Misuse of emergency ambulances

i can remember when GPs would visit their patients in hospital, and discuss the case with the doctors there.
people would not believe that now.

growstuff

Callistemon21

A patient has to be assessed beforehand.
^When you contact us for transport you will be asked a series of questions that will determine whether you are eligible for transport. Eligibility is based upon this medical criteria^

Errmmm! Transport isn't based on medical criteria either - not here anyway. Ambulance transport for hospital visits is based on entitlement to benefits. There is a local voluntary organisation, which can sometimes help out.

There are some strange practices where you live is all I can say growstuff.
Here’s the NHS England non-emergency transport criteria, as Callistemon21 says, it is based on medical criteria. Patients who are on a range of benefits are entitled to reclaim the cost of transport to hospital appointments, but they aren’t entitled to receive ambulance transport unless they meet the criteria.

Fleurpepper

Several generations of GPs did out of hours, nights and week-ends, on top of a full time day, and home visits- with pride and because they believed in what they did. Even when it put their own lives in jeopardy and their family.

If only the Governement in 2000-2004, had chosen to reward them with extra payment for doing so, instead of threatening to take away a sum which was an insult to their hard work and dedication, they would probably have continued to do so.

Very sad- and this caused huge damage to the profession, and to patients.

I think we can all remember being visited by the GP at home with his medical bag.
The out of hours 111 service must be costing far more.

Casdon

growstuff

Callistemon21

A patient has to be assessed beforehand.
^When you contact us for transport you will be asked a series of questions that will determine whether you are eligible for transport. Eligibility is based upon this medical criteria^

Errmmm! Transport isn't based on medical criteria either - not here anyway. Ambulance transport for hospital visits is based on entitlement to benefits. There is a local voluntary organisation, which can sometimes help out.

There are some strange practices where you live is all I can say growstuff.
Here’s the NHS England non-emergency transport criteria, as Callistemon21 says, it is based on medical criteria. Patients who are on a range of benefits are entitled to reclaim the cost of transport to hospital appointments, but they aren’t entitled to receive ambulance transport unless they meet the criteria.

Here’s the claim process.
www.nhsbsa.nhs.uk/help-travel-eye-care-wigs-and-fabric-support-costs/travel-receive-nhs-treatment

Many years ago I used to work in the London Ambulance Service Control Room. People rang for an ambulance with the most ridiculous reasons. One man rang to ask for an ambulance for his pregnant wife. When the call operator asked if she was having pain he said "No, she has an anti natal class" He was told we wouldn't send an ambulance out unless she was having problems. He hung up then rang back and said she was having pain. The Ambulance Service have to go so we sent an ambulance and they took the wife to the A&E. However, although we had to send an ambulance we are not obliged to take them to a particular hospital so the crew took her to a different hospital, not the one where her anti-natal appointment was. Obviously the crew checked her out first but she had no pains, she just wanted a taxi!

I’m sure one problem was the online system Drlink which assessed your symptoms and guided you to the correct care before you could get a GP appointment. It has now been decommissioned. The GPs said it was A rubbish system but patients had to use it. To my utter amazement on 2 of the 4 occasions I used it the system told me to call 999 immediately. I went through the tick boxes first. Of course I did no such thing but I do wonder if plenty of other people “did as the system told them to do”.

I work for the ambulance service and demand was down on strike days partly due to patients not phoning for assistance as they knew the pressures we were under and the fact we were only responding to Cat 1 calls, ie those that are classified as life-threatening and needing immediate intervention and/or resuscitation, e.g. cardiac or respiratory arrest. I dread to think how many Cat 2, 3, 4 calls were stacked to the next day. The ambulance service is on its knees - staff welfare and patient safety is being seriously compromised. Our staff and patients deserve better treatment.

i watch the 999 show on tv and sometimes they go but don't take the person to hospital, they check the situation and then decide. i am 59 and have only used an ambulance once in my life when i had sepsis and i had no idea who or where i was, i was lucky my neighbour was an ex nurse. they should have more out of hours services that can deal with small injuries and not fill up a&e or take time away from the ambulance service.

Lady may I had necessity to call ambulance as my husband ( Alzheimer’s ) had fallen for 2nd time that day …I picked this 12.5 stone man from the floor once already ( I’m 9st 11)
aged 72 …and have arthritis . They came after 4 hours and lifted him for me….one of them said I looked my more in need of the ambulance and I smiled and explained Ed situ. “Always call” he said …”you cannot be expected to keep doing this “…… I was at time sleeping just 3 hours a night. every night god two years! I had to go to shop and when I got home my husband had fallen fir third time that day so I started to try lift him ….I could not call the ambulance again …whens there’s folk having heart attacks! While trying to left him I had my third stroke . We ended up with two ambulances …. me going to a stroke unit 29 miles from home and my husband going to local hospital for ‘safety’ reasons! All because I felt guilty not being able to lift him. A great many 999 calls are from people like me who can’t lift their partners from floor. Surely some sort of ‘special recovery’ unit is needed where calls from ‘fallers ‘ can be quickly dealt with…assessed as to whether they actually need a previous ambulance or just a bit of first aid. What a bell a ‘flying squad’ like that would be!

When Mum was unable to lift Dad the fire brigade came. They were brilliant.

growstuff

Dickens When I was discharged after my heart attack, I was told by the hospital to see a GP within days for a check up and to arrange medication. I lived on my own and wasn't allowed to drive. When I rang the GP, I was told in no uncertain terms that I didn't qualify for a home visit because I wasn't old and frail enough. That was five years ago.

That is disgraceful.

I assume they thought you could just jump in a taxi - or hang around for public transport?

Each surgery has it's own rules, obviously - but it should not be a postcode lottery.

... and as for this 'phone on the day' at 0800 hours... only to find out that all the slots have been allocated - surely there's got to be a better way?

Sometimes people need an appointment on an urgent basis - but not necessarily urgent on that particular day. But at our surgery you can't get a 'timely' appointment... it's either on the day or at least 3 weeks ahead. I believe that people are giving up and presenting themselves in A&E because of it.

I'm happy to accept telephone appointments when it's feasible, and it often is for me, but I do have a couple of problems that need the eye of a doctor - but I can't get an appointment until end of February, and I don't think it's urgent enough to take up an emergency slot that someone might desperately need. A nurse who visits me for another condition said I should see the doctor "within a few days" to get an opinion, but that I didn't need to hot-foot it to the surgery. I'm not going to go to A&E, but I am looking for 'red flags' and if things deteriorate, I just might have to in the end. Because one of the complications of my particular problem - is sepsis.

... and the NHS definition of "old" is 65 onward... if you'd just had a heart attack - would you not be in rather a 'frail' position? I think Kinnock was right... I warn you not to be young, not to be old, not to be ill...

Fleurpepper

A neighbour was quite happy to pay for taxis to go to hairdresser's, nail salon, coffee with friends, shopping, etc. But she refused to pay for taxi to take her to hospital apps, 5 mins away by taxi, or with direct 10 mins on bus.

Her right she said, to have an ambulance.

But surely ambulances don't take anyone to hospital for "appointments"? Triage by 999 call handler would sort that, and even if your neighbour lied or exaggerated her symptoms, they would Triage her too. Patient transport and 999 🚑 are two different areas of service

Yes, patient transport and ambulances are separate services. Each of the letters I receive from hospitals regarding forthcoming appointments include details of hospital transport available if you are unable to get to an appointment under your own steam.
Uniformed drivers in liveried estate cars emblazoned with NHS logo.

Niucla97

Tell me about! I have an eighty five year old neighbour who suffers from COPD. He has been told that this is liveable but refuses to accept it. Years ago I have called an ambulance for him because he really was struggling to breath and his chest was 'rattling.' Over the years they have found medication that has helped. He will call an ambulance at the drop of a hat. He must tell lies to get one? he will ring me , he has a sore throat - gargle with salt water, honey and lemon, plenty fluids. He is an educated man but has no common sense of how to deal with every day things. Next thing you know there is an ambulance outside

He thinks it is his divine right to call an ambulance, Even when they were on strike I told him he mustn't call an ambulance as they are only dealing with life threatening calls. His reply - what do you think not being able to breath is ?A couple of weeks ago he called an ambulance every other day, He is already on the frequent callers list and is heading for the nuisance callers list Paramedics can waste at least one and a half hours justifying why they can't take him to hospital!

The ambulance is taking longer to get here of late. He called an ambulance at midnight they told him four to five hours so he got into bed and snuggled down to go to sleep - hardly an emergency?They rang him and woke him up saying they would be another four hours. They arrived before 8.00 am and were here for over three hours!

The majority of the paramedics are on first name terms they know him so well. On the odd occasion that he does go to hospital he has been in the ambulance all night, He thinks it's wonderful, he has attention and someone to chat to! Then he has been sitting in a wheel chair for three days in A & E and then been sent home. it's sad in one respect but a complete and utter waste of resources. Especially when a lady of one hundred and three is left lying on the floor for nine hours, the paramedic comes and gives her pain relief and says an ambulance will be along in a couple of hours. This is all in a village in a rural area in North Wales!

I wonder where you got your medical training? Of course you can live with COPD but you can die with it. As far as I am aware, COPD patients are given medication to use in an emergency when breathing becomes difficult. If this doesn't work then they are advised to ring 111 and they will ask appropriate questions and, if considered necessary, send an ambulance. This is done because the ambulance paramedics carry additional medication which can be tried. They can check on how the heart is holding up, etc. However, if that doesn't work the patient may have to be taken to hospital.

Your scurrilous gossip about a neighbour carries no weight. You are not this person and cannot know his medical history. Not being able to breathe must be terrifying. I do hope this person has other neighbours than you. I am certainly glad you are not the neighbour of those I know with COPD.

you can die with it you can also die with it

Germanshepherdsmum

When Mum was unable to lift Dad the fire brigade came. They were brilliant.

Many areas have set up Falls Rapid Response Teams, separate from the Ambulance service. I don't know if these have continued though with the running down or the NHS. The may be so short handed that they can't and yet work done at the time may mean the fallen person is able to stay in their home.

By the sound of things the Fire Brigade being involved in the response team might also cheer up the carer

One of the women in my coffee group called an emergency ambulance because she was constipated - and the paramedics took her to hospital. She calls an emergency ambulance every month or so as she has a bad back. Every time she turns up at the hospital she is told that A+Es are for emergencies and not for pain management for chronic back pain. Still calls the ambulance though - and her husband often follows in their car!

DaisyAnne

Germanshepherdsmum

When Mum was unable to lift Dad the fire brigade came. They were brilliant.

Many areas have set up Falls Rapid Response Teams, separate from the Ambulance service. I don't know if these have continued though with the running down or the NHS. The may be so short handed that they can't and yet work done at the time may mean the fallen person is able to stay in their home.

By the sound of things the Fire Brigade being involved in the response team might also cheer up the carer

Services like the Falls Rapid Response Teams should be expanded. It's much better if the patient can stay at home.

No Casdon it isn't just my area. To be honest, you don't know as much about how the NHS works at ground level as you think. I've experienced it.

When I was about to be discharged from hospital, I was worried about how I was to get home. I was in hospital 30 miles from where I live and still felt weak after the op. I had been told not to drive for four weeks. There was no public transport. I lived alone. I had no family living close, I didn't know my neighbours and I didn't have the phone numbers of anybody who didn't work and could pick me up. At the time, I lived from self-employed earnings and on a knife edge. Obviously, I couldn't work, so I had no income and would have been overdrawn, if I'd called a taxi.

I assumed there would be some form of hospital transport (not ambulance). There was, but I was told that I didn't qualify for it because I wasn't claiming certain benefits. The eligibility had nothing to do with clinical need. I had been told that somebody should be with me 24/7 for 24 hours after discharge, so I couldn't have travelled alone anyway. (Nobody was with me after discharge, but that's another story.)

In the end, I discharged myself a day early on a Sunday, so that my daughter, who lives 200 miles away, could take me home and didn't have to miss a day's work.

PS. There was a thread some weeks ago about people packing a hospital bag and some people mocked it. My "hospital bag" now includes phone numbers of people I could contact to take me home, should the need ever arise in the future. I learnt my lesson and have discussed the situation with a couple of friends, so that they know what to expect and have my phone practically glued to me.

Callistemon21

Fleurpepper

Several generations of GPs did out of hours, nights and week-ends, on top of a full time day, and home visits- with pride and because they believed in what they did. Even when it put their own lives in jeopardy and their family.

If only the Governement in 2000-2004, had chosen to reward them with extra payment for doing so, instead of threatening to take away a sum which was an insult to their hard work and dedication, they would probably have continued to do so.

Very sad- and this caused huge damage to the profession, and to patients.

I think we can all remember being visited by the GP at home with his medical bag.
The out of hours 111 service must be costing far more.

I can't ever remember having a home visit, not even as a child.

I can’t ever remember having a home visit, even as a child

I can. Once when I had the mumps, sounds impossible but back then you weren’t encouraged to go to the doctor’s with something catching. I had to be off school quite a while.

And then when I was 11, I was extremely wheezy one Sunday. It got so I had trouble breathing, the GP came out and gave me an injection. Sat with me until I was breathing better. Diagnosed with asthma, made to stay off school several days.

Back then, in the early 60’s, it would never have occurred to my parents to call for an ambulance or take you to hospital. You called the doctor.

Growstuff I have a clear memory of the doctor visiting me when I was poorly as a child. It was probably 1946. He was Dr. James, his brother was Dr. John. By the age of nine I became very ill with jaundice and had regular visits from Dr John. Soon after, my father became terminally ill, he was regularly visited by Dr. John.
At some point in his short illness my father was taken to hospital by ambulance and remained there for a month. He returned home for his final four weeks, regularly visited by the same GP. This same doctor visited me when I was married, pregnant and suffering extreme sickness and had moved several miles out of his catchment area. My husband, baby and I moved to live in Chester in 1965 and I have strong memories of the GP visiting the children when they were ill with ear, nose and throat infections.

growstuff

DaisyAnne

Germanshepherdsmum

When Mum was unable to lift Dad the fire brigade came. They were brilliant.

Many areas have set up Falls Rapid Response Teams, separate from the Ambulance service. I don't know if these have continued though with the running down or the NHS. The may be so short handed that they can't and yet work done at the time may mean the fallen person is able to stay in their home.

By the sound of things the Fire Brigade being involved in the response team might also cheer up the carer

Services like the Falls Rapid Response Teams should be expanded. It's much better if the patient can stay at home.

Services like the Falls Rapid Response Teams should be expanded. It's much better if the patient can stay at home.

The FRRT was a key part of the 'NHS Long Term Plan' under Matt Hancock in 2020.

It was to be supported by an additional £4.5billion a year for primary care and community services by 2023/24.

According to NHS England, further areas across England will receive extra funding to begin working to the new standards from 2021, with every part of the country covered by April 2023.

Bearing in mind the continuing and accelerated cuts to public spending, I have my doubts.

I'm not good with figures, but can only think that keeping elderly people out of hospital after a fall which didn't result in an injury, would be cost-effective. It would also free-up ambulances that are called out on a regular basis for this reason. The ambulance crew will not automatically ferry you to A&E if they are confident there is no injury, but as long as the ambulance is parked outside whilst they do an assessment, it is one ambulance less available for life-or-death emergencies.

The government recognised, rightly, that this was an issue that needed addressing. We now have a new Health Secretary and the announcement of further spending cuts, so who knows whether this initiative will be expanded as forecast?

Aldom

Growstuff I have a clear memory of the doctor visiting me when I was poorly as a child. It was probably 1946. He was Dr. James, his brother was Dr. John. By the age of nine I became very ill with jaundice and had regular visits from Dr John. Soon after, my father became terminally ill, he was regularly visited by Dr. John.
At some point in his short illness my father was taken to hospital by ambulance and remained there for a month. He returned home for his final four weeks, regularly visited by the same GP. This same doctor visited me when I was married, pregnant and suffering extreme sickness and had moved several miles out of his catchment area. My husband, baby and I moved to live in Chester in 1965 and I have strong memories of the GP visiting the children when they were ill with ear, nose and throat infections.

As 'recently' as 1971 - my then GP used to pop in to see me at home after the birth of my son (I was a single parent at that time), on his way back to the surgery after other home-visits in the area. He did this 4 / 5 times until he could see that I was coping well.

Fast forward 4 years and - this is mind-boggling - he arranged for a NHS Psychiatrist and his Assistant to visit me at home when I suffered a sudden and severe episode of anxiety and depression. The point is, he was my family doctor and knew me well enough to know that this was completely out of character (I was by then a happy and successful working single parent), so was concerned. Within about 20 minutes the Psychiatrist had got to the root of the problem - it was the horrendous side-effect of a particular drug I'd been prescribed, a rare side effect, but one he recognised. Medication was stopped and within a matter of days I'd started to recover.

Can you even imagine what would happen to anyone suffering a similar episode now?

Of course, long term, this kind of care could not continue at such intensity - but we've gone from the sublime to the ridiculous since then. And you don't need to do too much research to discover why.

growstuff

DaisyAnne

Germanshepherdsmum

When Mum was unable to lift Dad the fire brigade came. They were brilliant.

Many areas have set up Falls Rapid Response Teams, separate from the Ambulance service. I don't know if these have continued though with the running down or the NHS. The may be so short handed that they can't and yet work done at the time may mean the fallen person is able to stay in their home.

By the sound of things the Fire Brigade being involved in the response team might also cheer up the carer

Services like the Falls Rapid Response Teams should be expanded. It's much better if the patient can stay at home.

The only problem then is ensuring people have care and contact following the fall. I do think we have to look at the greater use of technology but (so far) technology can't dress an elderly frail person who will not have breakfast until they are dressed.