Pressure on paramedic services calls for a change to how we use 999

5 December 2016

Following a 999 emergency call, ambulances are expected to reach patients suffering with a life threatening illness within 8 minutes. The reality in the UK is that only one out of the 13 ambulance trusts is meeting this target. Services can even run out of ambulances at the busiest times. This begs the question - do we have enough ambulances and paramedics in the service?

Research into the area doesn’t point to a lack of ambulances or paramedic staff. So what is causing the potentially fatal delays?

Firstly, there has been an increase in the number of 999 calls being made.  In 2015, 9.4 million calls were received by the emergency services, almost three times as many as were made 10 years ago. This is probably due to the number of mobile telephones in use now compared to 2005.  Perhaps the most striking statistic is the 500,000 hours spent by ambulance crews waiting to handover patients at Accident and Emergency (A&E). Those hours amount to time paramedics could and should be spending attending on other patients in need of emergency assistance. Surely once the patient is in hospital, they are in safe hands? Why does the paramedic need to stay?

Unfortunately, the vicious circle continues because hospitals are facing increasing pressures of their own. A&E departments around the country are already struggling with overuse and a lack of beds to send patients onto. Patients brought in by emergency services have to “wait in line” before they are seen by A& E staff and until the handover has been completed; paramedics must wait with their patients.

The Welsh ambulance service has changed its guidelines, redefining what amounts to a “life threatening” case.  This has resulted in that service being the only one in the UK meeting its targets. The extent to which this has an impact on patients is yet to be seen.

There isn’t a simple solution to this crisis. However it is clear that there is a great deal we as the public can do by ensuring we do not misuse the 999 service or A&E.  We have all seen guidance in our GP surgeries and elsewhere about when to call 999, when to go to A&E, when to dial 111 or see a GP.  Is it time for penalties to be introduced for misusing or repeated misuse of the 999 service? Of course another factor, but not for discussion in this blog, is funding for A&E departments and hospitals more generally. 

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