We have an internal monthly 'magazine' called LAS News, and to be honest it's fairly awful (sorry communications department). But in this month's issue there are two interesting tit-bits of connected news.
'Savings to be made to ease the financial pressure'
Savings of nearly £11.5 million will need to be found to balance the Service’s books this year. Increased costs – including £14 million for staff pay as a result of the introduction of Agenda for Change – means that the Service’s £219 million budget will not cover outgoings over the next 12 months.
As approximately 80 per cent of costs relate to staff, it is possible that some posts will no longer be funded. Although no decisions have been made on how many jobs and which areas of the organisation will be affected, some reductions on posts will be achieved through not recruiting to vacant posts.
It is also hoped that some savings will be able to be made through more cost-effective purchasing of resources such as uniforms, vehicles and fuel.
Which I read as we are in danger of going bankrupt due to changes forced on us by the government. It's also the first time I've known how large our budget is – £219 million pounds to run a 4,000 jobs a day 24 hour service and civil emergency planning service.
Which, if my 'back of the envelope calculations' are right (£219,000,000 / 365 days in the year / 4,000 calls a day) equals £150 per job. That is to pay everyone, get new vehicles, new stock, petrol, uniforms and so on and so forth. Around £30 of that £150 goes to my crewmate and I, of which our bank balances see around £10 each.
And then it looks like we are going to lose some posts – probably starting with the training department as we can't afford to hire new staff. Then some people will leave the job due to retirement and the total number of staff will decrease as they won't be replaced.
But I'm not budget minded, so it's a bit hard for me to comment on such things.
'Boost for alternative patient treatments'
A payment of £38 is to be made to the Service for every patient who receives appropriate care that sees them not needing to be taken to an A&E department for treatment. In a bid to reduce inappropriate A&E admissions, London’s primary care trusts have set aside £800,000 this year as an incentive for the Service to provide alternative treatment for patients who do not need to go to hospital.
So – every person who we go to, and don't take to hospital means we 'earn' £38. Which is a fair chunk of the £150 that I mention above. To be able to claim the full £800,000 we just need to leave 21,000 patients at home (sorry – refer to alternative care pathways), which is 57 patients a day. Out of 4,000 calls this means we only have to refer a shade over 1% of patients.
This is easy – I refer far more than this number and I'm a 'nervous nelly' when it comes to leaving people at home. So it's not really an incentive if we are doing it already is it?
Now for the complicated part – We supposedly refer 32% of patients via our telephone advice service, or they are attended to by an ambulance crew but not transported (data from the same story), yet we are looking to double the amount of telephone advice staff. I have no problem with this if it means that more people are given appropriate advice and an ambulance isn't sent. But, given our budget pressures mentioned in the first story, where are these staff going to come from?
Off the road? If we are going to less calls then we need less ambulances don't we?
Yet I still hear Controllers on the radio asking for any free ambulances to attend to emergency calls because we are all busy.
I don't know – I'm just a bloke with a big yellow van; I'll leave it up to people brighter than me to work out if I'm missing something obvious. As always if someone from management wants to email me corrections I'm more than happy to print it.
(Apart from the magazine being poo – I'm sticking by that. Also the internal website makes my eyes bleed and is completely unfit for purpose).