4 Responses to “Now you see us: soon you won’t”

1. Adam Says:
   October 10th, 2006 at 6:53 am

   It sounds like there’ll be staff manning cars and less manning ambulances. So less ambulances, meaning longer waits for transport to hospital?

2. Carmelo Says:
   October 10th, 2006 at 6:56 pm

   And when they change the ORCON game in 2009….
   ..which means at the moment ORCON is measured from when the resource is dispatched. In 2009 it changes to when EOC pick up the phone, essentially taking 2 or 3 minutes off ORCON times. No doubt times will go down.

3. Millietant Says:
   October 10th, 2006 at 11:16 pm

   League tables? What with like a premiership and a third division etc? Will those in the premier league be paid more money and have wives that like to shop. Will the wives develop eating disorders and appear ‘airbrushed’ in the latest edition of ambulance times. Who will sponser the PremierPara’s, will it be Carlsberg, or more likely White Lightening ? I don’t think there’s an official supplier of heroin with the exception of Afghanistan.
   My original reason for posting was your ‘uk forces killed in action’ image at the top, having spoken to the father of a medic in Afghanistan the death toll is apparantly the tip of the iceberg which doesnt reflect the number of horrific physical and mental injuries, which are not being reported.

4. Al Says:
   October 27th, 2006 at 10:24 pm

   Bloody great, I work for a different service and part of my responsibility is to put ‘league tables’ together. I always come out last.

   I remember traipsing for 55 minutes a few years back into another services area that had lots of cars and very few ambulances, the poor patient we had been called to had no less than four cars on scene attending to him from no less than two ambulance services, we came from a third service and landed just behind another ambulance from the original service. So for one patient - four cars, two ambulances, three ambulance services, confused? I was.

   Fortunately nowadays it would all be the same service anyhow so it wouldn’t be quite as astonishing. Good thing really, I think we shall see more of it. Desperately ill patients waiting for well in excess of the ‘golden hour’

   http://diagnosisnfi.wordpress.com/2006/10/09/now-you-see-us-soon-you-wont/

   • 

   A blog from Magwitch, an ECP on the frontline in the South East

   Ambulance service struggles due to lack of staff

   Evening Standard (London),  Dec 16, 2005  by REBECCA SMITH

    

   STAFF shortages are leaving London Ambulance Service struggling.

   There are almost 200 vacancies and a recent salary shake-up has cut the amount of overtime paramedics want to do.

   It means fewer 999 calls are being reached within the eight- minute target.

   Staff were commended for their response to the 7 July bombings but the disruption was felt for months afterwards.

   With the busiest time of the year approaching, more disruption is feared.

   Russell Smith, deputy director of operations, said: "We have been struggling."

   Union representative Phil Thompson said: "We don't know if the shortfall will be coverable."

   (c)2005. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

    

   Bike-riding paramedics set to patrol the City

   Evening Standard (London),  Aug 15, 2006  by REBECCA SMITH

    

   PARAMEDICS will travel on mountain bikes in an effort to improve response times to 999 calls in the City.

   In a two-month trial, a team of four will be sent to all emergency calls in the Square Mile and a regular ambulance will be dispatched at the same time.

   The bright yellow bikes are fitted with blue lights and sirens and carry equipment including a heart-starting defibrillator, oxygen, pain-relieving gas and a maternity pack for delivering babies.

   For more minor calls a bike paramedic will be sent alone and can request assistance if required. It is hoped the move will free ambulance crews to attend more serious calls where patients need to be taken to hospital.

   Bicycle teams have already been judged a success in saving lives at Heathrow.

   City Cycle Response unit manager Paul Davies said: "More than 300,000 people work in the City of London and their numbers are swelled by the several million tourists who visit the area each year.

   "Using the bicycle gives us an opportunity to save potentially vital seconds in starting treatment, especially in the narrow streets which ambulances have difficulty negotiating quickly."

   (c)2006. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

    

   999 ambulance computer failure putting lives at risk

   Evening Standard (London),  Aug 23, 2006  by REBECCA SMITH

    

   LIVES are being put at risk because of a crisis with London Ambulance Service's computer-controlled 999 system.

   The system, which sends ambulances on emergency calls, has failed repeatedly over the last three weeks.

   To track ambulances, staff have had to go back to using pen and paper - a system last used 10 years ago - sparking fears that people could die in the confusion.

   A shortage of staff in the call centre has compounded the problem.

   At peak times calls are diverted to the Met Police control room, to staff who have no medical training and cannot give emergency advice such as how to start CPR in a patient whose heart has stopped.

   It is reminiscent of a computer crash in 1992 which resulted in the deaths of up to 20 people because ambulances were delayed in reaching patients.

   An insider at London Ambulance Service said: "It has taken us back to the old days of call-takers having to use a London A-Z to find addresses and the allocaters having to try and guess where ambulances were - and who was available and who was not.

   "It has been a nightmare. Patients are being put at risk because when they dial 999 and it's busy, they get through to a voice message and are then diverted to a police call-taker who is not trained to give medical advice.

   "This does not happen every day, only when call volumes are high, but it is now a regular occurrence.

   "When the computer systems crash, the operations centre does not know which ambulances are on emergency calls, or returning to their stations and available."

   When working properly, London Ambulance Service call-takers input details of emergencies into the computer system.

   Then it automatically alerts the nearest ambulance via a screen in the cab, allowing the most efficient response.

   Managers at London Ambulance Service say there is no evidence that patients are being put at risk, that the system only goes down for a short time, and that the pen and paper system works well.

   A spokesman said the main problems have now been fixed and were related to a software upgrade at the end of July.

   "When the system has not functioned normally, we have reverted to the tried and tested process of recording details of emergency calls on paper and then passing information to ambulance crews over the radio system.

   "We are of course very sorry for any distress that may have been caused to patients or those who have called on their behalf. Staffing in the control room has been an issue and covering some shifts during this month have proved problematic," he said.

   This put "additional pressure on our ability to manage periods of particularly high demand", he said.

   "As a result, there have been a limited number of occasions when incoming calls have been diverted to the police for a very short period.

   "This is part of our normal contingency planning and is always in place to deal with surges in 999 calls.

   "Despite these issues, the service is meeting its key performance target of getting to 75 per cent of all life-threatened patients within eight minutes."

   In 1992 health unions said up to 20 people died because of a " catastrophic failure" with a new computer system.

   It led to the resignation of the head of London's ambulances, John Wilby.

   (c)2006. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

    

    

   Home-start paramedics to speed up 999 response

   Evening Standard (London),  Oct 3, 2006  by REBECCA SMITH

   PARAMEDICS will be scrambled from home to answer 999 calls in a bid to speed up response times in London.

   Specially equipped ambulance cars will sit outside the homes of on-call medics to deal with emergencies in their neighbourhoods.

   The scheme is to be piloted in outer areas of London where emergency response times are worst. In a raft of new measures, league tables of each paramedic's performance will be drawn up and those who perform badly will be asked for an explanation.

   The London Ambulance Service is investigating ways to speed up 999 response times before new targets are introduced. Paramedics and technicians-must be on the scene at 75 per cent of all life- threatening - or Category A - calls within eight minutes.

   Currently, the clock starts when the call-taker establishes the address and predicament of the patient.

   But in 18 months it will start when the call is put through the switchboard-meaning the whole process must be made quicker. Among other measures are: . Checking calls are categorised correctly so only the most serious trigger a response within eight minutes. Less- serious cases are not subject to the target.

   . Increasing the number of control room staff dispatching ambulances from seven to 14. Now it takes an average of 23 seconds to dispatch an ambulance.

   Part of this process will be automated.

   . Sending single paramedics in cars to the most serious calls more often.

   They can then request an ambulance to take a patient to hospital if needed.

   Eventually, most Category A calls and all Category B calls will be sent a paramedic in a car in the first instance.

   . Staggering shift start times to prevent a dip in performance when vehicles are being handed over to staff starting work.

   . Identifying individual staff who take longer to reach emergencies or hand over patients at hospital, and finding out why it happens.

   Some frontline workers say the changes are a "Big Brother" approach and morale will be hit.

   Others claim single paramedics in cars will endanger patients.

   But Ian Todd, assistant director of operations of the service, said the changes would mean significant improvements for patients such as heart attack victims, whose chances of survival drop by 10 per cent for every minute's delay in getting treatment.

   Mr Todd said: "By moving the clock start time back two minutes it gives every cardiac arrest patient a 20 per cent increase in their chances of survival."

   He said the move would also reflect a patient's experience of dialling 999 more closely but added: "It is a major change and effectively means we need to find a 25 per cent time saving."

   The service wanted to shave off vital seconds throughout the emergency call process.

   Mr Todd said: "As we move closer to the new clock start we are contemplating becoming much more reliant on cars and solo responders in the first instance.

   "There are many cases where patients can be assessed and treated on scene and then referred to other services without going to AE. We are moving away from the traditional blue light two-crew ambulances responding to all calls, which is very expensive."

   In addition, the service is now at almost full strength and so will be less reliant on staff overtime.

   (c)2006. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

   Ambulance crisis

   Evening Standard (London),  Oct 5, 2006  

   THE LONDON Ambulance Service is having to cope with swingeing cuts to its budgets, and all because other parts of the health service are struggling financially. The NHS in London ended last year almost 168 million Pounds  in debt; this year the figure is expected to be lower, at Pounds 90 million.

   Health trusts and hospitals are being asked to contribute towards cancelling the debt and building up a contingency fund for the future. The problem is that those parts of the health service that have managed their finances adequately, like the ambulance services, have to bale out those that have not.

   The ambulance service - although in credit - has to contribute Pounds 3 million towards the shortfall.

   As a result, it will have to reduce staff overtime, which will be restricted to busy periods, such as weekends, and to limit severely the number of ambulances staffed by a crew of two. Instead, there is to be an increase in the number of ambulance cars, driven by a single paramedic.

   It is right that the NHS should have to balance its books, but the idea of doing so at the expense of emergency services is unacceptable. The service is at the very front line of the NHS, dealing with critical situations very quickly. Cuts in staff overtime may save money but this may turn out to be at the expense of patients during unexpected emergencies outside weekends - the London bombing, which took place during the week, is a dramatic case in point.

   And sending out ambulance cars with a single attendant, rather than proper ambulances, may actually compromise the safety of crew and the soundness of the decisions that are made in emergencies. The service's management is trying hard not to compromise patient care - but this is a cut too far.

   (c)2006. Associated Newspapers Ltd.. Provided by ProQuest Information and Learning Company. All rights Reserved.

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