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The under-pressure Ambulance Service could see some big changes next year, with another leadership restructure and a potential review deep-dive independent review of its services looming, it has emerged.
Following a turbulent year in which serious concerns have been raised abour leadership, demand and capacity, funding and safety of staff, Express looks at the potential changes on the horizon...
While the service has been in the spotlight more recently following the Royal Court case of paramedics Tom Le Sauteur and John Sutherland, many say the issues extend back several years – and can, in part, be traced to the public sector-wide restructure of 2018.
The biggest restructure of the civil service in living memory, ‘OneGov’ tore up several Government departments and saw several new ones created – among them, Justice and Home Affairs, under which all the emergency services were to sit.
It was argued at the time that bringing the three – the Ambulance Service, States of Jersey Police and Fire Service – under one umbrella would lead to greater efficiency.
However, some insiders told Express that having the service sit outside of Health actually weakened coordination – what should be a seamless transition from a JHA-run ambulance to Health-run A&E was no longer as seamless as it should be, and synchronising improvements were now harder to implement, they claimed.
Pictured: Tom Le Sauteur (36) and John Sutherland (60) were recently convicted of failing to provide “reasonable care” to a patient who later died.
But, under Health Minister Tom Binet’s vision for an "all-encompassing, unified, Jersey Health System”, bringing together all health-related service providers including charities, that could be set to change.
The Health Board – a body which oversees the running of the department - were told last month that ambulances will be moved back to Health from Justice and Home Affairs. That transition is due to begin as early as next year.
But it’s long been suggested further changes to the Service may be brought about if another key review of its operations is undertaken. The department told Express it was currently “considering the potential” for a second independent review of its demand and capacity next year.
The first independent review of the service since it was brought under Justice and Home Affairs was undertaken two years ago in 2022. That review concluded that Jersey’s Ambulance Service is a good organisation with passionate and caring staff who provide a good quality of care to patients, but that demand was already an issue – and only set to worsen.
This, they said, was evidenced by longer response times and increased reliance on overtime or backup staff.
The review team expressed concerns with emergency preparedness, particularly the lack of capacity if there was a major incident given that the service is already stretched. It went on to query its funding – with overspends of over £420,000 on a budget of £4.8m.
Recommendations included increased staffing, improved funding, and better facilities to ensure the service can meet growing demands.
The following year, a report found the service was performing well against ambulance standards, it also predicted that demand would continue to grow in the coming years.
It forecasted that emergency calls would rise by 4% per year, with requests for non-emergency transport for patients travelling to and from medical appointments rising by 12% annually.
In response to these pressures, the service has already added a fourth daytime crew between 07:00 and 19:00.
The department added: "Work with unions and colleagues is ongoing to agree rostering three crews between 19:00 and 01:00. This is in line with the independent Demand and Capacity review."
Meanwhile, a request made under the Freedom of Information Law has revealed that Ambulance Services have spent £303,219 on agency staff between October 2023 and September 2024.
It is not yet confirmed if – or when – another independent review might take place.
However, when questioned by Express, Justice and Home Affairs said that they are always striving to improve services and training.
Among the improvements will be enhanced training for dealing with violence when they attend emergency calls, after several paramedics reported having been attacked. This year alone, 26 incidents of violence have been logged. One staff member spoke of having his nose broken.
A spokesperson confirmed that Ambulance management is working with violence behaviour training providers to develop a “programme to equip staff with a suite of skills and strategies to respond to the dynamic, wide-ranging and unpredictable risks of distressed, aggressive and violent behaviours, which they can face on a regular basis”.
Pictured: Eric Rolland was punched in the face by an intoxicated patient while on duty.
They said they had been working with experts in “restrictive intervention”, Maybo, who visited Jersey in September 2024. They said they had commissioned another programme with them for 2025.
The Department explained: “This will enable staff to safely facilitate immediate and necessary clinical interventions and safeguard patients who lack capacity.”
“The Service will support four in-house trainers and is exploring extra resilience from Justice and Home Affairs partners and other Islands to boost the cohort of trainers to eight.
“The training is to enhance the skills and confidence of our operational staff in their approach, assessment and handling of situations that could present risks to staff and/or patients.
“This will include the training module covering low-level restrictive interventions to facilitate essential treatment.”
In the meantime, work is ongoing to repair trust with staff, particularly after a vote of no confidence in management earlier this year. Unite the Union, which represents paramedics, confirmed this – but said progress had been "slower than expected".
Home Affairs Minister Mary Le Hegarat was grilled on that work in this week's meeting of the States Assembly.
Acknowledging that ambulance workloads have increased significantly, she said that reviewing the "facilities and resourcing" provided to the Ambulance Service "obviously needs to be an ongoing thing".
The Minister added: “As the ambulance continues to have a high workload, they are getting more and more calls, and so I think that is an ongoing process.”
Turning specifically to the vote of no confidence, the Minister explained that a “restorative practice” approach is now in place, offering a “facilitated programme of discussion” among staff to determine the way forward.
She added that face-to-face sessions are underway, with group discussions planned for early next year.
When pressed to outline the key issues behind the vote, Deputy Le Hegarat listed workplace safety, equipment concerns, support in relation to the police, and the additional response in relation to mental health matters.
Deputy Hilary Jeune questioned what measures were being implemented to enforce a zero-tolerance approach to violence against ambulance staff, and Deputy Le Hegarat responded that staff are encouraged to report incidents through the proper channels.
She said: “There is obviously ongoing work with the States of Jersey Police on how to appropriately deal with incidents of violence and aggression towards ambulance staff also difficult.”
The Minister went on to say that staff wellbeing remains a priority, with support systems in place during the festive season—a typically busy period—and also called on public support for frontline workers.
She said: “I would like to reassure staff that there will be the support that's necessary [from the government] during the Christmas period and fully accept that, that they will be a lot busier.
“But I would also like to ask the public support on this because obviously they are a frontline service, and I think that the public as a whole should all support them.
“So anywhere where people can actually assist them, I would ask them to do so.”
Elsewhere during the States meeting, Environment Minister Steve Luce said he was working on finalising legislation to regulate hospital and ambulance services.
He said: “My primary focus in this area is, since taking office, has been on ensuring that effective legislation is introduced to the assembly to regulate hospital and ambulance services as soon as possible – and I'm pleased to report that that work is on course, and I would hope to lodge it in the very near future.”
He said that legislation to do this should be lodged before Christmas, with a view to it coming into force in 2025.
Not just a “few” disgruntled paramedics… Union working to address "clear" issues with service (November 2024)
FOCUS: "Culture of fear"? Paramedics warned over speaking out on "systemic" concerns (November 2024)
Ambulance launches 'Work Without Fear' campaign amid surge in attacks (November 2024)
Paramedics lose appeal against convictions (October 2024)
Paramedic PPE rules got in way of timely patient care, appeal hears (October 2024)
Convicted paramedics thank public for support ahead of appeal (October 2024)
Court appeal date set as paramedics fundraiser nears £50k (August 2024)
IN NUMBERS: The violent reality of working in Health (August 2024)
"Zero-tolerance approach" to attacks on ambulance staff (July 2024)
Britain's biggest union calls for urgent review of Jersey paramedics' case (July 2024)
Paramedics found guilty of failing to provide reasonable care (June 2024)
"No cause for alarm" as emergency services reviews uncover staff and funding struggles (November 2022)
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