Government Targets

The Healthcare commission assesses and rates all NHS trusts.

The LAS got a 'Quality of Service' of 'weak'.

The reason?

We failed “All ambulance trusts to respond to 95% of category B calls within 14 minutes (urban)” – Possibly because we are chasing after Category A calls with not enough ambulances.

We also 'underachieved' at “Deliver a ten percentage point increase per year in the proportion of people suffering from a heart attack who receive thrombolysis within 60 minutes of calling for professional help.” – Is this because we don't do thrombolysis in London, instead we take the patient to an angioplasty centre, which is much better for the patient.

So, once more we are punished for not having adequate resources and punished again for providing a service superior to that normally expected.

We are getting used to be valued by the government.

Our boss gives his response here.

23 thoughts on “Government Targets”

  1. Well, look on the bright side. If you'd have been ranked as consistently 'Excellent', then some bright spark in the halls of power would have drawn the conclusion that you're probably overfunded and would cut the budget. At least with the lower rank the LAS can justifiably call for more resources to meet the targets….As far as Nationalised health care goes, I'd admit that the system in the UK is broken (don't get me started on the s**t that my Mum goes through). However, private health care doesn't really work either – just look at the system in the US. What's irritating is that the US could take what they spend in Iraq for just ONE WEEK and pay the cost of healthcare premiums for everyone who can't afford them. Priorities are just out of whack.

  2. Yuck! Gotta love politics, whether you guys have 'em or we have 'em here across the pond! If only the politicians took time to READ INTO what they're getting… or am I asking too much?Eug

  3. this is also presumably why you need 3m less as a service.If I bang my head off the desk, I promise I won't call 999…Keep fighting the good fight, Tom, and pass this message on to Laura: “please would you give Tom a nice shoulder massage. thanks, from dominocat”:)

  4. I know its ridiculous isn't it. Its the same with the 8 minutes, if we get to a red in 8 minutes and under, and the die its fine, but if its 9 minutes and they live we've failed.

  5. It's a world gone mad. I'm just on my first cup of coffee for the day and I've withheld the immediate rant which sprang to mind, I'm sure there are others who will do it better than I.What I will say is you do a cracking job under very difficult circumstances. Nuff mush. Hope you're feeling better.

  6. so you are a good service that does not need extra money, but you are a failing service due to responce to cat b and uing heart attack meds.does the one goverment hand know what the others doing. personally i think they ****ed it up again. like everythink else. i would not like to be your boss, he must be getting miffed off

  7. It's time all us NHS staff put our feet down before the NHS is KILLED by this inept , meddling, power crazed government.I'm not usually one for “action” but I think the time has come.

  8. Does this mean you'll get your 3M back next year?! Oh but then it'll be used to further improve the service, whilst you'll probably be penalised (again!) for exceeding performance where it matters but failing on things that either don't matter, don't exist within your operating parameters or some other meaningless automated rating which doesn't reflect the reality of what you actually do all day every day ad infinitum………..*zzzzzzzzzzzzzzz* <------- Politics. Nuff said.By the way - in case people think I am being needlessly sarcastic and vitriolic about Government and Targets etc, I'd like to take this chance to say the only thing I want to say (or indeed CAN say) about my previous employment in the UK - let's say I was a "Civil Servant" and leave it at that ;)

  9. Your boss sounds like a good boss – what a ludicrous set of targets. Hasn't Pat Hewitt ever heard of 'SMART' targets, to encourage good behaviour and promote it? Frustrating.Between you, Mike Myers and Dr Crippen, I am despairing of the bureaucracy put in place by the government – seems to be very little in the way of positive change and a lot of money being spent in bizarre directions. Why don't they have sensible people like you three get on advisory committees? Who are these advisors anyway, and why are their suggestions so impractical and so speedily acted upon?

  10. “only seven to 10% of calls to its control room are genuine, life-threatening emergencies.” well, maybe so, when I rang up after slipping on the stairs and breaking my tibia and fibula I wasn't in imminent danger of dying, but I hope they're not suggesting I should have hobbled half a mile to my GP's surgery (since moved a mile away to a super-duper new three-practices-in-one health centre)!My next door neighbour got carted off in an ambulance shortly before that. He later told me that the surgeon asked him if he realised how lucky he was – only about 3% of people with his complaint (leaking femoral artery) live long enough to reach the operating theatre, apparently. The surgeon also apologised for opening him up from the throat to the upper leg – “when you came in we knew what was wrong with you, but not where!”

    Strangely, our local hospital has since been rated one of the worst in the country, though we've got no complaints about the way we were treated. I wonder if the nurse who was bumping off elderly patients she viewed as bed-blockers affected the ratings….

  11. Its the same in every government “service”. It's crazy. I worked for a local council for nearly a year… it was demoralising despite excellent colleagues.There's also crazy statistics in the fire service as well. If a man doused himself in petrol and set himself alight in a park and dies, he'd be a “fire death”. If someone died in a house fire due to smoke inhalation, it's not a “fire death”. At least that's how one service class them, to try and make their numbers look good for targets etc.

    Relocating fire stations – they would drive an empty fire engine (not carrying water, no staff) on blues and twos, at the quietest time of the day/week (they'd probably do it on Christmas Day) and try and show that Location B is better for response times than station at Location B (using data from a FULL engine at rush hour) and so we must build a new one at huge cost and sell the old one for next to nothing.

    I'm sure it's the same everywhere. It's why we have more managers – its so they can fiddle the numbers/definitions. Argh!

  12. The thing is that politicians only ever get stats that they can use politically and that they can undderstand at a very simple level. That means that they are very limited in the info. that they get and never actually even glimpse reality. Someone said that there are 3 kinds of lies, “lies, damned lies and statistics” and that's where political stats belong.he reality is that the LAS does an extraordinary job dealing with all kinds of things in all kinds of circumstances. I often think that a high-up in the DoH should have to spend at least a week DOING the job he or she is nominally answerable to parliament for.

    Also, I know from having attended LAS public meetings that they try incredibly hard to find out what is really needed by the public and to meet those needs. I am quite happy to say all this out loud and in oublic if necessary.

    Is Laura good at massaging feet? That is the BEST!!!!

    Isobel

  13. I've seen in our lcal rag today that the Fire Service is to be excused from administering first aid in situations where it's needed, but they get there before the ambulance does. The Fire Service have said this “co-response” thing is a way of “papering over the cracks” in the Ambulance service.Do they have this down in London? I bet this is a provincial thing where there's that much more physical space to cover..

    I don't know that if I were a fireman (woman) I would like to carry on putting out a fire and saving a property, when there might be casualties there who would suffer if I didn't help them first.

  14. The impression I got was that the fire service were saying they shouldn't be dispached to emergencies where a fire engine isn't needed, e.g. a heart attack. They're basically saying that instead there should be more ambulances – which is fair enough.I'm sure that if they were at a fire/car accident and someone needed first aid they'd do all they could until the ambulance turned up.

  15. That report is so irritating and dispiriting but I loved your boss's response. Despite the HCC's ridiculous conclusions, it is very, very good that your boss said : -This report will come as a disappointment to our staff who have worked so hard in the past 12 months, said Peter.

    I am proud of what we have achieved in the past year I am proud of my staff and I know the public of London are as well.

    You know you are valued by the people who understand what you do and its complexities. Shame the nought-sh*tters don't.

  16. I've just checked it out (I work in health, and know a bit about the Healthcare Commission ratings) and they do exclude primary angioplasty. So it should be fair for London, unless the numbers getting thrombolysis are now so low that you start hitting the problems inherent in small numbers eg wide percentage changes over time periods.The information isn't easy to find, but if you go to:

    http://ratings2006.healthcarecommission.org.uk/Indicators_2006/Trust/Indicator/indicatorDescriptionShort.asp?indicatorId=2113

    and then look at the fourth paragraph from the bottom (which starts 'the eligibility is defined…' you'll get it.

    This is my first comment, but I've been reading your blog for ages, and bought your book – I've really enjoyed both.

  17. Fair enough, but I would say that we have the 'small numbers' problem, as I believe *all* of London should be going for primary angiolasty. I believe that all areas of London have an angio centre covering them.So we diagnose and cart them to there. There should be very few people getting thrombolysed these days.

  18. There is also some announcement today about the police forces still being rubbish because they failed to reach similar pointless targets laid down by people who don't have the first f***ing idea about the job they're overseeing.Tom – you and every other health care worker in the UK can just stick your fingers up at these ratings. You're *all* doing a great job and the govt can go **** itself, frankly. Apologies for strong asterisks, but this really p***es me off. This country deserves a better government, not better health care workers.

  19. Let's not forget that Laura is an ambulance-staff too, so we need a bit of give and take on those foot-rubs 😉

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