Misuse of emergency ambulances

Grandmabatty

I wonder who is telling this information and what agenda they may have. Usually a paramedic will assess first and then decide if an ambulance is required, even in an emergency. We know that NHS is overstretched so is this an attempt to blame people for using emergency services? I'm not saying OP is doing that, but who is giving this information, what are the statistics and what is their agenda?

^ 100% agree.

DaisyAnne

Quokka

No agenda from me I assure you to deflect blame from the chinless incompetents running the government. Perhaps the public need educating too in what comprises an emergency though.

The point brought up about minor injury units though is very valid. More of these would cream off those who don’t need quick intervention for life-threatening conditions or injuries. These would give the ambulance staff somewhere more appropriate to take patients and leave them.

The OP seems oddly biased and inaccurate. On arrival the paramedics assess the situation, stabilise the patient in necessary and explain the options to the patient. They don't take a patient to hospital unless it is necessary.

You still haven't told us where, exactly, you saw this reported.

This has been our experience on the rare occasions an ambulance has been called for my partners’ heart condition. Each time he has been assessed and the on call doctor consulted to decide whether hospital is necessary.

GrannySquare

‘ their GP if coughing for more than 4 weeks.’

Our very efficiently managed GP practice has waiting room walls covered with public health posters, clustered by interest e.g. children, elderly, MH, carers etc. Great care taken.

It’s rare to be sat there long enough to take all the messages in, but recently I saw the message about mentioning a persistence cough to the GP.

I had such a recurrent prolonged cough & mentioned this to the GP once the main matter was dealt with. The GPS face fell & I took this as a cue: ‘the poster downstairs tells me to let you know about my cough’.

Penny dropped for GP why so many patients mentioning non-urgent coughs, stretching the appointment.

Not seen that ‘general’ poster since.

My husband went to the GP three times about a very persistent cough. The first and second time he was barely examined and told to buy over-the-counter medication for his symptoms, the third time a very competent locum asked if we could get ourselves to the hospital or if he should call an ambulance which might take longer.
He had recognised the various symptoms of heart failure which were later confirmed in hospital when he was urgently admited to the Coronary Unit.

When I called an ambulance for my husband when he collapsed in the bathroom it came within half an hour. After they had got him “recovered” they said he could go and see his GP in the morning but if he still felt very unwell he could go to hospital. He chose the Gp option. We were very happy with the service.

In my case at christmas season nothing else was open- no gps no pharmacy, nothing.So my panicked disabled sons called 111- something i'm amazed at but eternally very grateful for as usually they wont 'converse' with people on phone or even in face to face situations (i have to attend all their medical appts with them) but even they knew i must be very ill, so rang that number.But imagine how many youngsters (or even older folk) who are like them who just panic and ring 999 instead? -they just want to get help.And the operators have to decide who needs it and who doesnt?At least if the outcome is someone surviving then they have made the right call.I dont think i could do their job.🤔

There have always been people who rang unneccesarily for an ambulance, or for that matter for a doctor.

To some extent this is unavoidable. The general public are not usuallly, doctors, nurses or para-medics, and cannot therefore be expected to assess the gravity of a situation.

Speaking as one who 50 years ago, answered the doctor's phone, I can assure you that with the best will in the world, however well trained the person answering the emergency phone is, it is not always possible to get a panic-struck relative or patient to tell you enough about what is wrong for you to be able to judge the situation.

In these cases, if there is no doctor standing twiddling his thumbs who you can send out, which there rarely is, the answer is always "send an ambulance".

It may prove unnecessary, but this is far, far better than someone dying because you did not send an ambulance.

Sending someone out to assess whether an ambulance really is necessary would only increase the risk of a patient dying unattended whilst waiting for the ambulance, so no, that would not be a viable idea.

There may indeed be an increase in calls upon the emergency services, and some of these may prove unneccessary, when someone with medical training actually sees the patient, but there is no way of preventing this, if when answering the phone, you found it impossible to gauge accurately the seriousness of the case described to you, or were unable to get a coherent account of what is wrong.

I remember my mother on one occasion asking for the address when someone screamed down the phone, send the doctor! only to discover that the caller had slammed down the phone. Recourse to the GPO, as it was then, showed the call to have been made from a public call box. My father being out on his rounds, my mother alerted the police, asking them to go to the street where the call box was, before trying to get hold of my father, by ringing the patients she knew were down for a home visit.

I work in maternity setvices and there is a staggering amount of parents to be who call for an ambulance for ridiculous things e.g. early pregnancy and the mum to be has slight spotting after intercourse, very early labour with a few contractions. In every case they claim to have no other means of transport but when they are discharged from hospital they manage to get home without an ambulance. I know every case is different and more often than not, an ambulance is definitely needed especially when expectant, labouring mothers are being told to labour at home because of lack of staff and beds but a lot of patients take the piss. Personally, if it's found that an ambulance shouldn't have been called, I'd charge the patient for the whole cost although I get that would be unworkable as who would decide when an ambulance was unnecessary and I guess nobody knows the mental health and anxiety each patient has.

hilz

A lot of so called idiots calling ambulances must meet criteria for one to be sent to them. Ambulance crew have criteria to meet before a decision is made to go to hospital. Even a drunk or some one with a toothache, an earache or a headache can quickly go on to have a life threatening issue. If you were a call handler would you like to take it upon yourself to decide NOT to send a crew and later find out a brain abscess or a brain bleed was missed and the person died. I wouldn't. Ambulance crews, triage nurses, Drs etc are all making decisions that may have long term implications for folk but at the end of the day are humans grinded down by the system. Its a huge responsibility they signed up for and not one many of us would want and of course thats priceless but funding is only part of the answer. Yes completely agree that other options may be available first. Like pharmacists, 111, or Gp's and of course a personal responsibility to be sensible before attending emergency care facilities. but there is no quick fix now. We need to accept that and find solutions before NHS is gone forever. 75 years after it began.

As an example, my partner has angina, often manifesting as bad toothache or pain in the jaw. On the couple of occasions I have had to call an ambulance, the call handler has always recognised the risk and erred on the side of caution with an ambulance.

GrannySquare

‘ their GP if coughing for more than 4 weeks.’

Our very efficiently managed GP practice has waiting room walls covered with public health posters, clustered by interest e.g. children, elderly, MH, carers etc. Great care taken.

It’s rare to be sat there long enough to take all the messages in, but recently I saw the message about mentioning a persistence cough to the GP.

I had such a recurrent prolonged cough & mentioned this to the GP once the main matter was dealt with. The GPS face fell & I took this as a cue: ‘the poster downstairs tells me to let you know about my cough’.

Penny dropped for GP why so many patients mentioning non-urgent coughs, stretching the appointment.

Not seen that ‘general’ poster since.

Sad really, because I know from experience that even a soft cough which is not even particularly troublesome, but persistent nevertheless, can be the first sign of cancer, and you were probably right to mention it. At first glance it does seem silly to bombard the public with this type of information if GP’s are too swamped to deal with the results effectively. On the other hand, we have one of the worst records for recognising early signs of cancer in this country, so you do wonder what the happy medium is.

If you would actually like to see something positive (those who don't thrive on negative thinking) this programme was very interesting.

www.bbc.co.uk/iplayer/episode/m001h917/panorama-the-nhs-crisis-can-it-be-fixed

When i was so very ill in 2019 an ambulance crew attened- two younger paramedics (sent by 111 service) who after taking my medical history & very high temp and blood pressure) stayed with me about 2 hours monitoring my condition- (early hours christmas day) they then decided i needed to be seen by a dr but asked my disabled son to take me by car as they'd had another call out- eventually i was sent home by a younger dr on paracetamol/ibruprofen(ibrupfofen is on my 'NO' list of tablets) as he thought 'might be flu'?) So as i deteriated so much overnight- paramedics sent back by 111 again- 2 older(& possibly more wiser & experienced) lady paramedics who quickly decided to take me in themselves where we waited outside in early hours in boxing day weather- me and an old gentleman not allowed indoors in case we were infectious) this time seen by older more experienced dr who gave me antivirals& antibiotics then spent a week in bed at home then 2 more wks before feeling up to even going downstairs/light household jobs.Its now believed i may have had the first 'inklings' of covid (been in italy in november & a had 4 week cough) So what im trying to say is- if the 111 operators or the paramedics or the dr has not had much experience then they might still make the wrong call over wether you need hospital treament, or which treatment, so they all do need more training/experiance in first place.(including the A&E dr) Im just grateful those 2 lady paramedics decided to whisk me off to A&E & that older wiser doc gave me the antiviral medication as with my other underlying conditions i might not be here still, i was that bad.

BlueBelle

If the reality paramedic type t v shows are correct grandmabatty and jackiesr there are many, many, many people ringing the ambulance numerous times for non medical reasons often lonely elderly, mentally unwell, and those under the influence There have been programmes where the ambulances are being rung for, numerous times a day and I can completely vouch for it with a neighbour .. very mentally unwell and very much worse since her mum and more recently her dad died (she lived with them) Now she literally rings 999 numerous times a day and night and they have to respond, She is taken off in the ambulance and after a short time of getting back home she starts again She has had SO much help from all agencies but it makes no difference

Slightly different but living in a flat opposite me is a young lady again very mentally unwell and under the influence of certainly alcohol (she usually has a can in her hand and a cig hanging out her mouth) She may well be on drugs as well she is living with some kind of boyfriend but almost daily they argue and she is thrown out onto the street where she lives in doorways gathering bits and pieces of tents, sleeping bags in a shopping trolly she is noisy, dirty, and badly needs help she’s probably mid 30 s with no teeth in her head she has piles of money falling out of her purse / bag
The police are called out so many times a day but can do nothing, absolutely nothing it is wasting their valuable time. She probably needs sectioning but that’s hard when someone is dependant on drugs and alcohol the homeless shelter won’t take addicts She’s probably falling between all nets

I think this is a reflection on the sad state of mental health services. Care in the community has been a disaster for many and it’s left to police and other emergency services to deal with the fallout. Saw a report not so long ago saying that lots of people with mental health problems are in prison when they should be receiving treatment in hospital. I agree that a lot of people are falling between all the nets, the problem is that the nets are getting fewer and wider apart.

When my 3 year old grandson had an asthma attack no ambulance was available and they couldn't even give an estimated time of arrival. They also had a new baby just weeks old. My son had to drive him to hospital, something they had been told NEVER to do in case he needed medical intervention on they way.
Luckily it all turned out OK (although he had to be admitted) but oh so scary
Don't know how people managed to get an ambulance when it's "not necessary"

A lot of so called idiots calling ambulances must meet criteria for one to be sent to them. Ambulance crew have criteria to meet before a decision is made to go to hospital. Even a drunk or some one with a toothache, an earache or a headache can quickly go on to have a life threatening issue. If you were a call handler would you like to take it upon yourself to decide NOT to send a crew and later find out a brain abscess or a brain bleed was missed and the person died. I wouldn't. Ambulance crews, triage nurses, Drs etc are all making decisions that may have long term implications for folk but at the end of the day are humans grinded down by the system. Its a huge responsibility they signed up for and not one many of us would want and of course thats priceless but funding is only part of the answer. Yes completely agree that other options may be available first. Like pharmacists, 111, or Gp's and of course a personal responsibility to be sensible before attending emergency care facilities. but there is no quick fix now. We need to accept that and find solutions before NHS is gone forever. 75 years after it began.

Cudos to our paramedics. One young man who lodged at my house for a few years had to put up with all sorts of abuse at work. This came from callers whom he politely explained did not need an ambulance for something like a sore throat or similar. Worse still was the yelled abuse from those who were temporarily inconvenienced by his parking. Apparently they didn't care what was f***ing wrong with anyone - just move out of my way.

‘ their GP if coughing for more than 4 weeks.’

Our very efficiently managed GP practice has waiting room walls covered with public health posters, clustered by interest e.g. children, elderly, MH, carers etc. Great care taken.

It’s rare to be sat there long enough to take all the messages in, but recently I saw the message about mentioning a persistence cough to the GP.

I had such a recurrent prolonged cough & mentioned this to the GP once the main matter was dealt with. The GPS face fell & I took this as a cue: ‘the poster downstairs tells me to let you know about my cough’.

Penny dropped for GP why so many patients mentioning non-urgent coughs, stretching the appointment.

Not seen that ‘general’ poster since.

I still believe that doctors aren’t seeing enough patients so they go to hospital

Quokka

No agenda from me I assure you to deflect blame from the chinless incompetents running the government. Perhaps the public need educating too in what comprises an emergency though.

The point brought up about minor injury units though is very valid. More of these would cream off those who don’t need quick intervention for life-threatening conditions or injuries. These would give the ambulance staff somewhere more appropriate to take patients and leave them.

The OP seems oddly biased and inaccurate. On arrival the paramedics assess the situation, stabilise the patient in necessary and explain the options to the patient. They don't take a patient to hospital unless it is necessary.

You still haven't told us where, exactly, you saw this reported.

When my husband was unwell we phoned the Gp - who told us to phone an ambulance. They send a transport ambulance with no paramedics since they felt it was not an emergency. In the event it required hospital treatment but not immediately life-threatening.
It was clear the ambulance drivers, though friendly, thought we had been poorly advised by out GP but put 'GPs advice' on system to cover themselves.
Still don't know if that was supposed to be acceptable ambulance use or not.

Agreed!

My husband had a heart attack 2 weeks ago and I phoned 999 only to be informed that it would be up to a six hour wait so we drove him to A &E (he’s ok now thanks to the fantastic nhs staff)

My neighbour is a paramedic and often has his emergency ambulance or Rapid Response car parked outside his house for 30-60 mins in the mornings.

discoqueen

Think I'm kind of becoming that old lady!
I live alone and have looming health problems with no social support. It's scary.
I looked into retirement communities and tbh there is nothing. So plan is to get a cleaner if needed.
I was so ill over New Year that I was genuinely frightened. I've had pneumonia alone when younger, but worked, so someone would miss me.
I don't phone randomly phone the doc when off colour but was both very frightened and aware of being infectious at New Year.
Also had friends, who apparently had the same thing out partying in spite of the sniffles, in their words. Plus far worse health problems.
All of whom have family support. So I get it. That feeling of being alone, disbelieved, worthless and vulnerable.
And I'm also guilty of making my very damanding neighbour feel like this.
I have enough self esteem and fear tbh to fight if very ill, regardless of what other people, who haven't visited, think.

That's sad - move to Marlborough, there are so many places for the elderly in supported housing there's nothing left for anyone else! Honestly, there are dozens of complexes here, with new flyers coming round regularly for new ones being built.

The original NHS legislation said that ambulances would be provided to take people from place to place. It did not specify 'place'. I recall patients being sent home in an ambulance. I was sent home in one in 1963 after an Achilles tendon injury. Obviously we are now in a situation not envisaged by the legislators of 1947. The underfunding and government mismanagement chiefly by the Tories has meant homeward journeys are pretty much ruled out to save resources, understandably. Can we ever return to a service which meets the aspirations of Bevan and Beverage?

We had to have the ambulance out to my Mum because of falls. Most times they were quite happy not to take her to hospital and advised she should stay home. My experience is that they are perfectly able to treat and leave the patient at home.