I've been back at work just 6 shifts and I have to be honest, I never thought I'd be ranting so soon but I will. Firstly, don't get me wrong - some of the changes, however much I don't always agree with how they are done or how much lack of thought is put into them, are not necessarily a bad thing. It's the way they've been forced through without any care or consideration for patients or crews, it's now simply down to statistics both within the service and nationally.
AAC (Active Area Cover) could be a good thing. If a crew is in the ambulance and in a central point for deployment, they don't have any delays setting off on a call. If they are on station, you have to call them, they have to be told there is a call, they have to get to the ambulance and then get out of station. It may only be a minutes delay but for stations where they have to go down flights of stairs etc, then we have seen substantial improvements in reaching Category A calls. However, it now means that crews will rarely return to station other than for their scheduled break (yet another bone of contention). On a busy shift, it's rare for them to return anyway but on a quiet shift we now have them sitting out on the roadside for 60 minutes at which point, if they haven't got a job, they are then allowed to return to station for 30 minutes (although they are still available for calls). However, I have yet seen a crew not get a call whilst on AAC. We also have to log exactly where we have sent the crew - gone are the days of "can you go on standby in SW2". Now it's "please go on AAC at Big main Road @ Little Side Road, Sw 2". They are allowed to roam within 1/2 mile but have to be in the truck.
The thing that really annoys me is that when you only have one crew for a large area, somtimes the station they are on IS the best place for deployment. I had this exact occurrance over the weekend. I had one vehicle for the South of the sector - potentially it was covering 4 maybe 5 station areas. From where they were, via main road, they could access everything fairly easily. But no I'm forced to put them on AAC - they must be in the vehicle. Fine. I call up the crew, explain the situation and off they trot into the ambulance. They stay where they are but they can zoom off on a call immediatly. No No this isn't good enough. I have to send them off station. Fine I saw - you tell me where a better place is. Do you know where management send them. Go and sit on this road - IN THE MIDDLE OF A ONE WAY SYSTEM. It's ridiculous. Now the crew will yake problably an extra 5 minutes getting out of the one way system delaying a call by 5 times as if they were sitting where they were. It is moving crews for moving sake and THAT is what pisses me off. The allocators know the sector. The crews know the sector. Let them decide which is the most appropriate point. I know I'm new to the sector and I have been on the phone with crews and admitted that. Between us, we have then decided the best place for them to go. I can tell them where I have cover and the areas I need them to cover and they can say well if we go here, then we have access to all of that. Surely that is the more logical way of doing things. Looking at a map and guessing is not always the best policy. I personally prefer the honest approach and I think the crews appreciated that honesty (I hope they did anyway - they seemed very nice on the phone!)
I'm going to continue this rant on a second post - it was getting a bit too long!!