Where's my ambulance?
 

I thought I'd start this thread after reading a couple of (heart felt) comments from members who ( in their moment of need) felt let down by Emergency services.
Personally I've not had a bad experience but I'm curious to hear your views.
In times of crisis, information and support must be readily available and easy to access for those who need it IMHO.
While I praise the bravery of emergency workers,procedures in areas including communications,response times need to be improved (also my opinion).

After ringing 999 callers are asked a series of questions which are based on the initial query as to why an ambulance is required. The questions link to other questions and depending on how the questions are answered depends on the grading of the call.
Currently the ambulance service use several grades of call, ranging from a Red1 response (immediately life threatening) to Green4 (non-emergency, non-life threatening). Each different grading has a different response time allocated to it, as follows:

· Red 1 – Immediately life threatening call, such as cardiac arrest, requiring a defib. Response time: 8 minutes from call received and 19 minutes for conveying resource to scene.
· Red 2 – Life threatening call, such as cardiac chest pains. Response time: 8 minutes from call coding and 19 minutes for a conveying resource to scene.
· Green 1 – Serious, but not life threatening. Response time of 20 minutes from call received.
· Green 2 – Serious, but not life threatening and with no serious clinical need: Response time of 30 minutes of call received.
· Green 3 – Non-life threatening non-emergency call. Telephone assessment within 20 minutes of call received.
· Green 4 – Non-life threatening non-emergency call. Telephone assessment within 60 minutes of call received.

As you can see, not all 999 calls to the ambulance service will automatically get an ambulance attendance. Green 3 and Green 4 calls will be further triaged and assessed by a health care professional, usually a Paramedic or Nurse. These calls often result in self-care advice but the clinician has the ability to request an ambulance to attend so can re-grade the calls as required.

Good or bad,
What are your thoughts,experiences with our ambulance service??

re: Where's my ambulance?
 

The ambulance service in the past has been badly misused, almost like a taxi service.
It has meant that changes had to be made.
Also impact of waiting times in A&E departments has a knock on effect of when ambulances are available.
If an ambulance crew cannot hand over their patient to staff at the A&E dept, then that ambulance is out of service until they can hand over the patient.
Then there is the issue of ensuring that the ambluance is clean for the next patient, restocking of any items which have been used in the last 'call'.

Ambulances and ambulance personnel are much more technical than they once were.

My daughter has had to call on the ambulance service a couple of times in the last year.
I have nothing but praise and admiration for the lads and lasses that make up the backbone of this service - their care(kindness) and speed undoubtedly saved her life last April.

I know there are others who have not had the same experiences, when it goes wrong(for whatever reason) it can have tragic consequences. Even if the consequences aren't tragic, it is very difficult to see someone you care about in pain and waiting for help which doesn't come as quickly as you would hope.
In those situations, you have to address your concerns through the appropriate channels to get your complaint investigated.

When I worked in the NHS our complaints procedure was well defined.
A response had to be sent out to the complainant within two days of us receiving the complaint, and we had to specify in our response what we were going to do to investigate, a timeline had to be set for resolution and we would be strictly monitored on how the complaint was being handled......we were not allowed to 'drag our feet'.
Every organisation has its own policies, but they are usually along similar lines.
If you make a complaint, and hear nothing, then you need to phone and ask what the complaints procedure is.

re: Where's my ambulance?
 

Just like you Margaret I have nothing but praise for the paramedics on the frontline.It is the telephone operators and the"clinicians" who I have a complaint about

re: Where's my ambulance?
 

The two comments that made me start the thread:

Originally Posted by maxthecollie:
I know that when I dialled 999 when my 87 year old mother fell and broke her wrist and could not get up, it took one and a half hours for the paramedics to turn up after several calls.

Originally Posted by westendlass:
About eighteen months ago my son became ill, vomited and collapsed to the floor. We rang an ambulance straight away and was asked by the operator if he was conscious. We explained that he was but very confused and could barely get up from the floor,on that reply we were told they wouldn't send an ambulance and that a nurse would ring back for a chat! In a panic, we managed to get him in to my daughters car and set off to A and E and received the nurses call half way there. She sounded shocked when I explained his condition and her advice? 'If happens again, stop driving and call an ambulance'! He spent the rest of the day on a drip in hospital. What a joke.

re: Where's my ambulance?
 

It is the 111 service that is dire.
On the hottest day of the year my daughter was desperately sick, she had been taking no fluids and vomiting for 36 hours non stop....yes, she had anti-sicknes meds, but what use are they when they have to be taken by mouth.
I spent from 8am in the morning until 5pm at night trying to get assistance for her.
I was very worried for her - she was passing no urine was confused and was obviously dehydrated( people die from this).
I must have repeated the clinical details to a variety of people at least 40 times during this time span. A doctor came out and did give her an anti sickness injection during the early afternoon...but by this time she was past the point of no return.

In the end I called the ward that she had been on for her treatment and they called an ambulance......it was with us within 15 minutes.
She was seen immediately in A&E...was given further injectable sickness meds and infused with seven litres of fluid.
So I have nothing but praise for them.

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You know what to do next time, say she has fallen and I am not sure if she is breathing. You won't be lying if you haven't checked ;)

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Anyone had experience with Community First Responders (CFRs)?
I believe there's been a thread http://www.accringtonweb.com/forum/f...ers-13650.html

The dispatcher assesses all incoming emergency calls and determines the suitability of sending a first responder.
Given they live in the communities which they volunteer in, they are likely to be much closer than an ambulance crew and can provide life-saving help in the first few vital minutes,for example,a heart attack they can provide a better, long-term outcome for us.Considering first responders have the potential to save a life, A increase in activation would an inspiring figure to see.CFRs are invaluable, especially in rural areas (I take my hat off to them).
However in some communities there are(understandably) very mixed feelings regarding CFRs because there's a difference between a community first responder and a qualified paramedic (and his ambulance),Saying that if the CFR schemes stopped I don't think the local Ambulance Service would increase resources.

Do you think sooner or later there will be no ambulances for one reason or another? :eek:

Re: Where's my ambulance?
 

It's a little different over here ... how fast you get an ambulance, and what kind of ambulance it is, depends on where you live. There are thousands of communities that don't have a hospital, and many without highway access. Most of us live within a couple of hundred klicks of the US border; but this is still a country of small communities where ambulances are R.C.A.F. helicopters, or maybe planes with skis or floats on them, depending on the time of year. But wherever you are, the emergency services do their best to get to you. In Kingston we are lucky. Ambulances arrive quickly ... and if there is no ambulance available, and the emergency is dire, many fire fighters are trained paramedics, and a big red fire truck may show up at your home. Also, ambulance service isn't free. There is a nominal charge ... $45.00 I think ... of course, those who can't afford it, pensioners, and those on government assistance don't have to pay a dime. Also, if, in the opinion of the ER physician, an ambulance was not necessary, you get stuck with a big bill. In my humble opinion, this is not a bad idea. People who are not residents of Ontario are billed for the ambulance either directly, or, OHIP will bill the Province you reside in. Health care in Canada is a provincial responsibility (British North America Act, 1867;)). Furriners, like youse guys, pay the full shot. But no one is turned away, and everyone gets help, 'cause us Canucks are nice folk, eh:D Bottom line is: the service is great ... and if you can't be transported to the care you need, the care will come to you. I remember that a few years back there was a sick premature baby at KGH who needed the kind of care that only Sick Kids Hospital in TO could provide. A surgical team with all their equipment was flown into Kingston.

I know this is kind of a ramble, but some of you might be interested in how things are done over here where climate and geography are important considerations.

Re: Where's my ambulance?
 

I think there is always going to be an ambulance service.......I cannot see how it could be removed.....especially when you think of the number of 'critical incidents' there have been over the last few years.
But, there are finite resources both financial and logistical, so it goes without saying that there will be times when there isn't enough service to meet the needs.
Therefore, I think the coding of emergencies is the only way for the service to be effectively managed.
The only other way would be(shudder) to put ambulance services out to private tender and perhaps be able to call on these when the service is stretched to its limits.
I'm not sure how this would work in a practical sense, or for that matter how it would be paid for...other than the obvious...which is to make those who misuse the ambulance service pay dearly for that misuse.

Re: Where's my ambulance?
 

I bet a lot of those who misuse the ambulance service are dropouts and on benefits, so it will end up with us the taxpayers forking out again

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I think that no improvement in service will happen, because the cost cutting ideology will prevail - sick people are a severe drain on national resources and it is cheaper to let sick people die.

Re: Where's my ambulance?
 

Talking of misuse:
Lancashire ambulance bosses accused of being 'tactless' over luxury cars (From The Westmorland Gazette)

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Police say ambulance service putting demand on its resources :eek::eek:

BBC News - Police say ambulance service putting demand on its resources

Re: Where's my ambulance?
 

I am quite cynical about news stories from the BBC...at one time the BBC was a politically unbiased reporter of news, but in recent times I haven't found this to be so.(or perhaps I should say I have doubted the motives of the news that is reported by the BBC)
It isn't that these incident didn't happen ,but it is the tone that is used to report the news.

Re: Where's my ambulance?
 

The Beeb is more corrupt than anyone in Strangeways in my view.;)

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This might be the case Margaret, but I am sure there would be a publicity firestorm if such things were seen to be happening overtly - that, however doesn't stop them from happening covertly.

As to benefits users being the abusers of the ambulance service.......it may be the case that those who over indulge on recreational drugs, and alcohol could be seen as the abusers of the service......and while some benfit claimants may use drugs and alcohol, I feel sure that they are not the ones falling around in the streets of our towns and cities at the weekends.

Re: Where's my ambulance?
 

Gotta point :D

Re: Where's my ambulance?
 

almost 10 years ago when i was in hospital the amulance service was been abused by drunks and smackheads saying they had chest pains and demanding an ambulance who then upon ariving at the hospital legged it home which i assume was near to the hospital

fast forward to 3 or 4 weeks ago when i was with a paramedic this vile abuse of the ambulance service is still been allowed to continue and unlike nurses and doctors if a patient beats the crap out of a paramedic they still have to treat them and continue to do so if called out by the same attacker and can not refuse and face discilpinary action if they do.

i was shown a picture of a collegue whos face was severly battered and she was expected to attend teh persons house who did it if called out again.This person was a regular hyperchondriac and frequent caller.

your ambulance may have been delayed because of the moron that beat the crap out of the paramedic and put them in hospital prior to your call and unfortunatly thes eincidents are quite common

Re: Where's my ambulance?
 

The abuse of ambulance personnel has been going on for as long as I can remember.....but it used to be mainly drunks.
In fact if I remember rightly, the ambulance service changed its uniform to one which looked less like a policemans uniform, in the vain hope that these attacks would reduce.

Re: Where's my ambulance?
 

Approximate starting salary of £22,000 per year for a paramedic.I bet the average staff member at Asda, Tesco are on a similar wage, but they don't have the stress or daily abuse.
Which do you think sounds more appealing to today's youth?
Hope I'm wrong but I cant see a career as a paramedic ( bad hours and rubbish pay) appealing to future youth (law of averages says there will be a shortage).:eek:

Do you think paramedics should have the right to refuse help to abusive patients? Surely their duty of care is firstly to themselves?

Paramedics/NHS staff are at the front end of a barrage of physical and abusive threats.
They're professionals who when someone needs medical attention, put themselves out in the line of duty.
They should be respected not put in danger,They can do without being some reprobates/drug addicts target for the Night.:(

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I'm sure that ambulances carry notices that action will be taken against those who abuse their staff....but to be honest lots of ambulance personnel know that his comes with the territory.....and they still choose to do the job because they get job satisfaction.There is a vast difference between stacking beans or working on a till to knowing that you have saved the life of a baby....or seen a baby safely into the world, or played a part in rescuing a badly injured person and restored them to their place in their family.
Ask those in Adsa why they do the job.
I don't think many of them will cite job satisfaction...mostly it will be because it pays the mortgage.....ask them too if they would give up doing their job tomorrow....I bet most of them would.
When I worked in the NHS, the career structure was rubbish, the pay was rubbish......but every single day was different. It wasn't boring. It gave me job satisfaction. I looked forward to the challenges each day would send me and relished the opportunity to make a difference in the lives of my patients.....I was being paid to do something I loved!

Re: Where's my ambulance?
 

governments will always rely on the good nature of those who choose to help others to continue doing so even under the most stress and poor pay

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How much notice do you think a drunk,drug addict,thug will take of said notices tho? Like a lot of places today notices hardly seem to get noticed.
Alothogh job satisfaction might be high on the list of reasons for doing the job,sadly I don't think its number one anymore.They feel abused from up the chain as well as scum off the street.
I think it's more to pay the bills nowadays (I hope I'm wrong on this).

Glad you feel the way you do about your chosen career tho Margaret,it's getting harder an harder to find that satisfaction,good on you :)

Re: Where's my ambulance?
 

The thing about the notice is, while the drunks and the abusers may not read it......it is a warning that action could be taken against those who fail to treat the people who are looking after them decently.
Security and police are always ready to step in when trouble erupts....and while I know this should not be necessary, it is a fact of life that some members of society have respect for no-one.

It saddens me to think that job satisfaction would be low on the list of priorities when seeking a career(not a job-jobs are what you do out of necessity).
I have been in the position of needing a job purely in order to pay the bills and keep the wolf from the door, and it bears no resemblance whatsoever.
And before anyone tells me that young folk,often do not have the luxury of choice, I would say to them that for many years I didn't have the luxury of choice either. I was 26 years old before I got my chance to improve myself....the difference is you have to have the desire and the focus to make the changes. Things do not just 'happen' you have to make them happen. Sometimes you have to make sacrifices to get where you want to be....to be honest I think that that is what is lacking. People want to start at the top...it isn't sensible or for that matter possible.

Re: Where's my ambulance?
 

What proportion of assaults actually get reported to the police?
I think we mentioned stiffer punishment for those found guilty.
Can a negative spiral exist where staff won’t report incidents due to no action being taken in the past?
Although on the rise in a lot of places the main problem with assaults on staff is not caused by folk under the influence of drugs/alcohol in A&E or on the street at the weekend but in Mental Health/Learning Disability settings.

Re: Where's my ambulance?
 

No, I don't think so. Health and safety will require incidents to be reported.
This is essential because should an employee later suffer from ill health as a result of an incident at work, there has to be documentary evidence of what happened, and when.
Punishments, well, that is in the hands of the judiciary.
My Sister works in a mental health setting(OK, not in this country now, but she did work at Learning disability establishments before she emigrated) there are policies and procedures in place to protect those who work in the environment.

Re: Where's my ambulance?
 

Would you say we need to improve the investigation of criminal offences involving suspects who are mentally ill?
Seems a high number get dismissed as “not in the public interest”

Re: Where's my ambulance?
 

I think they need to take a step back n ask why they closed many of the places that homed the mentally ill, n pushed many who should never have been back into society. Which means unless they commit a very serious offence, theres no-where to put em.

Re: Where's my ambulance?
 

In what context?
Do you mean in the context of this thread or in general?
And where do you get the information that a high number are being dismissed as not in the public interest?

Re: Where's my ambulance?
 

I think that you have hit the spot with that one Cashy.
I know the mental institutions were pretty dismal, but they were more secure than the current situation ever could be.

Re: Where's my ambulance?
 

We have made a major thread wander here.......from where's the Ambulance to Care in the Community.

Re: Where's my ambulance?
 

In a roundabout way i dont reckon its much of a wander? I (my opinion only) think many of these attacks on Ambulance Staff are by people 3 slices short of a loaf.;)

Re: Where's my ambulance?
 

I meant in general,you may be right about the thread wander,Although cashman has a point ;)

Not In The Public Interest | MentalHealthCop

Re: Where's my ambulance?
 

Cashy, they may well be...but you and I remember the saying 'thur nod all daft that slavver' and I reckon that fits this quite well.
Most of those who abuse the rescue services are just plain ignorant morons rather than mentally deficient.

Re: Where's my ambulance?
 

thank you for that information.....I haven't read it thoroughly...yet.
I am sure it will give me a bit more insight.

Re: Where's my ambulance?
 

It's £21,783 to £27,901 for a paramedic and £25,783 to £34,530 for a senior paramedic and upto £40 for an area manager

No idea how they decide which point you are on in the pay scales though. I am not a big fan of that type of pay scale. If you're doing the same job as the person sat next to you then you should be on the same money is my usual thought on pay.

Re: Where's my ambulance?
 

Like other sections of the NHS pay is sectioned into bands. Paramedics start at band 5 and through the appraisal system you move up the band in increments.
To get to the next band you need to learn extra skills and/or gain extra qualifications.

http://www.prospects.ac.uk/paramedic_salary.htm

Re: Where's my ambulance?
 

Nursing is very similar in pay structure.

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My Mrs and daughter are both HCA`s, they are on a lowly band 2.:(

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The ward my daughter works on has a lot of dementia patients and the staff there are regularly hit, slapped or scratched by the patients. Don`t think there is any procedure in place to report this, would there be any point, 5 mins later they are nice as pie and don`t remember what they`ve done.

Re: Where's my ambulance?
 

I can't comment on that G. My ward was gynaecology, and we had well defined procedures for incidents.....mind you I have been retired now for 11 years(but rarely are procedures and paperwork issues rescinded).