Ambulance staff in Wiltshire, Avon and Gloucestershire may be balloted on whether to take industrial action in protest at the employment of lower skilled ambulance staff.

Union Unison, which has more than 650 ambulance members in the three counties, is opposed to the Great Western Ambulance Service (GWAS) employing emergency care assistants, who are trained in basic first aid but whose main role is to assist paramedics.

GWAS employs more than 230 emergency care assistants, who are the lowest paid of its clinical staff, and now aims to staff all ambulances with a paramedic and an emergency care assistant.

But Unison argues the assistant role is not fit for purpose as the assistant does not have the skills to treat patients autonomously.

The Wiltshire Times reported in September that GWAS had crewed five ambulances in Wiltshire with emergency care assistants only, a situation one paramedic described as “Russian roulette for patients”.

Unison want GWAS to employ either paramedics or technicians, who have a higher range of skills, instead of assistants.

Ian Whittern, chairman of the GWAS Unison branch, said only four out of 14 ambulance services in the UK were employing emergency care assistants.

He said: “We are working towards a point where we can ballot our members for industrial action. There is a national direction that the emergency care assistant role is not fit for purpose.

“There are 10 other ambulance trusts not employing emergency care assistants and we do not feel it is right to allow a postcode lottery in other ambulance trusts.”

Mr Whittern said a ballot could be held by May but in the meantime Unison would be urging the public to write to local councillors complaining that employing emergency care assistants had led to a “second-rate service”.

David Whiting, chief executive of GWAS, said news of a ballot by Unison was disappointing. He said currently there were paramedics on 80 per cent of the trust’s ambulances and of its workforce 20 per cent were emergency care assistants.

Response times fail to hit target

Ambulance response times to life-threatening calls in west Wiltshire are almost at the national target level, but other areas of the county do not fare as well.

Figures produced by Great Western Ambulance Service show that since last April the service achieved a 74.3 per cent response rate in sending an ambulance to life-threatening calls within eight minutes in west Wiltshire, compared to the national target of 75 per cent.

But in Kennet, which takes in Devizes, Marlborough and Pewsey, the figure was 54.9 per cent and in north Wiltshire it was 66.8 per cent. The worst performing area in the GWAS patch was the Cotswolds where the response is 48.4 per cent.

In contrast GWAS exceeds the national target in large towns and cities. Its best performance has been in Swindon where it achieved a response of 89.7 per cent.

The over-performance in urban areas means that GWAS is able to get close to or meet the 75 per cent target overall.

David Whiting, chief executive of GWAS, said it was difficult to achieve the 75 per cent target in rural areas, but he said he wanted to narrow the gap.

He said: “We have to get a good level of response across our patch but accepting that performance in cities will always be better than rural areas.”

A special task group comprising councillors has been set up to look at the worst performing areas – Kennet in Wiltshire, the Cotswolds and Forest of Dean.

Following the first meeting last week councillors agreed to publicise the community first responder scheme, where members of the public are trained to use a defibrillator to treat people who are having a cardiac arrest.

Technicians are set to be replaced

The Great Western Ambulance Service wants to bring in emergency care assistants to replace technicians on its ambulances.

Dr Ossie Rawstorne, medical director at GWAS, said the ambulance technician role is being phased out nationally.

GWAS is looking to retrain its 200 technicians to become paramedics via a 44-week foundation degree course.

He said: “Emergency care assistants have been a valued, important part of the GWAS skill mix for the last three years.

“Because every vehicle we send to an incident will have a registered paramedic, the assistant is the appropriate support role for those vehicles that have a crew of two.

“The model of a registered clinician supported by a care assistant has worked well in other parts of the NHS for many years – typically in hospitals where a registered nurse is supported by a healthcare assistant – and the ambulance service is looking to mirror that approach.”

Grades at the centre of the dispute

Emergency care assistant -

Can give basic life support, use manual defibrillator, undertake spinal and limb immobilisation and give oxygen therapy. Training: Eight weeks. Salary: £15,190-£18,157

Technician -

Same skills as ECA but can administer certain drugs autonomously. The role is being phased out nationally. Training: 11 weeks. GWAS is training its technicians to become paramedics. Salary: £17,732-£21,318

Paramedic -

Can give advanced life support, including cannulation and intubation and administer a wide range of life saving and other drugs, including diazepam, morphine and a clot busting drug for strokes/heart attacks. Training: 44 weeks Salary: £20,710-£26,839