UNISON response to ‘A Time for Change’ proposals

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Click here to download a PDF of the letter written to chief executive Ann Radmore regarding the ‘A Time for Change’ proposals. Please display in your workplace.

The letter is also shown below:

Ann Radmore
Chief Executive
London Ambulance Service 

10th May 2013

Dear Ann,

 A Time for Change

I am writing formally to respond on behalf of London Ambulance UNISON to the proposals/plans contained within the document ‘A Time for Change’ and the three draft arrangements (annual leave, rest breaks and active area cover) that have a direct consequence for our members.

This response will cover:

  • Partnership
  • ORH
  • Staff Rosters
  • A&E Support
  • Rest Breaks
  • Annual Leave
  • Active Area Cover


UNISON has a policy of Partnership Working within the National Health Service at a national, regional and local level. LAS UNISON has supported that policy over many years, and, although it has been difficult at times (for both sides) we still believe that it is the right thing to do for the staff, patients and Service.

I am disappointed therefore, and voiced my disappointment at the recent Staff Council, that the details of these major plans for change were kept secret from us until the eleventh hour.

In my role as Staff Side Secretary I had asked to be given copies (or at least be told the details) at a meeting with Caron and Tony (Management Side) as recently as the 11th April 2013 but this request could not be sanctioned.

In a letter sent to me after a telephone conference call (as Staff-Side Secretary & UNISON Branch Secretary) via email on the 24th April 2013, along with attachments of the booklet ‘A Time for Change’ and the three draft arrangements (annual leave, rest breaks and active area cover) I was told ‘the information is therefore confidential and must not be shared or discussed with staff prior of its formal release at 10am tomorrow (25th April)’

I did not return from Glasgow until late on the 25th April so my first real sight of all the paperwork was on the morning of the Staff Council (26th April). The irony being that most staff had seen this before me or the union.

At best, this smacks of mistrust and, at worst, of a deliberate attempt to keep UNISON and staff side in the dark.


I will be honest and upfront. There is an historic suspicion and lack of confidence in ORH by the Staff-Side and staff within London Ambulance.

This is for mainly two reasons:

  • The methodology and report writing is incomprehensible to most staff.
  • They are not always right.

I request a special Staff Council/OPF that just deals with the ORH report. The methodology, the data used and the sources of that data, the conclusions and rationale of those conclusions should all be properly explained and demonstrated.

We can only move forward once Senior Staff Representatives understand this better and can explain to staff the reasons for rota and staff changes.


Changes to Rosters are dealt with under the jointly agreed ‘Framework Agreement for the Review of Shift and Working Patterns for Operational Staff’.

Once the ORH issue is understood the Framework agreement can start to be used at a local level with staff, staff representatives and managers. We expect, as we have been told, that the consultancy company will work closely with staff representatives and staff on Stations.

A&E Support

This is the most central, fundamental change that forms the backbone, and thrust, of ‘A Time for Change’.

A&E Support Staff (AES), working with a registered Paramedic performing the full range and full duties of ‘frontline’ ambulance personnel.

This is a major change for the London Ambulance Service and our staff and members.

UNISON supports the principle of A&E Support Staff working with a registered paramedic, but not as it is proposed within ‘A Time for Change’.

Senior management would have already had sight of the A&E Support Staff Survey that was written, organised and the results analysed by AES staff that care about their role and career.

This survey was supported by UNISON.

I refute the statement that this is ‘a nationally accepted model of care’. It is not used everywhere and, from its original pilot (and eventual imposition) within the West Country it has been a bone of contention with staff at each Ambulance Trust that has gone down the same road.

UNISON does not believe that six days’ extra training will give staff the skills or confidence to attend all potential calls.

UNISON believes that this will put at risk both the Paramedic (a forgotten person in all this) and the A&E Support member of staff.

UNISON does not believe that patients will get the best care and treatment if this goes ahead as stated within ‘A Time for Change’.

UNISON does not believe that this is in the best interests of the London Ambulance Service or the people of London.

UNISON believes that this is a ‘down banding’ and ‘de-skilling’ of the Technician role through the back door.

UNISON wants to see our A&E Support Staff fully trained and performing a Band 4 Technician role.

UNISON is ready and willing to negotiate how and when that happens and how we create a better career pathway and fair rewards for all our operational staff.

We welcome and applaud the work that the Service has done in obtaining extra funding and extra staff within a difficult time. We acknowledge the commitment and energy of particular senior managers who have worked tirelessly to achieve this.

It should not be forgotten however that UNISON has campaigned over a long period for proper funding of the Capital’s Ambulance Service. We helped bring vital funding into the Service when it was under resourced and that funding turned the Service round. We now feel as if we are back where we started.

We all have to accept, however, that the extra funding and extra staff, welcome as they are, will still mean that our Service has, and will continue, to lose funding and posts through the Coalitions’ NHS policies in the shape of the Cost Improvement Programme (CIP).

In other words we are still down on where we should be. We will still have less staff to do more work and less funding to deal with higher demands. We still have no guarantees of extra funding or extra staff continuing after this year.

What is the status of the Cost Improvement Programme now? A programme that was pursued with relish it seemed by senior management not so long ago.

This is about resources and Government cuts. Changes to rest breaks or annual leave provision will not change that.

Rest Breaks

Section 10 of the Agenda for Change national handbook covers the right to rest breaks as being part of staffs’ Terms and Conditions, in that 10.1 refers to a working week of 37.5 hours excluding rest breaks.

How rest breaks are managed in particular Trusts is down to local partnership agreement.

UNISON does not accept nor agree the Draft Arrangements ‘Rest Break Arrangements Operational Staff (Revised April 2013)’.

Annual Leave

Section 13 of the Agenda for Change national handbook covers the right to annual leave as being part of staffs’ Terms and Conditions.

How annual leave is managed in particular Trusts is down to local partnership agreement.

UNISON does not accept nor agree the Draft Arrangements ‘Annual Leave Arrangements Operational Staff’

Active Area Cover

Working practises and operational decisions such as these of course are not part of the Agenda for Change national handbook but are, nevertheless, important to the well being of our members. They also impact on the health and safety of staff.

It is for that reason that UNISON has always opposed 24 hour Active Area Cover and we do so now.

UNISON does not accept nor agree the Draft Arrangements ‘Active Area Cover Arrangements for Accident & Emergency ambulance crew staff’

We are concerned also at the increasingly rapid attempts to marginalise the importance of ambulance stations as a place for the lowering of stress and for the increasing of health and wellbeing for staff.

We want to see and work in a successful Ambulance Service. We support the London Ambulance Service. We support our members. We support staff.

We do not believe the proposals/plans within ‘A Time for Change’ as I have highlighted will help any of us to jointly create the environment to make good the LAS Vision and lift it from the page into reality:

To be a world-class service, meeting the needs of the public and our patients, with staff who are well trained, caring, enthusiastic and proud of the job they do.

UNISON looks forward to serious, meaningful negotiations.

Best wishes

Eric Roberts Branch Secretary LAS UNISON

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