Ambulance service accused of blocking pioneering Shropshire 999 project

West Midlands Ambulance Service terminated the Physician Response Unit in early September and said it will not re-instate it.

The move has angered members of Shropshire's CCG, who discussed the issue at a meeting yesterday.

But WMAS officials have said the project was only ever intended as a two-month trial – and that two serious incidents had happened during that time that had raised concerns.

The response unit was launched in Shropshire in July last year in order to reduce the number of ambulances queuing outside the region's hospitals.

The scheme consisted of an ambulance car, based in Shrewsbury, which had a GP trained in pre-hospital medicine on-board, dispatched after a 999 call. It was funded by Shropshire Clinical Commissioning Group as part of steps to alleviate NHS pressures.

Dr Julie Davies, Shropshire CCG director of strategy and service redesign, said: "The scheme meant about £2 million worth of admissions were avoided. In total 63 per cent of patients seen by the unit avoided being conveyed to hospital. It involved a new ambulance vehicle with a physician and GP with an extra qualification on board being sent out by the control room, if the call fitted a certain criteria.

It is an innovative system and one of the first in the country."The model costs about £400,000 a year. We paid the ambulance service for the car and technician. We are still paying for the doctors employed for this project and hope to re-claim these costs from WMAS."

She said medics employed as part of the service were now on "other projects" including audit paperwork, adding: "We need those doctors operating clinically. They are highly skilled in pre-hospital responses and are wasted at the moment."

"The scheme could have reduced A&E admissions further. It is a tragedy and not acceptable not to use it.

"In a time where there are work force issues - this role attracted a doctor from the North West with key skills which are needed in Shropshire.

"If the scheme is not re-instated we run the risk of losing those doctors and their skills."

Dr Julian Povey, CCG chairman, said he had personally written to the chief executive of WMAS asking for the services to be re-instated. He said: "The response I got from WMAS does not explain why the service cannot be re-instated. We thought the scheme ticked all the boxes. It took the pressure off the ambulance service and was a good use of the clinical resources we have.

"It helped to stop ambulances queuing and also reduced the number of patients seen in corridors at A and E who could have been seen in the comfort of their own home.

"It was a win-win scheme."

West Midlands Ambulance Service Director of Clinical Commissioning, Mark Docherty, said: "We are surprised by the suggestion that doctors in the Clinical Commissioning Group are not aware of the situation regarding the Physician Response Unit given the large number of emails exchanged; the letters written and responded to in recent days and a teleconference that was held last Friday on the subject.

"WMAS agreed to run a two-month-long trial which took place at the end of the summer. During that period, two potential 'serious incidents' were raised by medics at other organisations about the actions of the doctors involved in the scheme. These were formally investigated and the reports provided to the CCG.

"The scheme was set up to look at how GPs could work with the ambulance service to reduce the number of patients being conveyed to hospital. The scheme was meant to focus on urgent primary care needs rather than a blue light response for an emergency and as such was not as successful as had been hoped.

"However, West Midlands Ambulance Service is committed to schemes that will reduce the number of patients being taken to hospital. As such, we have proposed that a GP scheme similar to one that has been running successfully in Worcestershire for four years, without clinical incident, is implemented in Shropshire.

"We await comment back from the CCG as to whether they would like to proceed with such a scheme."