F.A.O. Daren Mochrie (CEO), Salman Desai, and other Directors of NWAS

This letter comes to you with support from a large section of the community of Alston Moor. We are appalled and barely able to believe the recently-announced intention to withdraw our ambulance with its Emergency Medical Technicians. We can only assume that those making the decisions are not fully aware of the situation of Alston Moor, especially in terms of our geography, the concomitant weather and roads, and unaware of the history of the project.

Over seven years ago, we made the case for retaining our ambulance, at a previous point when it was threatened. We pointed out that ours is the most remote settlement in England, spread over a large area at 275-450 metres (900-1500 feet) above sea level. All but one of the five routes to/from here go over high passes, including the road to Penrith, our nearest urgent treatment centre, which reaches nearly 600 metres and is frequently closed in winter by snow and ice. The route to the nearest main hospital with accident and emergency provision is 30 miles from Alston (and an additional distance of up to seven miles from some parts of Alston Moor). Our permanent population is just over 2000 people, but frequently much-enlarged by visitors, not only in the summer but by some who come to stargaze or ski in the winter.

As NWAS staff became aware, through representations from many residents of Alston Moor (and finally through their own experience coming here for a public meeting) this is not a community that can be treated in the same way as most of the communities in the area covered by NWAS. As a result of these understandings, at that meeting in January 2014 Salman Desai tasked NWAS officers with establishing, in collaboration with us, a fully equipped, staffed and functioning blue-light ambulance. Since then, it has, sadly, been a struggle at every step to attempt to make this commitment a reality, as poor project management by NWAS has made it very difficult bring the intentions to full fruition.

The community has worked hard with NWAS staff to keep our vital service in place and to find solutions to challenges that have arisen. It is beyond disappointing that no Board members seem to have realised the situation resulting from the poor management. The announcement that our ambulance is to be terminated feels like a betrayal of the intentions of those NWAS people who committed to creating, with us, an excellent local ambulance service.

Our dedicated and committed Community First Responders, some of whom have only recently completed their training, will, if this plan goes ahead, find themselves in the unenviable position of being expected to attend calls which will only be backed up with an ambulance and trained crew 45 minutes later at the very earliest (and may indeed be waiting with a seriously ill or injured person for up to two hours, longer in severe winter conditions). Many may baulk at being put in such a position, having trained in the understanding that our local skilled and experienced crew would arrive very quickly, even if still unable to transport patients. Ambulances which can transport sick and injured people are sent here from considerable distances when (as seems to happen often) there is no free ambulance that could get here within an hour (and a wait of up to two hours is not uncommon).

The NHS Ambulance Standards state that the average response time for life-threatening illnesses or injuries (category 1) is seven minutes and emergency call-outs (category 2) 18 minutes. Without an ambulance and EMTs on Alston Moor, we would have nothing resembling these standards.

An additional issue is that ambulance crews from elsewhere frequently struggle to find the sites where someone needs help, across our widely-flung community. Satnav often goes to the wrong place or suggests impossible routes, and the ‘what three words’ app provides a clear indication of where someone is, but gives no hint about how to reach it. Currently, our local ambulance crew knows how to get to a place and guides the ambulance from elsewhere – and makes sure they understand the direction to go when they leave.

Awareness of this situation contributed to the decision of NWAS in early 2014 to ensure that we retained our unique ambulance service.

Since then, our Cottage Hospital in Alston has had its beds removed and promises by North Cumbria Healthcare Trust concerning provision there have also not been fulfilled. We are sure you will understand that local residents are very worried by the situation, which would be made inordinately worse without our ambulance.

We rely on tourism to a large extent (as does much of Cumbria) and some potential visitors will be discouraged once they realise the lack of emergency care, which will have an impact on the local economy. Many of those who might consider moving here – and we need new people to come and ensure that our economy and our schools are thriving – will be deterred by the lack of the help they assume and expect elsewhere in the country. Road accidents (and the huge numbers of bikers who come through certainly contribute to rather more accidents than in other places) and serious illness can happen at any moment, anywhere.

Self-reliance has been a hallmark of Alston Moor, given our location and the weather at this height. Despite the small population, we have been able to raise thousands of pounds towards our emergency services. We have always united in the face of threats to our survival as a community, and we will do so again.

However, without urgent medical care, our situation becomes exceptionally difficult, if not disastrous. We believe that Salman Desai and his colleagues understood what was needed and fully intended that a fully-functioning blue-light ambulance would be established and supported here. It is disappointing that their promise has been let down by poor project management.

We are sure you will want to remedy the situation. Not only would you not welcome adverse publicity – particularly in the event of disaster that might occur if the ambulance is removed – we are certain that this could be a real feather in your cap if you commit to working with us to establish a proper ambulance service on Alston Moor. Given what is at stake, we anticipate a favourable response.

Yours sincerely

On behalf of the residents of Alston Moor