Why are 999 call handlers like this?

[NotADailyMailJournalist]

Hello

I came across a man collapsed and bleeding heavily from a head wound in the street today. Literally a thick puddle of blood. I slammed a folded, fabric shopping bag on the wound to stem the bleeding.

Me: Hello, I've found a collapsed male, conscious but with heavy bleeding
Call Handler: what age is he? Do you know his name? Did you see him fall?
Me: 60-ish maybe, not sure on name, Davie he says, maybe, no I didn't see it happen. Is the ambulance on its way?
Call Handler: YOU NEED TO ANSWER THE QUESTIONS, LISTEN TO ME! Further questions about when did this happen etc etc.
Me: he's very distressed, can I tell him the ambulance is coming?
Call Handler: FINALLY says ambulance is on way.

Speaking to friends, they say this is common. Why can't the call handler just say "it's ok, ambulance is on way, answer these questions in the meantime"?

Thanks

They need as much info as possible so when they get there paramedics know what to expect. Also need to know if they need police backup. If the patient is violent or if they have been attacked. As well as if you think they may have overdosed and need the drug to reverse the affects.

Yes, this.

I'm happy to accept that there are plenty of questions that, to an ordinary untrained person, may seem stupid but actually are well-thought-out and have a very useful purpose; however, some of them are just clearly stupid and pointless.

Kind of like the 999 equivalent of when you call your deceased family member's utility supplier to notify them of their death and they insist that they have to speak to the named account holder first.

I realise that it's an extremely high-pressured environment for those working in it, and they're only human.

I think the problem is that, whilst you have the idiots quite cheerfully calling 999 because they've cut their finger or stubbed their toe on the side of the bed, at the other end, you have those like some of the people on this thread who have called for genuine serious emergencies and been left wondering why they bothered.

My understanding is that What 3 Words is a private company; it wasn’t a government effort to map the globe

So even when posters have explained clearly why the call handler is asking the questions they are, you still feel you know better?

The creator was on R4 this week explaining his personal reasons for setting it up - he was involved in getting musicians and equipment to music venues, but to the stage door rather than the front door.
The 3m x 3m size was chosen because there are a similar number of permutations as there are squares. Many emergency services us it because postcodes (in the UK) relate to aproximately 20 properties and in some rural locations there are difficulties ascertaining which side of the road/river you want. Additionally (from personal experience), the 'house number and postcode' sequence suggested by the police for marking bicycles etc may not be unique - Number 6 Smith Street, may share a postcode with Flat 6, Smith House, Smith Street.

I was listening to 'Its a fair cop' on BBC sounds which is police officer who does stand up about his life as a cop. He told about going to a scene where a dog walker called the police after finding a disembodied head in a bush. I cant remember all the ins and outs of the authorization process, but the police officer had to call the ambulance to come to the scene and was asked if the victim was breathing.........

Also sometimes you have to drag the info out

I've had a woman ring for a cut finger who forgot to mention the sucking chest wound

You have people who when you ask what the problem is start with "so he had his breakfast, but he wasn't very hungry, he only had one piece of toast which isn't like him. Anyway in 1999 he had a heart attack"
(Have to interrupt the story)
"Ok so what's wrong with him right now?"
"Now? Oh he's stopped breathing"

It's important to clarify because a crew responding to a red call travels on lights and sirens and puts themselves and other road uses at risk. I'm surprised a call was made to Ambulance for this - it should be a GP/Police doctor then funeral director. The Police probably thought it was quicker to get a paramedic to certify death (they can) rather than wait for a police surgeon or local GP.

Yes, it was to do with certifying the death - thanks, my memory was a bit patchy and the bit I remembered was the obvious script and him being asked if the head was breathing.

Am I allowed to call you an idiot? Do you think the call handlers just type what you are saying into a box and that is it? Of course not - they have questions on their screen that come up and need to be answered in order that the despatch team (not necessarily the person who is handling the call) can decide whether and what to despatch to the incident.

I had a shocking experience with them. I had fallen in my local village, in the pouring rain, and had clearly broken my wrist. It was bent. I also suspected I had fractured a vertebrae as I had done previously and the pain was exactly the same.

They were spectacularly unhelpful, not least because I had a gang of drunk spectators who had emerged from the local pub all weighing in.

They refused to triage more than one injury and insisted I had confirm which was the worst and refused to proceed until I had. They would not accept that without an xray machine I could not confirm that or that I was clinically skilled enough to decide whether a broken back or broken wrist (that likely needed surgery) was the worst. Eventually, to crack on I said the wrist as the pain ramped up.

They spoke to me as though I was semi literate and refused to take account of the suspected broken vertebrae trying to insist that I could lever myself up and get into a car and didn't need an ambulance. If I had had only a broken wrist I could have done but I didn't but they refused to listen. I was told a clinician would call back they didn't.

After 45 minutes a bystander rang again. I went through all the same questions (I assume they can't read the notes already taken) still insisting I should get into a car. When I made a fuss I was told that if I was in pain I should go to a pharmacy and get some paracetamol. When I pointed out that I couldn't get up or walk I was told to Google the nearest pharmacist and speak to the pharmacist. Not particularly helpful and clearly the person I was speaking to had not listened to a word I had told him. This was an individual who, when I asked if he would please help, told me that saying please wouldn't get help any faster! He said a clinician would ring. They did eventually.

The clinician went through, for a third time, all the same questions, tried to insist I get in a car because an ambulance wasn't necessary because they could only advise in relation to the worst injury. When I noted that there was also a suspected fractured vertebrae they were dismissive. The standard of service was atrocious and shockingly they actually said "yeah so atrocious you get free ambulances in the UK"

2.5 hours after falling and having been in the pouring rain an ambulance arrived. The crew confirmed an ambulance was absolutely required and tanked me with morphine. I did have a fractured vertebrae and my wrist was pinned and plated 48 hours later. The jagged edge of the bone was one mm away from the median nerve.

When I was sufficiently recovered I made a formal complaint. The tapes were listened to and a full apology ensued.

The call handlers were utter jobsworths unable to process information or exercise empathy. They were dismissive and unhelpful. With hindsight I should have called the police to ensure my safety vis a vis the assembled hoi poloi and drunks.

It was an utter disgrace. This was nearly three years ago and I have never felt so scared and so vulnerable.

It's a misuse of the ambulance service by the police. There is a lot of passing the buck to other services - everyone's under pressure, sadly.

I think in your situation op you desperately wanted to rush the phone call assuming that would speed up an ambulance being despatched.

If you listen to examples of 999 calls online, the first things the caller says are often garbled, panicked, spoken at high speed with background noise and interrupting to repeatedly to ask for an ambulance.

It would be dangerously unprofessional not to be asked to go through the details again more calmly. That’s not a call handler being “cold” or “unmoved”. They have to take control of the conversation.

In fact the operator asked some pertinent questions and you had an ambulance within ten minutes.

It sounds like a frightening experience for you and I expect those ten minutes felt like a lifetime where you felt alone and responsible for a man with a serious injury.

You coped well, did the right thing and it’s natural to feel all sorts of emotions afterwards.

Dont beat yourself for “getting in a flap”. It sounds as though you were admirable in a traumatic situation x

Just wow.

Sometimes I'll take a call and think it should be a high priority and the dispatcher will disagree - I will then ask even more questions of the caller, amd although it may seem it's delay the response, I'm actually trying to get as much info as possible to justify upgrading it to get help there faster.

Maybe that system then needs to change to be more fit for purpose? If a question is impossible to answer, the injured person shouldn't be left stuck because of an overly rigid computer algorithm.

So that ambulance might have been on another job, they're not sitting parked up waiting for you to call

I had a similar experience with the triaging where the call handler couldn't/wouldn't look at multiple symptoms and insisted that I triaged what was the most concerning symptom. We'd found a woman collapsed, in and out of consciousness, cold, bag full of empty medicine packets and unable to answer questions about who she was or her medical history, vomiting and incontinent, floppy. How is someone not medically trained supposed to pick one of those symptoms as the "most concerning"?

"Are they on any medications?"
"I'll ask them" <goes off and returns> "They say they're on XXX".
"Are they conscious?"
"Well they're answering my questions!"

Cool story bro. Except that the algorithm doesn't ask about medication before level of consciousness.

I'm really sorry, OP - I realise that this was an incredibly stressful experience for you, and it was very kind of you to stop and help - but they can't just send an ambulance because someone's phoned up and asked for one these days (if they ever could). Those questions don't seem unreasonable to me. I'm sorry if that sounds unsympathetic.

I think you’re putting too much trust in the general public OP. You might be more clued up than the average Joe. Honestly after working with the public I’m shocked a 999 caller doesn’t have to explain what breathing / bleeding to some people.

Call handlers have an unbelievably difficult job. It's "just reading off a script" and "anyone could do it" until you're talking someone through CPR or having someone tell you they know where you work and they're going to come and wait outside and rape you after your shift, and you've still got to be polite and stay on the phone with them. It's absolutely not a job anyone could do, and that's why the turnover is so high, and that's why many call handlers are inexperienced - they're often very new to the job.

I don't know if it's still the same now, but their training is woefully short. When I started in the mid 2010s, we had 4 weeks of training and 4 weeks of mentoring. I then became a trainer, and during COVID, I was given the job of condensing the training into 2 days. I tried to argue against it but I was ignored, so I had to do it. I remember delivering the condensed training and thinking that people would die as a result, and I've no doubt that people have done.

Call handlers do the best they can in extremely challenging circumstances. They don't send the ambulances out (dispatchers do that), they don't decide the grading of the call (the system does that in relation to your answers to their questions), they can't control the amount of training they had (the service decides that, and at least one of the NHS ambulance services has let their call handlers down massively on this front). They control their emotional response to your call, but they're often new and terrified of getting things wrong (audit is seen and portrayed as a punitive measure, not the support it is supposed to be) or apathetic and desperate to get out of the service.

It doesn't make any of it right for patients, but the blame does not lie at the feet of the severely underpaid, overworked call handlers.

I know why. I'm sorry if my sarcasm was too on the nose, but the sentiments are honest, genuine, and shared among many.

Due to the unique way in which the healthcare system is funded and run, even emergency medical treatment is rationed, and, owing to the definition of a medical emergency being vastly different from person to person, the service has to contend with serial abusers of the service and outright idiots.

I am fully aware of the why, I'm just highly critical of the why. As I said, I've thankfully never been in a situation to call an ambulance, which would also imply that I know what an emergency is. Although with how long it takes for an ambulance to reach emergencies nowadays, I can understand why people prefer to take matters into their own hands and make their own way to A&E.

And do you think the crew were just sat in it, waiting for a gentleman to have a huge stroke in front of you??