You’d think that when you are in trouble and an ambulance is called it would arrive quickly and take you to the nearest hospital for you to receive treatment. It would seem reasonable that the time it takes for the ambulance to arrive is measured and perhaps that there is a target set to judge performance. Well there is. There is a national target that an ambulance will respond to 75 per cent of all life-threatening calls within eight minutes. Why eight minutes and why only three quarters I have no idea and I’m not sure if any recognition is given to the time it takes for the phone call to be made either.
But there is more to this story. Ambulances today are staffed by highly trained paramedics and so the treatment starts as soon as it arrives on the scene and it is a good job too as there is often a significant delay in getting the patient into Accident and Emergency. In December, in the North East area, ambulances with patients inside them queued outside the hospital for more than an hour 733 times and over two hours 87 times. And at one hospital there was even a queue of 14 ambulance waiting in a line to be addressed.
So what is causing the problem? Several possibilities have been highlighted including hand-over delays, a shortage of hospital beds, a lack of frontline clinical staff, a rise in the number of emergency calls and the effect of winter. The problem is also being made worse by an increasing number of ambulances being diverted from one busy hospital to another.
But there is only really one problem, obvious after the event. The number of beds is known, the amount of frontline clinical staff available is known and winter comes around each time this year. What is clear is that the resource available is not matching the demand within the system. Thankfully NHS management has recognised this and a conference has been held to look at the problem from a whole-systems view. More money has been made available for more doctors, more nurses and action has been taken to ensure only genuine emergencies are responded to. (I had assumed that only genuine emergencies would be taken to the hospitals and so this must be a red-herring.)
Despite all of this, management appear to be confident that they can meet the 75% / 8 minute target in the next few months even though this will not solve the problem of vehicles and patients being made to wait outside A&E. The two issues are not necessarily related. What hasn’t been recognised is that the problem may well be exacerbated by focussing on a narrow (and apparently arbitrary) target on only part of the system. Perhaps more money should be made available to look into the real causes of the backlog.
Thoughts from a Guerrilla Worker 