Dear Mr Blezard

Thank you for your e-mail, as sent to me and to Sonia Kempsey of the Alston Moor Partnership and possibly others. This is the first time anyone has provided any of us with an explanation, so that is appreciated.

However, there is so much in this statement that is at odds with the facts as we understand them.

Crucially, not a single one of the ambulance team EMTs has any recollection of being offered and refusing any optional training. Indeed, the team has frequently requested further training and been refused. Even if (as is disputed) they had not taken up the ‘then optional AAP certificate’ training six years ago, why on earth was this not offered at any time since? We note that you say it is ‘strongly advised’ that EMTs should not operate without this certificate. Not only is this not the same as ‘legally required’, but all NWAS needed to do was to offer the team this training at any point since it became ‘strongly advised’. Why has this never happened? Why is it not being offered now, rather than disbanding the whole enterprise without offering that opportunity?

There appears to be a rather rigid approach to training. If new EMTs are required to go away for 18 months to a university elsewhere, this will obviously be very difficult for most people living and working on Alston Moor. What seems quite extraordinary is that no effort has been made to follow the example of the Open University, which has managed to have several fundamentally practical courses delivered through largely online learning supplemented by occasional face-to-face tutorials. Partnering with the OU or another organisation to devise such a course would seem an obvious way forward, not only for those on Alston Moor but for people elsewhere.

The only reason that EMT team do not have blue light training is because NWAS has explicitly – even at a parish council meeting – stated that this will not be provided. The EMT team has requested such training again and again but for some reason it has been refused by those they are directly dealing with. We are seriously wondering if perhaps the Directors are unaware of what is being said and done by those managers who have been speaking with the EMTs. The implication that somehow our dedicated team have not wished to extend their skills and capacity is so far from the truth as to be insulting. Their frequently-expressed wish to upgrade their skills and be able to transport patients has, according to your account, been written out of history.

We are unclear what suggestions from the community you are taking into account, since ‘the community’ is unaware of any attempt to discuss with us. Who are the “Alston Moor representatives” with whom you have been collaborating? As for the enhanced CFR skills to which you refer, how does this relate to the skills and experience of the EMT team? How on earth can this ‘standardisation’ have a “greater impact on care and intervention” than our current ambulance and EMTs? CFRs are very limited in what they can do, and are unable to attend road traffic accidents, fire-related injuries, children’s injuries and illness, paediatrics, maternity problems, and mental health situations, among other things Do the enhanced skills to which you refer enable them to undertake all of these? Surely the retention and upskilling of the existing EMTs (and enabling training of future EMTs using the OU-type model mentioned above) would be considerably more likely to help create a team of EMTs and CFRs with real impact on care.

It does not help us to have trust in your process when you refer to a ‘village’. Alston is a town (not only does it have a market charter, but it is a main centre for the whole area, beyond the borders of Cumbria); Alston Moor is a large area including Alston itself, the villages of Nenthead and Garrigill, several hamlets and a large number of isolated farms and dwellings. It is the whole of Alston Moor which is affected by this decision and it would be helpful if you would refer to the area and not merely to the town where the ambulance is based.

Your letter reads as if the whole enterprise is funded by NWAS, whereas it was always largely funded by the CCG at least in its initial establishment. Additionally, it was left to the League of Friends of our hospital (where the beds were removed by the so-called Success Regime) to provide an electricity supply that can be accessed by the ambulance, in the absence of the expected garage. Has the CCG contribution changed? When and why?

Has the CCG consulted with the local medical practice which will be put in a difficult situation if the EMTs are withdrawn? The likelihood of the GPs having to be called out given the waiting times for an ambulance, without our locally-based and EMT-staffed ambulance, is considerable. The difficulties for the practice in this remote area are already considerable without having this burden placed on them as well.

You clearly intend this explanation to be the end of the matter, but there is no possibility of that while there is such an obvious solution to what you yourself have stated by way of reasoning. That is to provide the additional training for the AAP certificate, and blue light training.

We find it horrifying that you are suggesting that the ‘infrequent use’ of the ambulance means you cannot justify maintaining it. Does the health and wellbeing, even the life, of the residents of Alston Moor matter less than your financial bottom line?

There is a statutory duty to provide an ambulance service. This applies to every single person living in this country. We do not have to deserve it in some way by having enough emergencies to keep the ambulance fully-occupied. In any case, you must surely be aware that our ambulance is often called to road accidents beyond the limits of Alston Moor itself, not least because of the all-too-frequent motorbike accidents on the A686 from Penrith.

We find it hard to believe that, now you have been apprised of the facts, you will not reconsider what seems to have been an ill-informed decision. We look forward to hearing from you with more positive news.

In the absence of an appropriate plan for a way to enable our EMTs to upgrade their qualifications and receive blue light training, we must make clear that we will hold the individual Directors of NWAS directly responsible, in court if necessary, for any death or life-altering injury that could have been avoided were our ambulance and EMT still available.