Slide 1
Reforms Challenge & Opportunity for Independent Ambulances
Rob Ashford, Chairman, Independent Ambulance Association
Good afternoon and thank you for coming to the IAA’s first public
appearance since the Association was launched just a few months
ago.
It comes at a momentus time for healthcare in general and the
independent sector in particular.
Slide 2
After a long and politically charged debate by both Houses of
Parliament and the medical profession, the Coalition Government’s
reform of the NHS is now set in the statute books and what lies
ahead is the most comprehensive change programme that the public
health service has undergone since it was established nearly 60
years ago.
How the NHS will end up in the future remains a question still to be
answered but what is certain is the continuation of the political and
professional resistance.
But, according to Bob Hudson, who is a professor in the school of
applied social sciences at University of Durham, there is a final form
of resistance that has probably yet to be articulated – it could be
terminated resistance.
He says: “The changes have been sold as a radical dose of
decentralisation – local GPs to become commissioners of healthcare,
local HealthWatch bodies to look after patient interests, local
foundation trusts with greater freedoms and new roles for local
government through health and wellbeing boards.
“In reality these measures are meant to be of much less significance
than the centralising powers of the NHS commissioning board and
the new roles for Monitor in setting up a market in healthcare, but in
the right circumstances they could be the entree for local resistance
to market encroachment.”
In the background will be the well documented concerns that the
reforms are yet another step towards the privatization of the NHS.
This is an argument which will be difficult to counter because the
reforms, with their opportunities for increased focus on patient choice
and outcome related measures of performance will open up the
market even further for independent providers of all healthcare
services.
This view is supported, at least in theory, by the move to give Monitor
increased powers as the economic regulator of the industry, with the
tools to aid the development of a level playing field for those involved
in health services provision.
Slide 3
The emerging healthcare landscape presents the independence
ambulance sector with both a challenge and an opportunity and was
one of the key factors in the decision to establish at the beginning of
this year the Independent Ambulance Association (IAA) as a not for
profit membership organisation for companies registered by the
Government’s Care Quality Commission.
The sector’s need for its own trade association has been confirmed
by the surge in membership and so far more than 30 companies, big
and small, have joined.
Slide 4
Of equal significance is the welcome the IAA has been given by
regulatory
bodies
encouraging
and
working
NHS
organizations
relationship
between
which
the
signal
public
an
and
independent ambulance services.
Slide 5
Our sector plays an important 24/7 role in providing highly efficient
patient transport services for the young and old and also working in
support of many NHS trusts. It is probably responsible for around
half of all patient journeys yet for far too long its contribution to the
nation’s healthcare
has not been fully recognized by the policy
makers; there has been a distinct lack of engagement with
independent providers when considering service redesign/reform and
this is a void the IAA is committed to fill.
Success in reversing that state of affairs by further professionalizing
the independent sector is at the heart of all our policies.
The introduction of registration by the Government’s Care Quality
Commission in April 2011 has been helpful in kick starting a change
in the sector’s perception because it gave us equal billing with the
NHS ambulance service in that we are both now regulated under the
same terms and conditions.
Slide 6
In order to meet the challenge of the new reforms, the IAA will work
closely with the CQC as well as other third parties from both the
public
and
private
healthcare
communities,
to
upgrade
the
professional qualifications demanded of independent ambulance
providers. The commercial rewards for all independent providers of
healthcare services are clear to be seen now but will take time to
materialize.
It will be a long haul and the IAA will be advising
member companies, if they haven’t done so already, to start learning
now how to market to the new NHS. They will also need to be
innovative and think laterally about collaboration with the NHS in joint
ventures and the like if they are to realize to the full the opportunities
that the reforms present.
Slide 7
Under the new regime competition for contracts will be even tougher
with more NHS trusts joining the bidding wars and the customer will
inevitably demand more service and resources, for less money.
In this era of change, ambulance companies have the potential for
commercial success but will need to substantially up their game improving their services, investing in training, resources and new
technologies – in order to be competitive.
Those which respond in this way will survive and prosper – others
which decide otherwise will probably fall by the wayside, or be
acquired by others with greater vision of the opportunity which lies
ahead.
Slide 8
In its favour the independent sector has support, expectedly, from a
most powerful figure from within the NHS.
Gareth Goodier, the chair of the Shelford Group, which represents
the 10 most prestigious and powerful acute trusts, in a recent
interview with the Health Service Journal called for an expansion of
independent sector provision.
Dr Goodier, chief executive of Cambridge University Hospitals
Foundation Trust, who is soon to take up a new post in Australia,
complained about a lack of “honesty” in the debate about using the
private sector and he rejected the argument that NHS inefficiency
means it should be opened up to private sector competition.
He went on: “The reason for going down that road is choice. Not
because the NHS is inefficient.
“Does the NHS need to change? Yes. There is a tsunami of need
coming and the way we deliver care needs to change. But is the
NHS inherently inefficient? I don’t think it is.
He believed increased private sector provision of NHS care would
boost quality and efficiency and added:
“Personally I like a mixed [provider] system – 70:30 per cent [the
latter being private]”.
There’s also some support for Dr Goodier’s view from the Health
Service Journal itself which rarely has devoted its comment column
to the independent sector in such a positive way.
Slide 9
Given that analysts Laing and Buisson recently estimated less than 5
per cent of NHS-funded elective care is provided by private firms,
Dr Goodier’s views paint an optimistic future for the independent
sector.
So maybe it is more than a pipedream when one day we will witness
NHS ambulance trusts & independent companies regularly working
side by side to deliver a 5 star safe and caring service for all
patients.
What do you think?
Slide 10
The floor is yours for comment & questions
End
Rob Ashford is Chief Executive of Thames Ambulance Services
www.iaauk.org