Dear Ms Mutch,

Thank you for your letter of 17 July 2022 about the death of Ronald Hartley. I am replying as Minister with responsibility for Health and Secondary Care.

Firstly, I would like to say how saddened I was to read of the circumstances of Mr Hartley’s death and I offer my sincere condolences to his family and loved ones. The circumstances your report describes are very concerning and I am grateful to you for bringing these matters to my attention.

In preparing this response, departmental officials have made enquiries with NHS England and the Care Quality Commission (CQC).

The government is committed to supporting the ambulance service to manage the pressures it is facing, ensuring that people receive the treatment that they need when they need it.

This will be supported by the government investing an additional £3.3 billion in each of 2023-24 and 2024-25 as announced in the Autumn Statement. This will enable rapid action to improve urgent and emergency care performance towards pre-pandemic levels. The NHS will set out detailed recovery plans in the new year.

In the short-term, ahead of this winter, the NHS is substantially increasing capacity and resilience. Bed capacity will be increased by the equivalent of at least 7,000 general and acute beds, alongside a £500 million Adult Social Care Discharge Fund, helping improve patient flow through hospital and reduce long waits in handing ambulance patients to A&E, getting ambulances swiftly back on the road.

Addressing ambulance handover delays is a key priority. NHS England is providing targeted support to some of the hospitals facing the greatest delays in the handover of ambulance patients into the care of hospitals, helping them to identify short and longer-term interventions to improve delays and get ambulances swiftly back out on the road. This is alongside a new national Winter Improvement Collaborative programme to help other trusts identify the root causes of handover delays and implement best practice.

Further winter actions include establishing 24/7 System Control Centres in all local systems to better manage demand at a system level, and expanding falls response services right across the country, which will see local teams sent to help people who have fallen in their home or in care homes, rather than unnecessary trips to hospital.

During this year NHS ambulance trusts have been supported with NHS England allocating £150 million of additional system funding for ambulance service pressures , supporting improvements to response times through additional call handler recruitment, retention, and other funding pressures. This is alongside £20 million to upgrade the ambulance fleet.

The Government has also made significant investments in the ambulance workforce and the number of NHS ambulance staff and support staff has increased by over 40% since September 2010. Health Education England has a mandated target to train 3,000 paramedic graduates nationally per annum from 2021-2024, further increasing the domestic paramedic workforce to meet future demands on the service.

I hope this response is helpful and you are assured that we will continue to work with the NHS to ensure the ambulance service has the support it needs to deliver for patients, both through winter pressures and beyond.

Thank you for bringing these concerns to my attention.