To attend to 999 emergencies target calls, health chiefs from East of England Ambulance Trust have been sending cars instead of ambulances. Rapid response vehicles (RRVs) are being used to hit response targets, including patients who are in need of ambulances not cars to be transported to the hospital.

In trying to make sure that help is reached to those injured on time, patient safety ends up being compromised.

An anonymous source said, “Care, patient safety and dignity are really being badly compromised. Everyone has horror stories. It’s as bad as I can ever remember.”

The criticism about how this approach is careless has forced the NHS to think of other ways to attend to the high number of patients requesting help through the 999 emergency call-line. New changes are expected to be implemented, which will pave the way for urgent cases to be attended by ambulances as quickly as possible.

Quantity vs. quality


Due to a high number of 999 calls to attend to, ambulances take a long time to reach those badly in need of help. As a result, health chiefs thought that it is better to send RRVs to reach out to the patients faster.

Speaking on this, Norman Lamb, former health minister, said, “The trust was at risk of chasing a target, rather than improving patient care, which was “perverse in the extreme.”

Compared to last year, there has been a significant increase in the number of RRVs dispatched to attend to 999 emergencies. On their part, the East of England Ambulance Trust said, “The trust does not put targets before safety. Rather it prioritises its response to the sickest patients.”

“In addition, the trust has been reducing the rapid response vehicle hours it has been deploying since December 2016.”

The trust continued to reiterate that patient safety is important to them, and that they are constantly monitoring the situation when it comes to the arrangement of getting patients to the hospital.

A new approach


According to health service rules, “life threatening” 999 emergency requests should be attended to within eight minutes. It’s been more than two years since ambulances have been able to reach critical 999 cases within that timeline. Ideally, if it’s a life or death case, ambulances are dispatched immediately. Nonetheless, for other cases, responders take more time in asking questions to analyse the situation.

To adapt to methodology, the NHS in England will set around 8% of call-outs as urgent and in need of the fastest response from paramedics. This doesn’t change anything from the current situation except that half of the callouts are considered urgent, even though many are not serious cases in need of urgent attention from paramedics.

In a new approach, NHS said more crews will be freed to attend to the sickest and more urgent cases.

Call handlers will also have four minutes to assess the urgency of the call and patient’s case before sending out a crew to tend to the situation. At the moment, operators have 60 seconds on hand to assess everything before sending out the paramedics.

The new changes are meant to create an efficient system that will help keep the lives of patients safe by assessing the situations better before dispatching the paramedics. In other words, the new system is all about making every call count instead of rushing out for the sake of meeting targets.

Speaking on the new system, Gerry Egan, chief executive of College of Paramedics, expressed that “it is vital to patient care that paramedics are targeted to the most appropriate patients.”

The NHS admits that the current situation is all about meeting targets quickly rather than prioritising patients appropriately. Many healthcare professionals have agreed that the new changes will make things better for everyone and will help save many more lives. MIMS

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Sources:
https://www.theguardian.com/society/2017/jul/13/ambulance-trust-accused-jeopardising-patients-cars
https://www.thesun.co.uk/living/4006923/nhs-bosses-sending-cars-instead-of-ambulances-in-bid-to-fiddle-999-figures/
http://www.bbc.com/news/health-40592286
https://www.theguardian.com/society/2017/jul/13/ambulance-response-targets-overhauled-to-save-more-lives