Who Are You Calling Inadequate!

Talk about Black Friday! Today (27/11/15) is the London Ambulance Service Black Friday. The report by the Care Quality Commission (CQC) is publically published today. It is not good reading. The overall assessment and rating is ‘Inadequate’!

The saving grace, as always, is the staff. The CQC acknowledges that staff were “overwhelmingly dedicated, hardworking and compassionate..”

The CQC report! Here’s how the politics work… In 2010 the Conservative Coalition government announced £20 billion cuts to the NHS. The share that the LAS had to take was a £50 million of cuts over 5 years. £50 million of cuts plus 980 or so job losses.

Recruitment was stopped. Paramedic training was stopped (or severely reduced). Not surprisingly the LAS struggled (not helped by poor leadership and management by a newly appointed Chief Executive and Executive Team at that time) but the struggle in the main was because of lack of funds, lack of training and lack of staff. We were set up to fail.

Everyone who knew our Service, except the Executive Team it seems, could see that we were heading off in the wrong direction and heading, very quickly, for the public sector equivalent of a train crash. I wrote (on the 10/11/14) to the then Chief Executive with the grave concerns of UNISON. I once again publish this letter in full without apology.

Dear Ann,

I am writing to you on behalf of London Ambulance UNISON, but also making a personal plea for our Service to act, take the initiative, and force through radical changes to retain and reward staff. We both know that needs to happen.

The very fact of UNISON writing to you directly reflects the seriousness of the situation.

 A major issue, as you are fully aware, is that the LAS is being squeezed by neighbouring Services whose offer of Band 6 for the Paramedic post is seriously stripping us of valuable staff whom we have spent time and large amounts of money in training. The trickle of staff leaving that we saw nine months or so ago has developed into a tidal wave. A tidal wave that, if not stopped, will take our Service down.

If this trend continues, the reduction of front line staff – currently we have around 300 fewer staff available over the Christmas and New Year period – will be exacerbated to the point where none of our targets can be met, and lives will be lost. Of course, it is not just ‘front line’ staff that are leaving. The pressure on all staff within this period is unacceptable. It is not an exaggeration to say that tension and anxiety can be felt throughout the Service. Staff know that something needs to be done. They do not want to work in this atmosphere of crisis, compounded by good people giving up on the Service.

I do not believe that we are a failing Service, but I do think that we are a falling Service. Falling from one crisis to the next. Falling unrelentingly from the position that we, as the Capital City’s Ambulance Service, should be. And, more worryingly, falling into the inevitable spiral that will, in a short time, turn falling into failing.

It has to change for staff. It has to change now.

I know that you and Jason (and others) realize this, and you are having difficult discussions with Commissioners, NHS London, TDA and other outside agencies. LAS UNISON is not criticising your efforts, but we are seriously, and without any ambiguity, warning of failure.

UNISON puts the following six demands to you directly that we believe need to be addressed, agreed, signed off and the outcome put together as a unique ‘London’ package for all staff working for the London Ambulance Service.

This will make a huge difference and impact on staff.

Whatever else you have heard, believe me when I say that the Banding issue is key to all of this and needs to be urgently resolved. Without that there can be no recovery, no fresh start, no stopping the tidal wave.

We (LAS) have been congratulated on our Cardiac survival rates within London. The report on The Pulse had the following quote from our own Medical Director:

Medical Director Fionna Moore said: “These figures show what an excellent job staff are doing resuscitating and stabilising patients and giving high quality CPR.”

Do we really want to lose the dedication and skills of these staff?

UNISON calls for:


  • All Paramedics at Band 6.
  • A re-think of the Senior Paramedic role.
  • Technicians’ future to be secured.
  • Make it easier, and affordable, for our own staff to study to become Paramedics.
  • Make it financially attractive for all staff to stay with LAS.
  • Create a unique London Package for all our staff that recognises the stresses and strains of working in London.
  • Outside of this we should review all Bandings as a result of ‘Market forces’. London is different. London is unique.

We believe that this has to happen, and happen quickly.

UNISON is prepared to continue working in partnership to save the Service from the greatest risk it has faced for twenty years. We stand ready to work together with the Service and important NHS bodies such as the TDA and NHS England to resolve these problems. However, if this opportunity is missed our close working relationship may be one of the casualties.’

Ann, together we can change the LAS. Our starting point is the London Package.

Best wishes


Most of that letter, if not all, is still relevant a year on. The Executive Management Team ignored this letter.

I am upset and disappointed that a great public service like ours has been reduced to this. I am also angry that the government and Secretary for State hides behind the CQC report as if they had nothing to do with our problems.

Our staff are not inadequate. The majority of managers are not inadequate. It is an insult to us all. I know the overwhelming majority of staff are proud to work for the Capital City’s Ambulance Service, looking after Londoners. London is a great City. It needs a great, well trained, well paid, well rewarded, well thought of Ambulance Service, with proper leadership and direction.

I support the Chief Executive, Fionna Moore, at this difficult time.

We now have a responsibility to all work together to defend our Service, to improve things and to put right the things we know are wrong (the CQC were not wrong on everything).

I say this though: Once the storm has settled, very senior management need to take a look at themselves and reflect on how they managed decline of a once proud, loved Service, in so short a time, notwithstanding the vicious government cuts that I outlined.

UNISON will present the letter again and this time we demand action.

Defend our Service. Support your Union.

Thank you.


Information on all issues can be found elsewhere on our website.


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We are stronger together.

Eric Roberts

Branch Secretary