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

Surely it's possible to have a script but also yo allow a certain amount of flexibility in it, for common sense. This could be built into the algorithm.

Take finding someone dead for example.
Couldn't the call handler first ask how they know the person is dead. If they are told it's because they've only found a head, or the body is very badly decomposed, then they aren't asked to check breathing or attempt CPR.

Likewise, if a person says that they don't know the person/are a passer by to soccer unconscious, then the set of questions asking about their medical history should be skipped and I've asking for sex and an estimate of age instead.

It sounds from a lot of the posts on here, that some callers are SO welded to their script that they don't actually listen to the answers.

They need the information and quite often people are panicking when phoning 999, which is understandable but time is of the essence, a minute reassuring you is a minute that they're not guiding you to potentially save someone's life, or offer immediate first aid that can have a massive impact on severity and recovery. It's also an extra minute they're on the phone to you when there could be someone else waiting for them to answer with another emergency.

As another pp said, it's an emergency services dispatch, not a customer care line. Service in that sense doesn't come into it, they're not there to massage your ego or make you feel special, heard or listened to, they're there to get help to the people that need it the most as quickly as possible.

If I came across a random unknown situation I would want to call for help but no more. I am not the help. I'm not able to assess whether a person is breathing or stem bleeding. I have posted about how traumatic it was for me when it was my own relative and I wasn't even inside the house, I could just hear they needed help. So while I wouldn't want to call an ambulance and 'bugger off', I have to prioritise my own mental and physical health ongoing so of i can alert the services to someone who needs them I would always do it, but anything else isn't within my abilities.

@Blondiebeachbabe

I have a lot of respect for people like your husband. I watch all the tv documentaries on emergency workers.

It must be such a difficult job.

My DH collapsed last Saturday and hit his head and was unconscious in a massive pool of blood our friend rang for an ambulance, it arrived in 15 mins. We were in a small village a fair distance from the nearest big hospital. I told a police officer I know and he said would have been graded a category one as DH was unconscious and unresponsive.

DH is on the mend now after a very short stay in hospital but for a while I was worried I was going to be widowed. I have felt ok till the last couple of days and now feel mentally drained and a bit weepy.

I think you have to put yourself in the seat of the call handler. They have to make life or death decisions based on what an anonymous voice on a phone is telling them. The person on the phone could be hysterical and over-reacting OR they might equally not appreciate the seriousness of the situation they're in.

Call handlers are detectives and they presumably have to ask seemingly stupid questions in order to establish if this person who's been 'shot in the chest' has been blasted with a sawn-off shotgun or just poked really hard with a blunt object. The answers are going to determine how quickly the person receives help.

I'm not a call handler (don't know either!!) but from what I can see on TV, it seems like a really tough, stressful job trying to work out what's really going on, based on just what a panicked person is telling them. I'd honestly cut them some slack!

They follow an algorithm and its not always logical to follow. Like on the news telling relatives of palliative care patients with a DNR to do chest compressions on a final stage cancer patient during covid. I'm no medical expert but I found someone cold, blue and stiff I wouldn't do cpr whatever 999 said to me for example.

If you didn't see him fall and can't say why he was on the floor likewise I'd be firm.saying I wasn't there. I can't tell you that.

I heard someone being hit by a car with force and went out into the street to see a man on the floor on the other side of a dual carriage way. All I could tell them was what I knew. He had Bern hit at 30 plus mph. He wasn't moving. I couldn't cross the road to help him. Others had stopped their cars and got out. That was it. Without running across the busy 60mph road and voting the barrier I couldn't do more.

Sometimes you can't comply completely to the questions.

but if I found someone cold, blue and stiff I wouldn't do cpr whatever 999 said to me for example

I wouldnt either. Its pointless and distressing.

Unfortunately the nature of the job, the stress and the physiological impact of doing it daily means many call handlers become completely emotionally detached from your situation.

They cope by sticking to the script in front of them and ignoring any conversation outside of that.
That comes across as cold and un empathetic.

Add to that the deluge of prank callers and mentally unwell people that need to be filtered out.

My sister left her job on the 111 night shift because over 50 % of the calls were men masturbating down the phone and NHS policy is to not terminate the call until the set questions are answered.
She found it quite traumatising.

It must be one of many reasons call handlers are very curt/ impatient and robotically run through the script to protect themselves.

I did this job 15 years ago (999 ambulance call handling) - I'm assuming it's not changed too much. They have a script. Questions appear one by one. You can give them all the information in one sentence but they cannot record it like that you have to answer the questions asked before the system moves to the next one. They work 12 hour shifts. You will get more than one CPR call in a shift - sometimes 2 or 3 in a row. There were hoax calls, time wasters, historical callers, callers with little to no English - you have to get the same information from each. And often then there was no time in-between calls to just take a few minutes to reset. I imagine it's worse now.

Oh I hate them. Absolutely no urgency whatsoever!

and too scared to deviate from their script. 111 are the worsttttt for it!!!

Agree with @Mercury238
Lets have some empathy for how fucking difficult and physiologically gruelling a call handler’s job is. Particularly when they are faced with thousands of calls and a shockingly limited number of paramedics and ambulances to go round.

The 999 folks need the information in order to decide whether you need an ambulance. I understand your bemusement about this, but sadly many people do misuse the emergency services, or don't use them appropriately.

e.g. Ambulance for minor injury or illness - yes, people do request this, plus there are hoax calls, calls that should really go to somewhere else, e.g. local council, etc. There are limited resources so there needs to be a system.

Sometimes its the opposite, though. e.g. Older person genuinely needing help, but they sometimes underestimate their needs because they don't want to cause a fuss. The call handlers need to assess whether an ambulance is needed.

Trust the process. They’re asking questions for a reason.

they won’t say an ambulance is despatched until they can guarantee that one’s on its way.

Honestly some people wander through life looking for reasons to be offended.

I agree, but also, some empathy for someone who has suddenly come across a horrible emergency situation right in front of them and has no idea what to do. The call handler is at work and knows what is coming, for a person coming across a stranger bleeding to death for example they werent expecting that at all and are probably in shock.

Sorry I’m with the handler here, they do need to know detail.

When I rang for my baby not breathing she said IMMEDIATELY she was sending an ambulance and then asked questions.

it was because of the question asking we not only got the bike (which got there quicker), but then an ambulance and a Dr.

I suspect they are not actively listening and selected the wrong questions to ask.

They rule out airway and consciousness.

Can you tell me what happened?
"I've found a man covered in blood - there's so much blood" ought to get them clicking the right buttons.

Describe the amount of blood as something you can compare to to give them a visual.

I wonder how much training the telephonists get?

established system that operates for a reason

Exactly. Complying with the initial questions takes less than 2 minutes and works to prioritise all the hundreds of emergencies they are dealing with.
An ambulance being dispatched every time a panicked caller starts with I need an ambulance now! would have devastating consequences.

It also filters out the high volume of prank callers and patients needing mental help.

I’ve had to call twice, for the same thing ( DSis, bleeding heavily). I found the process of answering clear questions as clearly as I could very calming. It made me feel that a process had been instituted which was going to help, and was taking matters out of my ( inadequate) hands.

I’ve also had to report a death to the emergency services in unexpected circumstances , the person was clearly dead ( stiff and cold). I just asked for the police at the first question: ‘which service’, as it was obvious that no ambulance on God's Good Earth was going to be able to reverse the process.

All three times I found the response exemplary

@VolvoFan

Ridiculous, ignorant comment.

There is zero emotional intelligence built into the call handling process. The system is set up with a patronising ‘we know best’ mentality that doesn’t consider the best way to interact with the person phoning in, so it doesn’t get the best response from them.

OP you are right, if they said ‘we are informing the ambulance now’ then asked the pointless questions it would engender more trust and respect and get a quicker response all round.

IME it all feels very passive and ‘computer says no’, not at all calm and reassuring.

I do see your point.

Unfortunately experienced call handlers are emotionally detached as a coping mechanism. They find working methodically and almost robotically is the only way to get through a 10 hour shift without breaking.

Not the point, but @LetsGoRoundTheRoundabout - I have seen this job advertised locally, and even though it’s a pay cut am considering it as it really appeals and I have wanted to change my career.

why don’t you do it anymore?

The ambulance service in this country is horrific. I’ve had so many traumatic experiences. One of the most ridiculous call handler experiences though was when my mam had a bad fall in a holiday cottage. she called the ambulance, could tell them the address, village, landmarks, name of holiday cottage (which had a website) etc but not the postcode. She was in too much of a state and pain to look it up. The call handler point blank REFUSED to send an ambulance without the postcode and they wouldn’t just look it up themselves to help the injured person get help faster. Instead she had to wait for a family member to drive there and take her to hospital.

Whole thing is bizarre.. so essentially unless you need the ambulance to come to your home or somewhere you know the postcode off by heart you’re stuffed!