# Ambulance services 'not coping' as demand rises



## Northerner (Jan 27, 2017)

Ambulance crews are finding it "increasingly difficult to cope", an audit of the service in England says.

The warning by the National Audit Office comes just two months after a BBC investigation highlighted increasing delays answering 999 calls.

The NAO said rising demand, recruitment problems and wider NHS pressures meant crews were failing to hit targets.

It comes as NHS bosses are looking at relaxing the eight-minute target for calls where it may not be necessary.

In November the BBC revealed ambulances were increasingly being delayed outside A&E units as hospital staff were too busy to take on the patients being brought in.

http://www.bbc.co.uk/news/health-38669589


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## mikeyB (Jan 27, 2017)

Well, if they keep closing A&E departments, what do they expect?


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## Amigo (Jan 27, 2017)

What strikes me about this is the significant percentage of idiot hoax calls that divert ambulance crews from legitimate calls! It should be a very serious offence to interfere/disrupt or threaten the work of the emergency services in any form.

There should be greater use of other resources for more routine transport too instead of having the expensive resource of a fully equipped ambulance taxi'ing people around.


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## grovesy (Jan 27, 2017)

Amigo said:


> What strikes me about this is the significant percentage of idiot hoax calls that divert ambulance crews from legitimate calls! It should be a very serious offence to interfere/disrupt or threaten the work of the emergency services in any form.


I was talking to someone the other day a relative of theirs waited hours  outside an A&E in an ambulance but this was back in the summer.


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## mikeyB (Jan 27, 2017)

Amigo said:


> What strikes me about this is the significant percentage of idiot hoax calls that divert ambulance crews from legitimate calls! It should be a very serious offence to interfere/disrupt or threaten the work of the emergency services in any form.
> 
> There should be greater use of other resources for more routine transport too instead of having the expensive resource of a fully equipped ambulance taxi'ing people around.


I was taken from my home to the ferry in a fully equipped ambulance, and the same at the other end to Oban hospital, for my gastroscopy. Same in reverse.  Though it has to be said, on the Oban side it's usually a car or sitting ambulance. All of this service, taxi'ing folk around, is provided by the Scottish Ambulance Service. And made by patient request, and depends on patient needs, very strictly applied.

This isn't always perfect. I was once travelling from a Glasgow hospital appointment with one old guy. When he was dropped home, I noticed a car in the drive. The next day, he told us, he was due to go and see his daughter in Manchester, by car.


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## trophywench (Jan 27, 2017)

Could be he had had to have sedation for his procedure, or eyes dilated, or something or even just told best not to drive himself in case owt went wrong.


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## mikeyB (Jan 27, 2017)

Not from what he was saying, but never mind. It's either a comment on people abusing the system, or a terrifying display of the decrepitude of some of the drivers on our roads


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## Mark Parrott (Jan 28, 2017)

mikeyB said:


> I was taken from my home to the ferry in a fully equipped ambulance, and the same at the other end to Oban hospital, for my gastroscopy. Same in reverse.  Though it has to be said, on the Oban side it's usually a car or sitting ambulance. All of this service, taxi'ing folk around, is provided by the Scottish Ambulance Service. And made by patient request, and depends on patient needs, very strictly applied.
> 
> This isn't always perfect. I was once travelling from a Glasgow hospital appointment with one old guy. When he was dropped home, I noticed a car in the drive. The next day, he told us, he was due to go and see his daughter in Manchester, by car.


I do voluntary hospital transport work & there is a lot of abusing the system.  Patients have even admitted to me that they use hospital transport because it's difficult to find a parking space at the hospital!  Even recent changes to make it harder to qualify aren't working.


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## mikeyB (Jan 28, 2017)

I can well imagine that being a problem in England, but when you've got a strict Glaswegian lady at the other end of the phone, you better make sure you need it


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## trophywench (Jan 28, 2017)

Very tempting to abuse it Mark, when eg you have to go every single day for 6 weeks for radiotherapy, there's not a suitable bus service and it can take anything up to 90 minutes to get parked.  Radiography at our hospital understand this perfectly and say doesn't matter because they will always treat you no matter how late you are, once you're receiving treatment and it's still within their working day.


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## mikeyB (Jan 28, 2017)

Well said, TW.


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## grovesy (Jan 28, 2017)

Mark Parrott said:


> I do voluntary hospital transport work & there is a lot of abusing the system.  Patients have even admitted to me that they use hospital transport because it's difficult to find a parking space at the hospital!  Even recent changes to make it harder to qualify aren't working.


This suprised me slightly,


trophywench said:


> Very tempting to abuse it Mark, when eg you have to go every single day for 6 weeks for radiotherapy, there's not a suitable bus service and it can take anything up to 90 minutes to get parked.  Radiography at our hospital understand this perfectly and say doesn't matter because they will always treat you no matter how late you are, once you're receiving treatment and it's still within their working day.


The hospital where my friend had Radiotherapy they had a special parking area for patients having Radiotherapy,I believe it was accessed by a code which was given to them.


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## Amigo (Jan 28, 2017)

My hospital arrange free parking for chemo patients. 

It cost me a total of £21 in parking when my mum was in hospital recently and that's just for visiting. Probably cost my brother a similar amount. It think it's obscene especially as the profits go to a hated private parking company.


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## mikeyB (Jan 28, 2017)

But they have to pay the private parking company for the privilege.

Parking in Scottish hospitals is free, but then the hospital has to pay for upkeep. Swings and roundabouts.


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## trophywench (Jan 28, 2017)

Oh the parking was free in that case - it's merely absolutely chronic lack of parking.  Huge site; Uni teaching hospital; virtually every speciality you could name; wanted at least one multi storey; local residents objections to it; denied PP.

From where you turn into the site it can take half an hour or more to even get to the drop off area for the building that patient needs let alone be able to see a public car park ticket barrier - just queuing - frequently the traffic jam starts way before the traffic lights where you turn in.  Chaos.


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## Mark Parrott (Jan 29, 2017)

trophywench said:


> Very tempting to abuse it Mark, when eg you have to go every single day for 6 weeks for radiotherapy, there's not a suitable bus service and it can take anything up to 90 minutes to get parked.  Radiography at our hospital understand this perfectly and say doesn't matter because they will always treat you no matter how late you are, once you're receiving treatment and it's still within their working day.


There are exceptions for Radiotherapy patients.  The qualifications aren't so strict.


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## Stitch147 (Jan 29, 2017)

They are also cutting back on the amount of ambulance crews. My nephew works for Essex ambulance and they are getting rid of 40 crews in the area.


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## grovesy (Jan 29, 2017)

Stitch147 said:


> They are also cutting back on the amount of ambulance crews. My nephew works for Essex ambulance and they are getting rid of 40 crews in the area.


Which will cause more problems if they go hard with downgrading some of the A&E 's.


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## HOBIE (Jan 29, 2017)

I have been twice to A & E at 4am in the last couple of years. You can not believe how many POLICE officers who are there looking after staff etc because of Drink & Drugs !


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## Ljc (Jan 29, 2017)

In my area they have closed the Ambulance station in Canterbury, our nearest one is in Margate.  They used to have some Ambulance crews waiting in various areas , now if they are not attending someone or at a hospital they have to return to Margate
Around 18 months ago I had an accident, broke my hip and upper humerus it took around  an hour for them to get to me.  One of the reasons is  staffing has been cut and so I've be been told, in my area the Ambulance service is  now run by a private company.


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## trophywench (Jan 29, 2017)

Yup - all been made separate 'cost centres'.

I'd like to see each ruddy 'management team' in every ruddy 'cost centre' having to be a separate 'cost centre' - and see if THEY can meet THEIR ruddy targets ....... chunter chunter chunter.

How 'cost effective' would a CCG be, purely judged on IT's own?


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## mikeyB (Jan 29, 2017)

There are no private companies doing hospital transport in Scotland. Just NHS, and Red Cross volunteer drivers (one of whom, a Geordie, gave me two hour lesson on why we had to leave the EU on the way to Glasgow.)


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## Owen (Jan 29, 2017)

When a diabetic who has been drinking all day calls for an ambulance because he forgot his insulin, another person calls because they have hiccups and its causing chest pain, another calls with chest pain (turns out it was long term not acute) and they forgot to take their tablets, another calls saying they are unconscious, but is sat smoking. All of these happened last week. Plus two hoax calls and an RTC. These are just the ones I have had personal involvement with.
Sadly an RTC is not a red call, as most have minor injuries, obviously this is different if there is major trauma or cardiac arrest. The average crew attends between 8 -12 pt's in a 12 hour shift. Most of these could have used a different mode of care.

The message is #choosewisely Cardiac Arrest is Urgent, CVA is urgent. Catastrophic Trauma Urgent. Glycemic Emergency Urgent. Hiccups No.


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## mikeyB (Jan 29, 2017)

If all these useless, wasteful calls were charged £50 for their misuse of the service they might think twice. Or, make it a criminal offence.


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## robert@fm (Jan 29, 2017)

According to the 2014 movie _What We Did On Our Holiday_ (which, incidentally, I saw at St. Thomas'), making a hoax call to the emergency services _is_ a crime. At least in Scotland...


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## trophywench (Jan 29, 2017)

Can't make it a criminal offence - don't you know our jails can't cope already?

I always want to introduce the image of Pamela Anderson playing a 'do gooder' on 'Not the 9 o'clock news'.  Round the table discussion by some invented TV discussion programme.  Various 'experts' on the social (or rather antisocial) problems on some fictitious housing estate somewhere.  She says various inane coments whilst the others babble on with highbrow sounding rubbish delivered in thoughtful tones, then she butts in with,  'Look! You have to listen to me - I KNOW these people so well - I've WORKED with them and tried to HELP them over many many years - and I honestly think the ONLY solution to the problem is - to chop their goolies off!'

I do feel, this could solve a good many problems, all in all.


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## Amigo (Jan 29, 2017)

I think it's an offence under Sect. 127 (2) of the Communications Act 2003 and a person making a hoax call to emergency services can be taken to court and may face a fine of up to £5,000 and/or be sent to prison for six months. Calls are easy to trace even from a mobile ‘phone.


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## Owen (Jan 30, 2017)

It is indeed a crime, but most of the false alarms are created by algorithms causing unnecessary escalation. Or patients knowing how to manipulate the system for an escalated response. 
One patient in the last few days was quite frank about using the system due to not getting a quick enough GP appointment.


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## Northerner (Jan 30, 2017)

I've called for an ambulance three times in my life - once in 1996 when I fell and broke my humerus, once in 2008 when I was virtually comatose with DKA and was diagnosed, and once a couple of years ago when I was desperately ill and feared for my life because I could neither eat nor drink without being sick. I had ketones of 6.4 and was fearful of correcting my blood sugar levels because I would not be able to treat a hypo if I over-corrected. I live alone and no-one would have found me. The ambulance service decided it wasn't an emergency and told me to go to my GP. My consultant was appalled when I told him about it


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## Owen (Jan 30, 2017)

Northerner said:


> I've called for an ambulance three times in my life - once in 1996 when I fell and broke my humerus, once in 2008 when I was virtually comatose with DKA and was diagnosed, and once a couple of years ago when I was desperately ill and feared for my life because I could neither eat nor drink without being sick. I had ketones of 6.4 and was fearful of correcting my blood sugar levels because I would not be able to treat a hypo if I over-corrected. I live alone and no-one would have found me. The ambulance service decided it wasn't an emergency and told me to go to my GP. My consultant was appalled when I told him about it


Sadly, algorithms went against you by the sounds of it. This is the problem with the current Pathways scheme. Some operators escalate unnecessary and some miss important information. If you had described breathing difficulty and a high ketone level, then this is unforgivable especially with vomiting. I quite often attend to conduct clinical assessments for our ambulance service and would certainly would have escalated the situation off your descriptors, even before checking other stats.


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