Times Covers Delays to Emergency Services from LTNs

The Times newspaper covered the delays to fire services yesterday (29/3/2021) caused by the introduction of Low Traffic Neighbourhoods (LTNs).

They reported that slowed emergency responses caused by traffic calming have jumped by more than one third in London boroughs. The article suggested that frontline workers were concerned that management was ignoring the problem due to political pressure. The Times notes that one serving officer, who asked not to be named, said: “The bosses are controlled by Sadiq Khan and don’t want to upset him as he controls the budget”. Another quote supplied was “They don’t even want bollards with keys as it takes too long. When it comes to strokes or heart attacks, every second counts.”

See full article here: https://www.thetimes.co.uk/article/3248bade-8ff6-11eb-930d-e9e6e3751f8f?shareToken=7e22feaa3656a60f5cfdf82e77775245

We covered the issue of emergency service delays in a note to our Lewisham campaign supporters which included the following evidence:

Many examples of delays to ambulances, police and fire service vehicles caused by road closures, road narrowing by cycle lanes and modal filters have been reported across London. The following letter from a paramedic was recently published in Private Eye.

Dead-end roads

Sir,

I saw the cartoon (Rotten Boroughs, Eye 1538) depicting “low traffic neighbourhood” barriers in Ealing preventing ambulance crews from getting to jobs. These are now pan-London and in Lewisham and Crystal Palace have caused severe delays getting to cardiac arrest calls.

On a recent job we were literally at the end of a street adjoining the road the cardiac arrest was on. Due to the barricade we had to take an almost five-minute detour around the side streets before we found our way to the address. Five minutes probably doesn’t seem long to whoever came up with the idea of the barriers, but to a London Ambulance Service (LAS) crew trying to get to a cardiac arrest patient and give that first shock, it slashes our chances of a viable resuscitation. In this case the patient did not survive.

We’re not able to call attention to the issue because our internal problem-reporting software only allows us to report equipment or personnel failures within LAS; there is no way for us to quantify’ the number of fatal delays caused by the council’s arbitrary road closures and no structure in place for us to report this. With the huge spike in Covid-related cardiac arrest calls we’ve seen in the past few months, these barricades are literally killing patients. Private Eye is the first publication I’ve seen so much as mention it.

PARAMEDIC (name supplied), London.

<END>

Residents who live within LTNs may have quieter roads but they need to bear in mind that their lives will be threatened if they suffer a medical emergency.

The Daily Telegraph also reported on a Freedom of Information Act request handled by the Borough of Greenwich. It included some comments from the London Ambulance Service:

“The London Ambulance Service (LAS) cannot support any scheme that involves the closure of a road to traffic using static bollards, lockable bollards, coffin bollards, gates or physical barriers like planters. The main reason for this is our vehicles do not carry any form GERDA or FB keys to access these obstacles and delays can be detrimental to patient safety.

Existing schemes already create us problems and gates and bollards are not generally routinely maintained pan London and are difficult to unlock anyway.

The nearest available ambulance is dispatched to a 999 call so we do not profile emergency access routes like the LFB because any crew from across London can be dispatched if they are nearest and this might not be a local crew.

Any delay in response to an address behind closures could be detrimental to patient safety and cause serious harm, injury or even death to a patient due to the ambulance response being delayed.

Consideration also needs to be given to the wider health and social care providers who will need access to address and are on tight schedules. Patient transport ambulance picking patients up for chemotherapy or dialysis appointments, district and community healthcare teams and social care carers will all be delayed by having to navigated additional road closures and restrictions leading to delayed care, welfare issues, humanitarian concerns and potential for emergency admission as a result of delays. Addition missed clinical appointments has a detrimental effect on service delivery and patient flow through the NHS system. Consideration of exemptions for these staff through restrictions would also need to be given.

Although the LAS does support the need to ensure social distancing this cannot be at the detriment of patients calling 999, but currently the use of any kind of bollards/gate/planter to close road is not acceptable”.

Clearly the “modal filters” used in so many LTN schemes are not advisable such as those used in Lee Green. Such objections may be why Councils are now installing camera systems to close roads instead. But that just creates complaints about the number of PCNs generated through inadvertent mistakes.

It is very obvious that the supporters of LTN schemes are ignoring the clear evidence of the impact on emergency services.

Roger Lawson

Twitter: https://twitter.com/Drivers_London

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Are There Any Benefits from Low Traffic Neighbourhoods (LTNs)?

Low Traffic Neighbourhoods (LTNs) are being promoted by local councils and central government and are actually being implemented in many locations around the country. Typically they are called “Healthy Neighbourhoods”, “Healthy Streets”, “Mini-Hollands” or other fine sounding names when in reality they usually consist of mainly road closures (“modal filters”, “school streets”, etc) that obstruct the use of roads. The object is stated to get us all to use “active travel” modes such as walking or cycling so that we live longer. But do they really do so? And what are the disadvantages?

These schemes are currently now being implemented using Temporary Traffic Orders using the claim that the Covid-19 epidemic justifies emergency measures to enhance social distancing without any advance public consultation whatsoever. But they have aroused very strong opposition in several London boroughs once people have seen the result. See Ref.2 below for a list of some of them in London).

It is frequently claimed that traffic “evaporates” once these schemes are installed, but is that true? A recently published academic study (see Ref.1 below) of three mini-Holland schemes in outer London gives a very different picture however.

The three boroughs studied were Enfield, Waltham Forest and Kingston. They selected over 3,000 people at random and gave them a survey of their travel behaviour with a follow up later to see the changes (although there was a high drop-out rate). There was a particular focus on their use of cycling.

Based on reports of past-week cycling, the authors suggest there was a trend towards higher cycling levels in the mini-Holland areas than the non mini-Holland areas. But this effect was not statistically significant (i.e. may not be true). Bearing in mind that these are self-reported numbers in addition which are likely to be biased, the claimed effect is likely to be a mirage.

The report also says “There was generally little or no evidence of differences by mini-Holland status in the proportion of individuals doing ‘any walking’ or ‘any active travel’ in the past week”. In reality therefore the mini-Holland schemes have had no impact on active travel use.

On car use the report says: “For past-week car use, there was a non-significant trend for those living in mini-Holland boroughs to be less likely to report any past-week car use than those living in non mini-Holland areas. Time spent driving in a car in the past week showed no consistent pattern in the results, and no evidence of a difference in any contrast [sic]”. In other words, car use had not changed.

At the follow up survey, in those living in mini-Holland areas there was an increase in the proportion saying that there was “too much” support for investment in cycling (from 27% to 33%). These differences were highly significant which shows the population were not convinced of the merits of the programme.

The report’s authors make some positive comments about the effect of the mini-Holland interventions but their conclusions are hardly consistent with the data they report.

In reality there is no substantial movement that is statistically significant into active travel modes, and car use continues at the same level.

Emergency Service Access

One of the complaints from those living in LTNs is the impact on emergency services access (ambulances, police cars, fire engines). The College of Paramedics has warned how lives could be put at risk and emergency response times increased as road closures, cycle lanes and one-way systems cause problems for ambulances and delay response times.

Richard Webber, a College Spokesperson, recently said “Previous traffic calming measures have caused delays for emergency vehicles. So now we are particularly concerned new measures are being rushed in without proper consideration and there will be a risk of further delays for ambulances and other emergency responders. For someone not breathing or having a heart attack, stroke or allergic reaction this risks causing significant harm. We would urge councils as they implement these new measures to give proper consideration to access for emergency vehicles and ensure they are not delayed reaching the scene of an emergency.

We fully support and understand the need to improve routes to protect cyclists and pedestrians, particularly while there is a reduction in the use of public transport following the Covid-19 epidemic. However, the designs must take into account fully whether an emergency vehicle – whether ambulance police or fire – can gain access in a hurry, rather than making it difficult to do so.”

But in reality little account is being taken of emergency service access. For example in Lewisham there are numerous reports of ambulances and police cars being blocked. They are supposed to have keys to open locks on the bollards on some roads, but they do not. Even if they do have keys, significant delays are caused.

Photo below shows an ambulance with blue flashing lights being blocked in Manor Lane Terrace Lewisham.

In summary, there is no evidence that Low Traffic Neighbourhoods produce any significant benefits while there is clear evidence that they delay emergency service vehicles. Residents also report massively extended journey times and increased air pollution on major routes as traffic is diverted onto them.

The ABD suggests that encouraging active travel may be a good thing, but there are better ways to do it than just closing roads. Closing roads simply does not work to encourage active travel and the extreme versions of LTNs implemented in boroughs such as Waltham Forest and Lewisham will never get general public support.

Reference 1: Impacts of an active travel intervention with a cycling focus in a suburban context: https://www.sciencedirect.com/science/article/pii/S0965856417314866

Reference 2: Opposition to Road Closures in London Grows: https://freedomfordrivers.blog/2020/07/12/opposition-to-road-closures-in-london-grows-sign-the-petitions/

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Keep LA Moving and the Impact of Delays to Emergency Vehicles

Back in September I mentioned a conference in Los Angeles, USA, focused on “Road Diets” and “Vision Zero” and other negative transport policies under the title “Keep LA Moving”. There is strong opposition to road schemes that increase congestion and remove road space in the USA. You can see some of the videos taken of panel sessions at the conference in October here:  https://www.keeplamoving.com/conferencevids but what follows are some of the key points from presentations shown at the event.

Fire truck

One presentation shown was from Les Bunte, former Assistant Fire Chief in Austin, Texas which covered the impact of delays in response times to medical emergencies – specifically to cardiac arrests. The delays to emergency service vehicles are a major concern to those opposed to increases in traffic congestion caused road space removal. He presented this chart:

SCA Survival

In England there is a target ambulance response time to Category 1 emergencies such as heart attacks of an average of 7 minutes which the country consistently fails to meet, and there are of course many responses that take longer than 7 minutes. In London the times are undoubtedly worse although I could not find any recent data on that subject as the London Ambulance Service does not report against the national target. All they report is that for Category A emergencies, 95% of ambulances arrive within 19 minutes. But you can see from the above chart that any response time of more than 10 minutes means you are almost certain to die.

Another presentation shown at the LA Conference was from the Portland Fire Department. According to the National Fire Protection Agency in the USA, in 2016 there were 35,200,000 emergency calls to fire departments around the country. Almost 22 million of these were fire and medical emergencies. Delays can have fatal consequences.

Delay to emergency response also means firefighters arrive at the scenes of emergencies in more dangerous conditions. In 2017, almost 59 thousand firefighters incurred injuries, and 60 firefighters died – most of which occurred at fireground operations. A number of fire fighters have also been injured from hitting the roofs of their cabs, rushing to emergencies when encountering speed humps.  At least two of these firefighters have been placed on permanent disability

The chart below compares the number of vehicle related deaths – pedestrians, cyclists and vehicle passengers (2018 stats) with the average yearly deaths caused by sudden cardiac arrest (SCA – not considering victims of other medical emergencies) plus fires in the USA. SCA and fires are Class A emergencies, requiring the most urgent emergency response times.

The data shows that a person is nearly 10 times more likely to die from fire and cardiac arrest than ALL vehicle-related accidents involving pedestrians, cyclists and passengers of cars. Clearly it is very important to maintain fast response times to medical emergencies.

USA Fatalities

This is quite conclusive evidence of the negative impacts of delays to emergency vehicles caused by road narrowing, speed humps and other traffic calming measures that increase traffic congestion and slow emergency services.

Roger Lawson

Twitter: https://twitter.com/Drivers_London

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