GEING ambulance stations across the region could be closed or redeveloped pending a review by the ambulance service.

The changing nature of the emergency service and the likely implementation of the new 111 phone service means Great Western Ambulance Service needs to do a "thorough review of its ageing estate". Interim chief executive at GWAS Martin Flaherty has announced that he plans to review all 30 of the services ageing ambulance stations, including Dursley, built in 1968 and Yate built in 1975. Mr Flaherty said: "Over 70 per cent of our existing buildings were built before 1975 when they came under NHS ownership with many considerably older and therefore coming to the end of their worthwhile life. The maintenance backlog alone on our ambulance stations is in excess of 2million. "As a publicly-funded service, we have to consider if it is a sensible use of taxpayers money to spend that sort of figure on ageing buildings. "The focus of the estate review, therefore, is about ensuring as much of our income as possible goes into frontline services to benefit patients. This includes ensuring our staff have modern, fit-for-purpose bases from which to operate." At the same time Mr Flaherty said GWAS was keen to roll out the 111 service, a new national phone number for non-emergency medical incidents, which is expected to generate up to 1.5 million calls in the Gloucestershire, Wiltshire and former Avon area. This is around four times the current volume of 999 calls for GWAS, meaning the current call-handling capacity would have to be significantly increased. "Bidding to run the 111 service in our region is a natural ambition for us, given that we already have considerable in-house clinical expertise and knowledge in handling emergency calls and the out-ofhours GP service in Gloucestershire," said Mr Flaherty. An estate strategy document will be presented to the next trust board meeting (May 26) and, if approved, will see the establishment of three project teams to start work on the first phase of the review.

Great Western Ambulance Service

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Map of the Great Western Ambulance Service's coverage The Great Western Ambulance Service NHS Trust (GWAS) is a UK National Health Service (NHS) trust providing emergency and non emergency patient transport services to Bath and North East Somerset, Bristol, Gloucestershire, North Somerset, Swindon and Wiltshire in the South West England region. It was formed on 1 April 2006, from the merger of the Avon, Gloucestershire and Wiltshire ambulance services. It is one of twelve Ambulance Trusts providing England with free Emergency medical services, and is part of the National Health Service, receiving direct government funding for its role.

Contents
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1 Operations 2 History 3 Wiltshire Emergency Services 4 Vehicle fleet o 4.1 Air ambulances 5 See also 6 References 7 External links

[edit] Operations
The Trust headquarters is at Jenner House, Chippenham, Wiltshire. The Trust has one main call handling control room ("EOC - Emergency Operations Centre") and two "dispatch centres". The main control room, the EOC at Acuma House, Almondsbury, has been recognised as a Centre of Excellence for emergency call handling and dispatch for 2006, 2007 and 2008. One of the EOC team received the International EMD of the Year Award 2007. The EOC in Quedgeley, Gloucestershire, is also the hub for the Gloucestershire out-of-hours "urgent care" service. The emergency control centre for Wiltshire is located in the WES building in Devizes, as the Great Western Ambulance Service in Wiltshire is part of Wiltshire Emergency Services project. In common with all UK ambulance services, the control room triages and categorises 999 calls into three categories - A, B, and C. Category A are potentially life threatening emergencies requiring an immediate response. Category B are potentially serious but not life threatening emergencies. Category C require do not require an emergency response and are relayed to NHS Direct, specially trained paramedics or nurses for over-the-phone advice, GP services or Emergency Care Practitioners(ECP).[1] Below are the performance targets the government has set out of ambulance trusts to meet.
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to reach 75% of immediately life threatening emergencies (category A) within 8 minutes to reach 95% of non life threatening emergencies (category B) within 19 minutes where a doctor requests an ambulance for a patient under the Doctors' Urgent Standard, to deliver 95% of patients within 1, 2 or 4 hour targets, as requested by the health care professional.

[edit] History
Formed on 1 April 2006, from the merger of the Avon, Gloucestershire and Wiltshire ambulance services, the trust had a difficult start, marked by redundancies, closure of its training centre and the threat of ambulance station closures, though in the end, only one ambulance station was closed (Newant, Gloucestershire). This caused strained industrial relations [2] with its recognised union, UNISON, and attacks from the local media. From the date of merger, Great Western Ambulance Service struggled to achieve the Department of Health Key Performance Indicators and in 2007-2008 the Trust lost two contracts for non-emergency Patient Transport Services (PTS) to private contractors. Huge numbers of ambulance shifts were covered by private agencies.[3] In September 2008, the Chief Executive, Tim Lynch resigned. He was replaced by an Interim Chief Executive, Anthony Marsh, from West Midlands Ambulance Service.[4] Marsh identified a

lack of operational leadership and a "competition of priorities" within management and removed two Directors (the Director of Operations and Director of Corporate Development).[5] In February 2009, a ceremony was held to present almost 60 staff, partner agencies and members of the public with Chief Executive Commendations. In September 2010 a specialist unit, the Hazardous Area Response Team, was established and went live after months of preparation and training. This unit consisting of 32 paramedics is trained to respond to complex or large incidents involving fire, chemicals, biological or nuclear risks, collapsed buildings, cliff or heights, confined spaces, water or firearms incidents. The GWAS unit was planned to be one of the last parts of the national scheme to be established, but has already had national acclaim with high levels of activity and a dedicated base being built in Filton, North Bristol. The team is currently working from a temporary depot in a classified location not far from Bristol. In summer of 2010, the regional NHS announced that after a tough competitive tenering process, GWAS had secured the major patinet transport service contract for the former Avon area, representing an estimated three-quarters of non-emergency patient journeys in the region. The new revamped service, operating 24/7, went live on 1 October 2010. In 2010 the trust board recommended the closure of at least one county's control room, and gave the go ahead to an "Estates Review" to prepare the trust for closure of local ambulance stations. In 2009, the new chief executive, David Whiting, previously director of operations from East Midlands Ambulance Service, was appointed as Chief Executive. He announced his resignation in November 2010,[6] having served just nineteen months, a situation the union described as "difficult".[7] The resignation came at the height of an industrial dispute as the trust attempted to adjust rota patterns, rest break configutarions and staff shift times, which caused staff to be concerned about safety and welfare of patients and colleagues.[8] In December 2010, the Trust announced another interim Chief Executive, Martin Flaherty of the London Ambulance Service.[9] When Mr Flaherty leaves, and his replacement appointed, it will be the 5th Chief Executive in only 3 years. At the beginning of January, 2011, UNISON (the only approved union within GWAS until January, when the GMB was 'suddenly' accepted) announced the results of a ballot for industrial action. From those that voted, the result was 96% in favour of taking industrial action as a form of protest against the changes implemented during 2010.[10]

[edit] Wiltshire Emergency Services

Main article: Wiltshire Emergency Services Great Western Ambulance Service's Wiltshire branch is a member of the Wiltshire Emergency Services project, a collaboration of emergency services in Wiltshire. The project has seen the construction of the WES building at Wiltshire Police Headqaurters and the relocation of all three

emergency services control centres into that one emergency control centre where information is shared instantly between the three. The project has overseen the sharing of station at Bradfordon-Avon and Mere, and also the sharing of Wiltshire Air Ambulance and the training of Fire and Rescue crews to use defibrillators on occasions when the ambulance service is busy. GWAS is also supported in Wiltshire by a group of volunteer doctors ('SWIFT Medics') who respond from home, in their own time, to incidents involving seriously sick or injured parients throughout the County. The doctors involved are all either senior GPs or hospital clinicians, who provide their time and expertise for free. The specially trained prehospital care doctors are able to supplement the skills of paramedics and other ambulance staff (for example with advanced decision making, administration of strong painkilling drugs, prehospital anaesthesia and certain surgical procedures normally carried out in hospital). The prehospital care doctor team receive no funding from either the Govt or GWAS, and rely entirely on charitable donations and fundraising to pay for their drugs, kit and training. All the doctors use their own cars and are permitted to respond with blue lights and sirens (having undergone an intensive three week police driver training course with Wilts Police). The team work closely with the Wiltshire Air Ambulance and the GWAS Air Ambulance. Currently SWIFT doctors are tasked to a job either by the Emergency Operations Centre in Devizes or following a direct request from ambulance personnel at the scene of a serious incident. www.swiftmedics.net

[edit] Vehicle fleet

Avon
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PTS - Renault Master, Ford Tourneo, Citroen Picasso and Fiat Multipla A&E - Mercedes Sprinter RRV - Vauxhall Astra and Vauxhall Zafira but now standardising on Ford Mondeo Special ops - Land Rover Discovery 4, Volvo XC70, Volvo XC90, Iveco HART units. ASU - Bo-105 charity funded helicopter operated as the Great Western Air Ambulance

Gloucestershire
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PTS - Renault Master A&E - Renault Master but now standardising on Mercedes Sprinter RRV - Renault Scenic, Honda CRV, Vauxhall Astra and Zafira but now stanardising on BMW. ASU - AS-365 charity funded helicopter operated as the County Air Ambulance

Wiltshire
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PTS - Renault Master A&E - Renault Master but now standardising on Mercedes Sprinter RRV - Renault Megane, Honda CRV, Vauxhall Astra, Vauxhall Zafira, Volvo XC70, V70 and V50. ASU - MD 902 Explorer, charity funded helicopter operated as the Wiltshire Air Ambulance and shared with Wiltshire Police.

The latest addition to the vehicle fleet are 140,000 Mercedes Sprinter coach-built ambulances [11] converted by WAS of Germany.[12] Although they are visually impressive and expensive, they represent little new advances over the smaller, cheaper, faster and less complex Mercedes Sprinter UVG Premia ambulances they replaced in Avon.[citation needed] A lack of on-the-road testing (the first batch delivered sat at the Trust HQ for six months) has resulted in later batches not being updated with essential modifications. The hydraulic taillifts are not approved for use by the manufacturers on slopes greater than 5 degrees, the 3,000 Stryker Rugged wheel chairs lack a 30 foot rest, the Ferno Falcon trolley stretchers do not fit inside as many premises as the competing manufacturer's and the ambulances do not have a light switch by the doors for crews to switch on the interior lights when they load a patient at night. They have also been criticised by crews for the design of the storage space for equipment, with standard items of medical equipment left crammed in cupboards and which left staff under 5'8" struggling to reach some items of immobilisation equipment from the external lockers. Previous to the WAS of Germany-built ambulances GWAS received a batch of UVG Modular ambulances.[13] Teething problems aside, the Mercedes ambulances represent a big step forward from the aging Renault Master ambulances in Wiltshire and Gloucestershire, many of which had to be removed from service when they were found not to meet modern safety standards.[14]

[edit] Air ambulances

GWAS has three air support units. The West Midlands Ambulance Service provides the County Air Ambulance which operates from Strensham and covers GWAS northern areas. It is crewed by two air ambulance paramedics. The Wiltshire Air Ambulance operates 24/7 from the police HQ at Devizes and is crewed by a air ambulance paramedic. The Great Western Air Ambulance is based at Filton Airfield, Bristol and operates 7 days a week during daylight hours. The helicopter is crewed by a specially trained Critical Care Paramedic and a senior Doctor trained in prehospital medicine. The helicopter covers the entire GWAS area and, if requested, will fly outside the GWAS boundary to assist other ambulance services. Although GWAS pay for the paramedics, vehciles, training and some equipemnt, the doctors all work on a voluntary basis and give their time for free. The helicopters and their associated running costs are paid for entirely by charitable donations, receiving no funding from either government or the ambulance service. The units can be tasked to an incident either by proactive disptach from ambulance control or by a direct request from an ambulance crew on the ground.

Great Western Ambulance Service NHS Trust provides emergency and urgent care, and patient transport services across Wiltshire, Gloucestershire and the former Avon. The trust employs more than 1,700 staff across 33 operational sites 30 ambulance stations and three emergency operations centres and in its headquarters.
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GWAS equality and diversity workforce profile (Updated April 2010)

Last year (2010-11), GWAS responded to more than 264,000 emergency calls. Our Patient Transport Service also carried out more than 238,000 patient journeys. The trust covers an area of 3,000 square miles with a population of almost 2.4 million people.

"Nothing but praise for the Great Western Ambulance Service"

About:Great Western Ambulance Service NHS Trust / Patient transport service Posted by Glowing647 (as a carer), 3 months ago My husband is waiting to have a heart operation and so we've taken over to Bristol from Swindon by the Great Western patient transport service twice now. The first time they came for us was in early January, when the weather was really nasty, there inches of snow on the ground. I was a little apprehensive because I'd never been in an ambulance before. I really needn't have worried. They were so kind. My husband uses a wheelchair because he can't walk far without feeling weak and I was worried about the ambulance staff having to wait around while I brought him out but they weren't concerned at all. They were very friendly and completely put my husband and I at ease. It was a lady and a gentleman that came out to us last time but yesterday, it was two young guys and they ticked all the boxes. They couldn't have been more polite and helpful. Nothing was too

much trouble - they were asking us if we were warm enough and attending to our every need. I couldn't have hoped for better service. We picked an old lady up on the way and they were so good to her. They put a blanket over her and constantly made sure that she was comfortable. My husband likes to talk, and one of the young guys, I think his name was Matt, talked to my husband all the way there. He was as happy as larry to have someone to chat away with! It really put his mind at rest. When we got to the hospital, the scanner had broken and so we were transferred up to A&E. I was worried that the ambulance staff wouldn't find us and I'd thought we'd need to walk back down to where they dropped us off but no, in walked the lovely guy to collect us as soon as we were ready to go. I was so impressed. Just as I was getting out of the ambulance at home, I was laughing and joking with the guy and saying I wanted to write a letter about how good they were and he said to give Patient Opinion a ring and share my feedback with you. This is actually a lot easier for me to do and i'm really glad that other people will be able to see how brilliant the ambulance staff are. We're going again with the ambulance service next Wednesday and honestly it feels like we're going on an outing! We're looking forward to seeing them! They're just such lovely people and made the whole thing so much easier for my husband and I. More about heart operation

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What's good?
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ambulance service brilliant comfortable efficiency friendly staff

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kind kind staff polite staff attitudes

What could be improved? Initial feelings:

grateful, happy and impressed

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Response from Patrick Mulcahy , Head of Clinical Quality , Great Western Ambulance Service NHS Trust on 11/03/2011 14:31:50
Thank you very much for taking the time to let us know about your experiences with our Patient Transport Service. It is very important for us to get user feedback as it helps us to gauge the quality of what we do and we are delighted with your comments and pleased that you have benefited so much from our service. We will ensure that we pass your kind words onto the members of satff. Sincere thanks.

Great Western Ambulance Service reviews building stock

Most of the service's 30 ambulance stations are at least 40 years old

Great Western Ambulance Service (GWAS) is reviewing its stock of ageing buildings ahead of the planned roll-out of the nonemergency 111 service. The trust said the new phone number was expected to quadruple the volume of calls it receives. It said its current call-handling system would have to be "significantly increased" to cope with the demand. GWAS owns or leases more than 30 buildings in Wiltshire, Gloucestershire and the Bristol area. It has three emergency operations centres (EOCs) which deal with more than 250,000 calls a year, a headquarters in Chippenham which is nearing the end of its lease and 30 ambulance stations, most of which are at least 40 years old. Interim chief executive, Martin Flaherty, said the review was about ensuring that as much income as possible went into frontline services, which included having staff in modern, fit-for-purpose bases. Reduce pressure "Bidding to run the 111 service in our region is a natural ambition for us, given that we already have considerable in-house clinical expertise and knowledge in handling emergency calls and the out-of-hours GP service in Gloucestershire," he said. "However, [our] facilities do not have the capacity to handle the considerable increase in call numbers that securing the 111 service would bring. "Therefore, we need to look now at how we could accommodate that additional activity for the benefit of patients and our staff." The new 111 service is being piloted in four areas, with further trials due to start in other parts of England towards the end of this year. People calling the number will be able to get health advice and information about services such as out-of-hours GPs, emergency dentists and 24-hour pharmacies.