improve response times for urgent cases.” |
| Prof Keith Willett, trauma surgeon and head of NHS acute care, said: “Any operational changes to ensure ambulances reach the sickest patients even quicker would need to be proposed by the senior doctors running ambulance services and agreed by the NHS nationally. | |
| “No such decisions have been taken on their proposals, nor will they be – one way or the other – until next year.” | |
| Mr Hunt tweeted about the Mail on Sunday’s frontpage headline about the proposals – “Secret plan to double ambulance wait times”. | |
| He posted: “Categorically refute scaremongering MoS headline - no plans to double ambulance waiting times, and there never have been.” | He posted: “Categorically refute scaremongering MoS headline - no plans to double ambulance waiting times, and there never have been.” |
| Tony Hughes, the GMB union’s regional officer for the ambulance service in London and east of England, said: “These proposals are ridiculous. They will only serve to bring worse outcomes for patients. The proposals are clearly motivated to the runup to the general election so that the Tories can show that the ambulance services are meeting their targets which is so far from the truth. | |
| “If these plans go ahead we will see more people die from conditions that can be treated given the right resource is with them in good time. | |
| “The whole of the A&E structure is at breaking point due the changes this government has already made.” | |
| But Dr Clifford Mann, president of the College of Emergency Medicine, said of the plans: “I think in large measure they are a pragmatic and sensible way forward because we have seen an enormous number of increases in ambulance dispatches in the last two years which don’t really correspond to that much of an increase in very severe illness and injury. | |
| “I don’t think the document is suggesting there should be a complete change of the Red 2 category, which is moving from eight minutes to 19 minutes, it will be dependent on the clinical assessment made by the call handler.” | |
| However, Mann criticised the way the proposals had emerged, telling BBC Radio 4’s The World this Weekend: “The first I have heard of them is today. I think that any change, for it to be credible, needs to be tested. | |
| “I would have thought the sensible thing to do is to pilot this either for a period of time or in a number of different areas and to be able to produce data which compares with the same area or the same period last year. | |
| “That way you will be able to have firm evidence that reassures the public that this isn’t simply a cosmetic exercise.” | |
| Martin Berry, executive officer for the College of Paramedics, told the programme the recommendations had come “out of the blue”. | |
| “There has been no effort to engage with the paramedic profession, we are very concerned about the way this has been kept in the dark,” he said. | |
| He added the targets needed to be addressed “openly, honestly and with evidence, it can’t be done behind closed doors”. |