Rob Mason

Of the nine-million patients seeking help from the ambulance service last year, five-million were transported to hospital. Yet only 10% of those seeking help have a life-threatening health need, indicating the vast majority might be better served outside of hospital and nearer to home, cutting costs and improving patients’ quality of life. As ambulance services strive to do their part in assessing, treating and referring patients outside of acute care settings, the time crews spend engaged on each task has increased from one to one and three-quarter hours. This increased "pace-of-care" strains resources, leaving fewer crews available and forcing patients to wait longer for help to arrive. Queueing theory tells us that if, at the time of the patients call, the nearest resource is not busy then the patient is served immediately. As more resources become busy fewer patients will be served immediately and more will have to wait. When crew utilisation reaches 50% sometimes the newly arriving call finds a crew available, sometimes there are several calls already waiting, but the effect is to double average response times compared to there always being a crew available to respond. As utilisation goes beyond 70% fewer resources are available to respond and response times double again. The opposite is also true. Reducing crew utilisation will improve response times. Restoring the pace-of-care to an hour (its historical norm) and ensuring crew utilisation does not exceed 50% (guaranteeing mandated response times) requires only two-thirds of the current 30,000-strong workforce. Reassigning 10,000 experienced paramedics from emergency duties to an urgent/unscheduled care service, paired with an efficient emergency ambulance system, could double out-of-hospital care (25% Hear & Treat, 50% See & Treat), halving hospital transports (25% See & Convey) without the need for additional investment. Decentralising ambulance services helps to ensure that those who are close enough to care are the ones empowered to make decisions. A national ambulance service could manage the delivery of each of the, 140 or-so, Medical Trade Economy Ambulance Systems (MedTeams), configured around the needs of local communities in England, with a single Board. Improving emergency ambulance service productivity and efficiency will increase crew availability, improve response times, patient outcomes, recruitment & retention, crew rest breaks and shifts ended on-time while reducing staff sickness, stress & anxiety. Two-and-a-half million patients will no longer be transported to A&E, saving £0.5bn. The reliable responsiveness of the MedTeams system will significantly reduce the clinical risk of managing patients closer to home. The ambulance service has the resources and financial capacity to transform urgent and emergency care. Within a few years, a national service for England could emerge, responsive to local communities, integrated with the medical trade economies around acute hospitals, and only-ever minutes away. @ShaunLintern @AliJaneMoore @AACE_org @AnnaParry12

@Megsenmumdr @HSJEditor @parthaskar @HSJnews is little more than Only Fans for the parasitic managerial elite who have overseen the decline in our NHS.

@HSJEditor @parthaskar Imagine lasting as a News Outlet for over 100 years and then being the man to run it to ground by turning a once trusted news outlet into a DHSC/NHSE propaganda rag ! So …. ? Don’t think HSJ ever compromised their values like you have been doing Shameful

Imagine how silly this quote is going to look in five years time

@Montyburnout123 @doctor_katie @Parody_RCGP @HSJEditor They’re an only fans account for the well paid managerial class who have overseen the decline in our NHS.

@doctor_katie @Parody_RCGP @HSJEditor Does anyone care what HSJ think?

@AACE_org @grok When was paramedecine recognised as a profession in the uk?

As the UK marks 55 years since #paramedicine became a recognised profession, North East Ambulance Service is celebrating the people behind the green uniform and the innovations that have shaped pre‑hospital care. >> neas.nhs.uk/news-and-event…

@sib313 @danielgoyal @SallyMi83941850 It doesn’t matter where the money is wasted Steve. It’s impossible to waste money in healthcare without also wasting lives.

@danielgoyal @SallyMi83941850 Since 2020 the NHS has spent more than £20bn extra, most on a large increase in doctor and nurse numbers. NHS activity is barely up. I suspect your hypothesis about where the money went is flawed.

There is money in the NHS but it’s not going to patients…. Years ago when I first worked as a physio there was no private organisation in health, every penny went on clinical care. Then it started. First with the cleaners. 1/5

@ww_munir @RupertLowe10 Ireland has no bins and no rubbish.

Everyone wants cleaner streets. The real question is: do you fix it with punishment, or with systems that actually work? Countries that stay clean don’t rely on forced labour — they invest in bins, regular collection, fines for littering, and public responsibility. Singapore didn’t become clean by turning citizens into chain gangs. It became clean by making cleanliness a culture. If Britain looks worse today, ask why councils are underfunded, why services were cut, and why prevention failed. Anger is easy. Fixing it properly is leadership. Clean streets shouldn’t come from humiliation. They should come from pride.

Drive down any motorway or road in Britain, and it is FILTHY. Litter everywhere. Our country is increasingly becoming a third world dump, and we should not tolerate it. Restore Britain would clean up Britain. How? Get healthy Brits who consistently refuse work out picking litter. If they don't want to do that, they will lose their benefits. Give them a few months to find a job they prefer, but if they fail? They must work for their benefits. Done right, it would mean hundreds and hundreds of thousands of men and women cleaning up Britain. What a great policy. If we were in power, there would be no foreigners on benefits - hence why they are not included in this scheme. Non-violent prisoners, they can pitch in too - safely and securely. Nearby prisons, in bright orange overalls. Instead of sitting around in prison doing horticulture classes or lifting weights in the prison gym, they can work and work bloody hard all day. Then back to prison. Because our country increasingly resembles a dump. It does not have to be like this. I am just so sick of it, honestly. It is disgusting. If you want to clean up Britain? Vote for, and join, Restore Britain.

@Witte_Os @RupertLowe10 Give them two days off their sentence for every day of work, like they do in El Salvador.

I applaud clean up efforts, and for compelling those accepting welfare to contribute to society, but surely once performing the work they should be paid fairly for their labour. Providing remuneration for effort will restore pride in those who have never experience it, or have come to believe they may never attain it through work. It is important to rehabilitate those who gave up on working, some due to other social factors that have been named in RB policies, and will be concurrently addressed during clean up efforts, and then provide employment opportunities beyond the clean up efforts. Bringing back a sense of national pride through work and through cleaning up Britain’s streets is a good start to recovery.

@opinion_black It’s telling that no productivity or performance metrics exist which compare crude inputs to crude outputs and would allow identification of healthcare value.

The NHS is a busted flush. It is no longer fit for purpose and should either be completely abolished or rebuilt from the ground up. Take for example the GP system. In the UK it is now operated on behalf of the doctors and NOT the patients. Getting an appointment in an emergency is now almost an impossibility. They have abdicated all responsibility to genuinely care for their patients. The NHS will quickly claim that the issue is one of ‘inadequate funding’. Nonsense. The NHS is Europes largest employer with a bloated administrative core. Its purchasing contracts are badly drafted enriching conglomerates at the expense of the overtaxed public. Many of its employees are rude, confrontational, benignly self righteous and unpleasant to be around. They are, generally speaking, contemptuous of the elderly, dismissive of pregnant women and on the wards prefer doom scrolling on their telephones to looking after their patients. Enough is really enough. With the exception of the walk in clinics (special mention to the Soho walk in clinic) I would dismantle this fiefdom with zero apologies. It has morphed into a political construct with undertones of a quasi religious organisation that one must never criticise. No thanks. #NHS #UK

@HKW1981 @Sanders4Health If you can’t tell the difference between fresh faced kid and a hardened professional then I can’t help you.

@robertgmason @Sanders4Health But how can we tell?

I am over 65. When I am acutely unwell and in hospital I do not want to be assessed by a ' clinical decision maker'; I want to see a doctor,

@areyoflight @anonoccu1 What difference has it made to your life?

@anonoccu1 It’s the worst thing this country did in my opinion

Can ANYONE, literally ANYONE, name ONE single, measurable, actual benefit Brexit has delivered? I’ve been asking for 9 bloody years and the best I get is the occasional “muh sovereignty” whimper from someone whose biggest achievement is owning a blue passport they never use. I’ll wait… 👀

@areyoflight Here’s 50…

@scruztiger @Ducks_n_Dogs @Electroversenet So you can do your own research! Good for you. Follow along with @SunWeatherMan and see if you’re not just a little persuaded or whether you do, indeed, have a mind that is closed to more common sense possibilities.

@robertgmason @Ducks_n_Dogs @Electroversenet In other words…

A new study shows a thick ice cap in Greenland was completely ice-free just 7,000 years ago. The cap is Prudhoe Dome, which today is some 1,600 feet thick. The researchers drilled through the ice and dated the sediments below it. It turns out those sediments were once exposed to sunlight, meaning there was no ice. 7,000 years ago, summer temperatures were 3 to 5C warmer than today. This study shows, once again, that large ice losses have occurred in the recent past, caused entirely by natural climate variability - no CO2 forcing required.

@scruztiger @Ducks_n_Dogs @Electroversenet Frozen mammoths with food in their mouth. They weren’t ruminating on the arctic, where there was no food. They didn’t just materialise there. The earth shifted on its axis, and took them there.

@Ducks_n_Dogs @Electroversenet Source?

@WagonTrain2 @jim_crawfurd The NHS has already been destroyed. Where he you been?

For those thinking “we’ll just give Farage a try because we can vote him out again”. Look at the damage Trump has done in less than a year. Apart from everything else once Farage has destroyed the NHS it’ll be all but impossible to rebuild it.

@WingsEcosse @Cathures72 @Glenn_Diesen @IndyLassie Denazification, demilitarisation, autonomy for the 4 regions and neutrality for Ukraine. They have largely achieved the first 3.

@Cathures72 @Glenn_Diesen @IndyLassie Yes it was

Russia is hopelessly weak and it's soldiers must eat pigeons, but we must prepare for war as Russia is immensely powerful and can conquer all of Europe. If you question the logic you are a Russian asset, so just embrace the virtuous hate and mindless warmongering of your political class and their stenographers in the media.

@DrSteveTaylor Have you been to @MTWnhs yet, as I suggested, to see how they managed to eliminate A&E delays by planning discharge on admission and throughout the patients stay? They didn’t need any additional capacity, they were able to make better use of the capacity they have.

Corridor care shames the UK Successive NHS leaders have failed to address the cause Not increased activity but lack of capacity for admission & discharge - beds Instead of 5000 additional permanent beds, ‘gongs’ given by the King to those responsible for failure It must end!

@kurtstat @sib313 @jim_crawfurd Here’s the relationship between the % of time on duty spent with, or responding to, ambulance patients versus response times. Ambulance resource utilisation is a near perfect predictor of response time reliability.

Something @jim_crawfurd said yesterday in a different context (“Just fix exit block FFS”) made me wonder how often ED folk get to see - for example - data that shows how the fullness/heaviness of inpatient wards affects ED crowding and length of stay. 5/5

Yesterday I drew this graph of ED crowding and ambulance turnaround times. I didn’t have actual ED crowding data, so I used a proxy: the percentage of ED patients staying longer than 12 hours. @TJCoats @RoyLilley @jim_crawfurd @StuartNuttall1 @RCEMPolicyVP @jmessillett 1/5

@clairebubblepop I can give you ambulances within mins for no additional funding. Canvassing all sides of the political spectrum and NHS management elite for 5 years leads me to conclude no-one wants to fix it. Do you?

SICK of people saying they want the old UK back. We ALL do. WE want same day GP appointments, ambulances within mins, dentists, a decent police force, good education, affordable food, clean water ways, BUT it’s not migrants who caused this. It was 14 YEARS of Tory austerity! It’s corporations being put first and the people being put last. It’s capitalist GREED.

Wales is fixing its ambulance service — by sending out fewer ambulances #Echobox=1770530736" target="_blank" rel="nofollow noopener">thetimes.com/uk/healthcare/…

@Parody_PM Formal education determines compliance, not intelligence.

It's official - thick twats vote Reform.