How Long is Too Long?

Where’s that bloody ambulance got to?

Many readers will, I’m sure, have read the recent article in the Daily Mail about Tom Reynolds in his war zone of East London. At the end of the article Tom says

“There is a plan to cut the number of ambulances and instead send us out individually in cars so we can assess whether an ambulance is really necessary.”

I’ve blogged previously how Nu-Labor’s target driven culture is leading to ambulance services being re-configured to meet the change in ‘A’ category response times due next April. Leaving the vulnerability issue aside, one of the primary results of this change in ambulance fleet composition is that solo responders will be left at scene with potentially very sick or injured people whilst waiting for Control to send them a back-up ambulance to convey the patient to hospital. From a management/Control point of view a patient with a solo on scene is no longer a priority no matter how sick or injured they may be. The response-time target will have been met (hopefully) and all the boxes ticked with the arrival of the solo. Diverting an ambulance only results in one less ‘resource’ available for the next target job. The are no points, prizes or cash available for using an ambulance to take a patient to hospital – clinical outcomes are not a priority.

We’re currently running a ‘scorecard’ on station for how long solos have had to wait before the cavalry arrived. The record at the moment is held by a trainee para (under-12 EMT) who was with a deteriorating patient for nearly an hour and a quarter. For myself, over just this last weekend, I can cite an 80 minutes wait with a patient having a suspected pelvic fracture and 55 minutes with a patient who’d collapsed in the middle of a car park, suffering a head injury, who subsequently fitted and who additionally had a confirmed tib + fib fracture. Luckily it wasn’t raining.

I admit to being a bit of a pessimist and reckon its only a matter of time before the Daily Mail (and other tabloids) start writing articles about how a patient died in front of a solo responder because the nearest ambulance was diverted away (probably to a patient with a cold that AMPDS had ‘triaged’ as a life threatening call – but more on that another time).