FOCUS: Alderney ambulance service faces uncertain future

Thursday 20 January 2022

Alderney's only paramedic has said he plans to leave at the end of the month, throwing the future of the island's ambulance service into doubt.

No contingency plans have been shared with islanders, who now face the possibility of an emergency service without a qualified paramedic.

In recent years, Alderney's ambulance service has been characterised by instability. 

In 2019, a report commissioned by the Board of the service found that some of its equipment had never been serviced and many consumables were past their expiry dates. 

That led to the departure of the Chief Officer of the service, Mel Walden, and her volunteer crew then went on strike in solidarity with their former boss.

At this time, the service was run by St. John Ambulance.

Pictured: Alderney's ambulance service volunteers are trained to the level of Community First Responder.

The States of Alderney then took over the ambulance service and run it ever since.

In 2019, it was amalgamated with the island’s fire service. They are now funded as a combined fire and recue and ambulance service through the collection of Alderney Property Tax. 

The service has been run by volunteers and one Clinical Support Officer, Al McLean.

However, long hours and low pay have forced Mr McLean to quit. He is said to have been on call all day every day for the past two years. He plans to leave his post by the end of January. 

Mr McLean's departure is the latest blow to the ambulance service after another review recently concluded that it remained "inadequate".  

A review carried out last year by the Association of Ambulance Chief Executives stated: “The current operating model as defined within the original concept as a formal fire, ambulance and rescue service is not appropriate for an effective and efficient provision of healthcare in a modern-day setting, considering the range and scope of provision that can be provided under a paramedic-led urgent and emergency care model."

Pictured: This graph shows the spread of incident activity in Alderney recorded between April 2018 and September 2021. 

Despite commending the exceptional commitment of those involved in providing the service, including volunteers, the Association of Ambulance Chief Executives found that the service was unsustainable in its current form and in need of immediate action.

The Association recommended that Alderney should adopt a full paramedic-led service and hire a secondary paramedic to support the primary paramedic - who was then Mr McLean. It called for more strategic governance of the service. And it urged the States of Alderney to put out an immediate call for more volunteers.

But now, far from appointing the recommended second paramedic, the service is losing its first and only paramedic. His loss has been described as a big blow to the service and the island. 

Liz Bowskill, Manager of Operations at the Connaught Care Home, said: “I’m personally devastated that Al has handed in his notice. He and his team have worked tirelessly over the past few years to keep this island safe.

“It’s extremely concerning. His local knowledge over the past few years is incredible. If it comes to any emergencies at the Connaught, or the 48 other people we look after in the community, he knows them, he knows their history, he knows where to find them.”

Pictured: The Connaught Care Home recently closed its doors to visitors in response to an increase in the number of cases of covid in the island.

Stakeholders and regularly users of the ambulance service are disappointed not to have received more information about how the States of Alderney plans to address the uncertainty currently facing the service. 

“We’ve been promised contingency plans from the States of Alderney that we are yet to see as an island,” said Ms Bowskill.

“The Mignot Memorial Hospital at the moment is full. It’s essential that we have a medical practitioner who can actually treat and assess and ensure unwanted admissions do not make it to the Hospital.

“If he [the paramedic] was to get covid, I don’t think there’s a contingency plan in place for that either."

Ms Bowskill's concerns are shared by former States' member Lin Maurice. When she was in the States, St. John were still in charge of the ambulance service. 

“The paramedic that we’ve got has been fantastic,” said Ms Maurice. 

She said the island "hasn't the faintest idea" what is going to happen next to the ambulance service.

"Whatever it is, they better get somebody who is fully trained up and working as soon as possible," she said.

“The States haven’t said anything to anybody. Boyd Kelly [Chairman of the States' General Services Committee, which is responsible for the ambulance service] said we’ve got the same contingency plan we’ve had for two years, but nobody knows what that is anyway.”

Express asked the States of Alderney whether they have a contingency plan and, if so, what are the details of that plan. 

Derek Llewellyn, Strategic Advisor to the States of Alderney, said: “I can confirm that an effective contingency plan is in place for when the current paramedic leaves, but this is being shared at a meeting with the ambulance volunteers who play a major part in this plan.

“A press statement with further details is due to be released this Friday, 21 January.”

Pictured: Alderney has two ambulances.

The General Services Committee met this week. States' members were able to attend as guests. 

The Committee said: “A meeting will be held with the ambulance volunteers on Thursday 20 January at which all recent positive developments will be explained."

Whatever the plans are to protect the island's population and steer the ambulance service out of its current crisis, it is clear that the current team which has kept the service going in difficult circumstances enjoys the respect and admiration of many politicians and the public.

The States of Alderney said they "would like to express their sincere thanks to the continued dedication and tireless effort put in by staff and volunteers in providing the island with an ambulance service, especially during the recent omicron wave of covid-19 cases on the island, which has placed an additional burden on all services".

“Like many essential services on the island, the ambulance service relies on a few dedicated individuals to ensure it continues to provide this function," they said.

Ms Maurice still hopes the current paramedic, Mr McLean, can be persuaded to stay. 

“I’m hoping that Al doesn’t leave," she said.

“If your life is at stake, you want somebody who can actually do something. We’ve got such a high percentage of old people, we need somebody who knows what they’re doing."