The plight of the ambulance service has been thrust into the spotlight in recent months. News outlets report, ‘record-breaking waiting times’. The Health Secretary recently declared ambulance wait times a “number one priority for winter”.
So what might ease the challenges faced by the ten core English ambulance services?
One solution is the creation of make-ready centres, sometimes referred to as ‘hub and spoke’ systems. These dedicated centres differ from traditional ambulance stations. They provide a single point of servicing and repair. This allows regular and easier maintenance, improving availability.
The NHS and Lord Carter produced a report before the pandemic. It outlined key points ambulance authorities should consider, to improve operational productivity and performance. The report identified three critical areas for improvement: staff, technology and fleet management. It is in the latter two, particularly fleet management where the make-ready centre really comes into play.
Reducing Estates Expenditure and Inefficiency
The report identifies the need for standardisation of vehicles, stock, processes and equipment. It also discusses estate expenditure and the need to use make-ready systems. One trust had reduced operational estates by 72% by employing such a system.
It is little coincidence then, that after implementing the Make-Ready system, one major ambulance’s response times in 2017 and 2018 were much slower than national averages, but their times are now much faster than average*. The latest data shows the service being seven seconds faster than average for category 1 emergencies. This improves to over one minute faster than average for category 1T calls.
The strong investment in make-ready centres by SECAmbs is ongoing. Our support on Banstead and other regional centres is ongoing. Chawton Hill has been working with several NHS trusts on make-ready centres. You can find out more about what a make-ready centre is in detail on our earlier blog. But what is it that makes them work, what needs considering, and what lessons have we learned over the years?
Standardisation is Key
Something Chawton Hill identified early on, was the need to create standardised processes. There are key lessons learned which we have recorded and now use for new projects. These enable us and our teams to ensure the construction and management of the centres is as efficient as possible.
Our lessons learned document is extensive, but includes such considerations as:
- Identifying standards for medicine rooms early in project.
- Positioning of wash facilities to minimise disturbance to other functions.
- Standardisation of facilities for electric vehicles and electrical facilities for ambulances.
- Standardisation of gas cages etc.
- Standardisation and adequacy of storage facilities.
- Identification of trusted and experienced approved suppliers.
- Standardisation of facilities for cleaning, washing etc.
- Functionality to maximise speed of vehicle entry / egress.
- Implementation of environmental standards such as BREEAM.
- Considerations for active travel for staff – cycle facilities etc.
- Positioning of facilities and equipment for maximum convenience. These include vehicle refuelling, oil, AdBlue, etc.
This list is a small sample of the many things we consider and standardise when managing the creation of a make-ready centre. By ensuring each one is as functional and standard as possible, the best use of space can be assured. Staff are able to work as effectively as possible in each location, guaranteeing full efficiency.
Should you or your colleagues be looking into the usefulness of make-ready centres and looking to ensure you get them right first time, get in touch. Dave or James will be happy to chat to you about the lessons we’ve learned and help you with your next project.
*Based on times in those years from the NHS website.