Ambulance service: this needs to end

[Nichebitch]

Hear me out. My dd6 had an accident at the playground and badly hurt her back - she couldn’t move, couldn’t stand, had difficulty breathing and was in a lot of pain. At some point lips turning blue so we called 911.
And I really get it - they told me that as she could still draw a breath and was not bleeding, we would have to wait, they didn’t think it was a life or death situation. BUT - how is it tolerable to leave an agonising and not able to move small child with breathing difficulties waiting, with orders of not to move her, for over 1 hour. The ambulance never came, she seemed to be able to wiggle herself a bit so we decided to take a cab to the hospital - seen in under 20m. She’s recovering now.
not criticising the ambulance people, that’s not my point. The hospital wasn’t rammed either. But more people need to speak about this because it’s not bloody normal. I don’t know what the solution is nor should I know, it’s not my effing job.

Why is everyone acting like they wouldn't have responded in the exact same way as the OP had it been their child lying on the floor saying they can't move properly and that their struggling with their breathing? We all know children tend to overreact but if my daughter told me she couldn't move or breathe properly (even if she was making it out to be worse than it is) I wouldn't question it I would just go into absolute panic call an ambulance mode.
We are parents & act on instinct, & in hindsight later on think ok maybe it wasn't that bad; but in the moment we don't really stop to question them. I remember when my daughter had a sickness bug I was up all night googling her symptoms and watching her breath incase she choked.

There is NOTHING scarier than a child having a bad accident or being really poorly. OP you coped a lot better than I would have. I agree the ambulance situation is a shambles but the NHS is in dire straits.

I agree that the NHS is in a shambles.
BUT, the vast majority of parents calling 999 will be sick with panic, very understandably so. Many of those calls won’t be a genuine life threatening 999 emergency situation. It is sometimes these calls that delay ambulances getting to people who really need them.
The point is, any child who can get in a cab isn’t paralyzed and likely doesn’t have severe back injuries. Very scarey, very frightening for the child, but not a life threatening emergency

and who will look after them? There is no physical space. There are no nurses to look after them. Unless you want to tip them on the floor then there is no option. Ambulances will offload who they can to the waiting room but otherwise they are stuck

So they make a space, they staff it.

If people can be left sitting in an ambulance for hours they could be sitting somewhere else freeing up the ambulance. The paramedics are stuck because they can't book their patient in. So make a triage area. Let the paramedics take patients into it, hand them over to a triage nurse and get back on the road. Then they can be booked in & assessed Instead of the car park being a massive ambulance waiting room move it indoors. Having an area managed by a couple of staff must be far more cost effective than half a dozen ambulances sitting for 4 hours.

Our local hospital has a similar set up for discharges. They realised doctors were saying people could go home but the process was so slow to actually physically get them out it took hours. So the beds that should be free for incoming patients still had the previous occupant waiting for paperwork & meds etc.

So now, as soon as you get told you're going home a porter comes & takes you to a huge room near the exit. Patients sit there and wait for meds etc. Its staffed by nurses who arrange meds and discharge letters and transport etc. You can be sitting down there for hours but it's allowing essential beds to be freed up.

Something like that when you arrive could be as effective in freeing up ambulances

But who do you think will look after them or even ‘book them in’? We already have a nursing crisis and a&e is one of the hardest areas to recruit to. Our a&e is often staffed to a large degree by bank staff, despite our best efforts. It’s hard to recruit because of the pressure, the staffing issues create more pressure and so on.

A&E sees patients with all kinds of injuries and illness, you couldn’t just ‘drop them off’ in one place. What about infection control issues, safeguarding vulnerable people etc?

There is often no space. Hospitals are often crammed to the limits. Where would the staff, beds, chairs, monitoring, equipment and a hundred other things come from? What about access to toilet facilities? Who do you think is going to pay for all this?

The NHS is in crisis due to decades of underfunding, lack of investment in staff, infrastructure, appalling social care etc etc
You make it sound so easy. The NHS is utterly broken, but fixing it is so much more complicated than you think. It needs addressing on so many levels.

It sounds so simple. It isn’t I promise. I work in A&E. We have tried it. It made things worse.
The discharges absolutely works. But for patients arriving it just doesn’t. A “holding bay” just becomes another treatment space, fills up and makes a bigger A&E with still no movement.

She got into a taxi….

Of course it is an emergency and should have been given priority. The only delay would have been shortage of staff and a back up of emergencies, motorway pile up or similar, but they didn't say that. They seem to come out pretty quickly where I live and the paramedics are first class, they are quicker than the police! From what I have gleaned from the media, the service seems to vary according to the area.

I am so sorry you had such a negative experience, thank goodness your daughter is recovering now but the outcome could well have been different.

Yes, something should be done, it is just not right. Your poor little girl must have been terrified, and you distraught.

They are stretched thin but even if not, it is really risk of death (life threatening) not level of discomfort that is the benchmark for an urgent ambulance. As you managed to get a taxi that likely meant it did not. We’ve had a few hospital trips and they’ve said get a taxi if you can, it will be much faster - and even with an obviously broken leg that is what we did, with some help from a neighbour. It must have been scary but hopefully on mend soon.

I do wonder whether some sort of field hospital set up in the car park would be better than this.
Both shit, and less than we deserve but at least thus would free up ambulances to attend the next call?

There will be a diversion system for people who get numbers mixed up or become brainwashed by medical reality shows from different countries. Where I am people can call 911, 999 etc and it all auto diverts to our emergency number which is neither of those. It’s a safety net system which the UK would also have.

Of course it needs to change. The system is utterly shambolic.

My Mum's elderly friend had to wait 8 hours for one after having a fall. She was on the floor the entire night because they couldn't send an ambulance.

😞

So she managed to get into a taxi, it was not life threatening there are people that had more priority

There is not endless ambulances available everytime someone calls one

Same as how many people in A & E need to be there over others, and people complain how long they have to wait

For those saying she got in a taxi - have you spotted that it was only after over an hour that she was able to wiggle a bit? Was the OP supposed to wait an hour to seeing her apparently paralysed child recovered any movement before phoning? Would you have?

My friend retrained as an ambulance officer - they are poorly paid.

Honestly - after being in a car accident where my friend became a quadriplegic - it’s common knowledge not to move head injuries, if they’ve broken bone and move they can damage neck nerves forever. This mum felt she had no choice after an hour not she was ok in a cab so it was not a ambulance trip - seriously why everyone wants to pile on this mum I have no idea she called an ambulance because her children lips were blue which is a sign of lack of oxygen!

@NewName24 peopel have a tendency not to listen to frontline staff. I quit A&E because in part the workload and expectation is too much. Wards have slowly been closed down leaving less space for people in A&E. Social care is poor which leaves them on wards, this means in turn no beds for A&E. So A&E becomes a ward instead of emergency department. Those who meed cubicles then lie in them for potentially days. So where do the ambulances go? There are still people walking in the door also needing cubicle. Either the ambulance is kept until there is space or they wait until they can’t and leave the A&E looking after more patients than can be safe to. They need more staff, more room and better social care and the public needs to look at the way they use the services. Not eveyone needs A&E or their GP, i was amazed by how many would go to A&E and have done nothing for themselves. It’s also become a just in case service as well. Its not surprise its buckling.

Sadly it's been the case for a good number of years. My DH had a heart attack and an ambulance was called. Luckily his GP was with him and asked my Mum to chase up the ambulance - she was told it wouldn't be there for a while as the next one was still on another emergency. They arrived, but too late.

From what the OP describes there was the potential for a spinal injury. Picking the kid up and putting her in a taxi obviously had the potential to really damage her further and possibly permanently. Obviously with hindsight we know that didn’t happen but nobody knew at the time. The ambulance service didn’t know at the time that the kid didn’t have a broken back.

Re the number: All generally known emergency numbers are programmed in the uk to divert to 999. You can dial 999, 112 or 911 and you’ll get there.

Ambulance requests are triaged - they come as soon as they can but if you can breathe and are in immediate risk of dying you are not the priority, you are category 2 in your DDs situation and as such are in the queue with the other cat 2 people including others with possible spinal injuries. So would you prefer someone in a more serious situation to wait instead?

Ambulances are finite. Be honest, if you had a car would you have driven her? She wasn't admitted from what you said so I'm guessing the triage team got it correct.

In an ideal world we would have more ambulances but back in this world they are managed to get to the most urgent first and always has been thus, I remember waiting 90 minutes 20 years ago when my sil fell and whacked her head, she was kept in too.

I’ve phoned an ambulance twice, genuine emergency, patient not breathing, first one got there in 3 minutes, second one in 7 minutes.

Maybe they could tell your DD wasn’t an ambulance emergency? Did they ask lots of questions, such as height of fall, position, any other symptoms or loss of feeling? Etc etc. I’m sorry it happened to you, but it seems the ambulance service made the right call.

I hope she’s on the mend now, did they need to treat her? Kids do tend to bounce back so I hope she’s ok.

If it were only so simple.

Hospitals already use corridors and any available rooms as make do corridors.

We ve less staff per head of population than any other european country.
..

We voted for this, in 2010, AE ambulance and healthcare targets were all being met, not perfect by any means but healthcare worked.

Now an estimated 14000 died last year because of poor AE treatment... its all on our voting choices.

The NHS is completely fucked, people regularly die waiting for ambulances or in corridors waiting for a bed, it's absolutely disgusting yet the government still aren't doing much about it (yes I know they haven't been in for long, but they don't seem to have any decent plans). There are things they could do immediately- despite the nursing shortage there are hardly any band 5 jobs this year due to budgets, so many NQNs are struggling to find work which is literally insane.

OP you did the right thing by calling an ambulance, and you're right to be disgusted by the lack of response. We should all be disgusted that the health service isn't functioning currently and anyone poorly enough to need to access it is subject to the roulette wheel of chance.

Yeah, it’s so commonly heard on shows some people can think it’s the correct number. Even if it’s only kids thinking that it made sense to add it.