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Ambulance service: this needs to end

153 replies

Nichebitch · 28/09/2024 23:48

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.

OP posts:
Garlictest · 29/09/2024 07:45

Alexandra2001 · 29/09/2024 07:34

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.

Edited

People moaning - quite justifiably - about emergency, health, social care and education services probably moan about taxes, too.

Can't have more unless we pay more.

@Nichebitch, did you cancel the ambulance after deciding to get a cab? Hope DD's on the mend.

sashh · 29/09/2024 07:46

Nomorecoconutboosts · 29/09/2024 00:05

I understand your point OP - I hope your dd is much better I was glad to see on your post she is recovering.
(those querying 911/999 - either a typo or OP not in UK but didn’t really make a difference to understanding the post - I was more focused on a mum who has recently had a worrying situation with a child)

It is a long wait for an ambulance, I’m a HCP and have had to call ambulances for genuine emergencies, sometimes the wait is hours. Not sure what the answer is other than major policy changes.
There’s enough staff to cope with the high number of calls, and at times they have to wait outside A&E. Perhaps in some cases an ambulance isn’t strictly needed but I’m not sure how that could be addressed.

But it does make a difference because it matters where she is. If she is complaining about the US ambulance service then that is different to the UK.

DanielaDressen · 29/09/2024 07:46

Yes, people talk about struggling to find staff and I don’t think realise there’s currently a lot of unemployed nurses and midwives who can’t find jobs. The hospitals even have vacancies but can’t afford to fill the vacancies. It’s truly insane.

sadly though it’s likely to be a temporary issue as recruitment for nursing and midwifery degrees has fallen off a cliff, especially nursing degrees. A combination of poor pay and conditions is now putting people off, though hearing about the potential for being unemployed won’t help. So in a few years time when more current staff have left there will be a massive gap.

things are going to get significantly worse.

LovedFedAndNoonesDead · 29/09/2024 07:46

To the people saying there should be a waiting/holding/triage area where ambulances drop off patients so they can get back on the road and be available for the next person; this is what happened in this situation from a patient’s point of view.

Had a GP appointment as, despite 3+ weeks of treatment from our surgery, I was still clearly unwell - wheezy, unable to talk in sentences due to shortness of breath, coughing; had been told over the previous weeks that it was a viral infection, a chest infection, exacerbation of asthma and all 3 at the same time; I was treated with antibiotics, steroids and increased use of inhalers. GP that saw me on that particular day decided that I needed nebulisers instead of inhalers, needed an X-ray and possibly needed admission to hospital. They called for an ambulance (I said I would drive myself but was told I was clearly too unwell and needed the care a paramedic team could provide for the 1 hour journey to our nearest A&E) and it took almost 4 hours for one to get to the surgery - during that time I was not left alone at any point, either a GP, once of the surgery paramedics or their advanced nurse practitioners was with me all the time monitoring me, giving more medication and making sure I didn’t deteriorate.

Once at A&E, I was one of the “lucky” ones allocated to go to the “ambulatory care area” - instead of waiting in the ambulance in the car park - literally a waiting room that was designed for 45 people but already had approximately 75 people in there all waiting for triage, investigations, care and potentially admission. Some people had been there 12+ hours waiting for scan or blood test results. Many people were on the floor as there were not enough chairs and nowhere else for them to sit; as soon as 1 patient was taken through to another area for an X-ray or blood test, the chair was filled with the nearest person able to get up from the floor - or a relative of someone waiting to be seen. There were many people coming in to A&E under their own steam and being told it would be better to wait until 8am and go to their nearest walk in centre/minor injuries unit as they would be waiting up to 24 hours before they got any treatment if they stayed where they were!!

I was in that area for over 16 hours alternating between a wheelchair, a metal chair bolted to the floor or even the floor itself. Nurses were
doing their best to trriage as many of those people as they could but they simply couldn’t manage the number of people they had to care for, do observations on, administer medications to etc - the nurse who triaged me was glad I had an inhaler and spacer in my bag and told me to simply give myself 10 puffed every 2-3 hours as needed until someone could get to me; I was offered paracetamol but it took 6 hours for anyone to bring them to me! Swabs for flu, RSV and Covid (I had already done a home swab for Covid which was negative), blood tests and initial care all happened in that waiting area apart from going to X-ray and into the next waiting area to be seen by the Dr.

Anyway, I was diagnosed with influenza A and told that really, I needed to be admitted to hospital for care as I was dehydrated and clearly unwell but, as I did not need BiPAP or ITU care, they were discharging me home with instructions “to rest and get well” because they simply did not have any beds to admit me to. I was told to get some dioralyte and more paracetamol and to drink as much as a I could, was given 2 new inhalers and told I could leave.

I had to call a taxi to get home as the only alternative would have been 2 buses that took over 2 hours from the hospital to where we live, plus had been told not to use public transport because of being diagnosed with flu. And then had to retrieve my car from the GP surgery car park before finally arriving home well
over 24 hours after I had left, having had no sleep and little in the way of food or fluids while I was gone. It took me another 5-6 weeks to be back to my usual levels of health.

So, while it’s a grand idea to suggest creating a drop off & triage/holding area for ambulance patients to wait for beds/treatment, it simply becomes yet another overcrowded dumping ground for patients waiting to be seen, diagnosed and treated before being told the hospital simply has nowhere to put you so off you pop home to recover by yourself!! Plus, it was woefully understaffed with just 3 nurses seen from the moment of arrival to when I was given the discharge meds and the basics such as toilets - 2 between 75 people, you can imagine the state they were in despite a housekeeper going round every 4-6 hours with a cart to empty bins and sweep floors 🤮🤮 and seating were also inadequate for how the area was being used!!

IDontHateRainbows · 29/09/2024 07:53

LovedFedAndNoonesDead · 29/09/2024 07:46

To the people saying there should be a waiting/holding/triage area where ambulances drop off patients so they can get back on the road and be available for the next person; this is what happened in this situation from a patient’s point of view.

Had a GP appointment as, despite 3+ weeks of treatment from our surgery, I was still clearly unwell - wheezy, unable to talk in sentences due to shortness of breath, coughing; had been told over the previous weeks that it was a viral infection, a chest infection, exacerbation of asthma and all 3 at the same time; I was treated with antibiotics, steroids and increased use of inhalers. GP that saw me on that particular day decided that I needed nebulisers instead of inhalers, needed an X-ray and possibly needed admission to hospital. They called for an ambulance (I said I would drive myself but was told I was clearly too unwell and needed the care a paramedic team could provide for the 1 hour journey to our nearest A&E) and it took almost 4 hours for one to get to the surgery - during that time I was not left alone at any point, either a GP, once of the surgery paramedics or their advanced nurse practitioners was with me all the time monitoring me, giving more medication and making sure I didn’t deteriorate.

Once at A&E, I was one of the “lucky” ones allocated to go to the “ambulatory care area” - instead of waiting in the ambulance in the car park - literally a waiting room that was designed for 45 people but already had approximately 75 people in there all waiting for triage, investigations, care and potentially admission. Some people had been there 12+ hours waiting for scan or blood test results. Many people were on the floor as there were not enough chairs and nowhere else for them to sit; as soon as 1 patient was taken through to another area for an X-ray or blood test, the chair was filled with the nearest person able to get up from the floor - or a relative of someone waiting to be seen. There were many people coming in to A&E under their own steam and being told it would be better to wait until 8am and go to their nearest walk in centre/minor injuries unit as they would be waiting up to 24 hours before they got any treatment if they stayed where they were!!

I was in that area for over 16 hours alternating between a wheelchair, a metal chair bolted to the floor or even the floor itself. Nurses were
doing their best to trriage as many of those people as they could but they simply couldn’t manage the number of people they had to care for, do observations on, administer medications to etc - the nurse who triaged me was glad I had an inhaler and spacer in my bag and told me to simply give myself 10 puffed every 2-3 hours as needed until someone could get to me; I was offered paracetamol but it took 6 hours for anyone to bring them to me! Swabs for flu, RSV and Covid (I had already done a home swab for Covid which was negative), blood tests and initial care all happened in that waiting area apart from going to X-ray and into the next waiting area to be seen by the Dr.

Anyway, I was diagnosed with influenza A and told that really, I needed to be admitted to hospital for care as I was dehydrated and clearly unwell but, as I did not need BiPAP or ITU care, they were discharging me home with instructions “to rest and get well” because they simply did not have any beds to admit me to. I was told to get some dioralyte and more paracetamol and to drink as much as a I could, was given 2 new inhalers and told I could leave.

I had to call a taxi to get home as the only alternative would have been 2 buses that took over 2 hours from the hospital to where we live, plus had been told not to use public transport because of being diagnosed with flu. And then had to retrieve my car from the GP surgery car park before finally arriving home well
over 24 hours after I had left, having had no sleep and little in the way of food or fluids while I was gone. It took me another 5-6 weeks to be back to my usual levels of health.

So, while it’s a grand idea to suggest creating a drop off & triage/holding area for ambulance patients to wait for beds/treatment, it simply becomes yet another overcrowded dumping ground for patients waiting to be seen, diagnosed and treated before being told the hospital simply has nowhere to put you so off you pop home to recover by yourself!! Plus, it was woefully understaffed with just 3 nurses seen from the moment of arrival to when I was given the discharge meds and the basics such as toilets - 2 between 75 people, you can imagine the state they were in despite a housekeeper going round every 4-6 hours with a cart to empty bins and sweep floors 🤮🤮 and seating were also inadequate for how the area was being used!!

I don't doubt that was a horrendous experience. But , lesser of two evils, doesn't it let the ambulances go to the next call where they may be able to save someone who would otherwise have died?

RamonaRamirez · 29/09/2024 07:54

How is your child OP? Are they still in hospital? Hope she is ok and you too

You said she was paralysed but then you moved her to your car, so hopefully she was not paralysed?!

(If you think someone has broken their neck or back please know you should not move them at all , for future reference )

Happii · 29/09/2024 07:55

A huge part is to do with liability, once the ambulance hands the patient to hospital care they're responsible, and they don't want to be until they can provide any sort of level of care.

LlynTegid · 29/09/2024 07:55

What the OP highlights is the result of long term policies towards the NHS, which has led to the ambulance service having to make decisions that are not what anyone with a conscience would want.

Not a surprise sadly.

withalittlebitofhelp · 29/09/2024 07:59

It is awful. My mum had a fall (she’s late seventies) in a car park and was left on the floor for FIVE HOURS with cars etc driving around her.

Hotsweatymumsspagetti · 29/09/2024 08:03

It’s not just ambulance services all NHS services are below par at the moment. I won’t trust doctors ever again after I lost my pregnancy thanks to the lack of care. It’s not the staff members fault in some ways it’s the funding / training. Although one GP in particular I will always say no training could make them a better doctor

MSLRT · 29/09/2024 08:04

Nichebitch · 29/09/2024 00:41

It doesn’t work like this in other countries in Europe where health care is also free. In the UK there’s this strange conviction that because is free we it’s all good and that’s the only way it can be.

I don’t think health care is free in many European counties. Most require a bank card or insurance details before they treat you.

LovedFedAndNoonesDead · 29/09/2024 08:06

IDontHateRainbows · 29/09/2024 07:53

I don't doubt that was a horrendous experience. But , lesser of two evils, doesn't it let the ambulances go to the next call where they may be able to save someone who would otherwise have died?

Yes the ambulance could leave - where were they supposed to take the patient that they went to?

The biggest issue at the moment is having nowhere to discharge patients to when they no longer need medical care. Social care doesn’t have the staff to provide the complex care needed by many people on discharge and many care homes that take socially funded residents are full so, unless you can afford £1,000+ a week for private care homes, you end up blocking a hospital bed until a solution is found. Also, having spent best part of a day in a discharge lounge waiting for meds etc, they were full of people who did have somewhere to go but, while waiting, needed at least 2 members of staff for transfers, assistance to use the toilet, to be fed etc. so there were as many staff in the discharge lounge as there were on the ward but working in a waiting area.

One area I used to live in instigated a “hospital hotel” in a disused back in the 90’s where patients who were clinically well but couldn’t go home or were waiting for a care package to begin could be admitted to while these things happened. The hotel had 30 beds, mostly in 4-6 bed bays, and a day room with tv and things to do such as magazines, puzzles, crafts (all donated by the league of friends); they had 2 nurses and 4 carers assisting with personal hygiene and giving some stimulating activities if requested so people didn’t stagnate on an acute ward. It worked well until the budget for staff was slashed due to cuts so the project was shut down!

IDontHateRainbows · 29/09/2024 08:09

LovedFedAndNoonesDead · 29/09/2024 08:06

Yes the ambulance could leave - where were they supposed to take the patient that they went to?

The biggest issue at the moment is having nowhere to discharge patients to when they no longer need medical care. Social care doesn’t have the staff to provide the complex care needed by many people on discharge and many care homes that take socially funded residents are full so, unless you can afford £1,000+ a week for private care homes, you end up blocking a hospital bed until a solution is found. Also, having spent best part of a day in a discharge lounge waiting for meds etc, they were full of people who did have somewhere to go but, while waiting, needed at least 2 members of staff for transfers, assistance to use the toilet, to be fed etc. so there were as many staff in the discharge lounge as there were on the ward but working in a waiting area.

One area I used to live in instigated a “hospital hotel” in a disused back in the 90’s where patients who were clinically well but couldn’t go home or were waiting for a care package to begin could be admitted to while these things happened. The hotel had 30 beds, mostly in 4-6 bed bays, and a day room with tv and things to do such as magazines, puzzles, crafts (all donated by the league of friends); they had 2 nurses and 4 carers assisting with personal hygiene and giving some stimulating activities if requested so people didn’t stagnate on an acute ward. It worked well until the budget for staff was slashed due to cuts so the project was shut down!

I was kind of thinking they could provide enough care to save someone's life eg cardiac arrest or stopped breathing is that not what ambulance personnel can do?

Where to take them is a secondary problem but at least it won't be the morgue.

Happii · 29/09/2024 08:13

MSLRT · 29/09/2024 08:04

I don’t think health care is free in many European counties. Most require a bank card or insurance details before they treat you.

Have a look at some European countries, you'd probably be surprised.

MSLRT · 29/09/2024 08:15

Happii · 29/09/2024 08:13

Have a look at some European countries, you'd probably be surprised.

I’ve lived in quite a few and always had to pay. So which are you talking about?

AppropriateAdult · 29/09/2024 08:18

This does seem to be a UK-specific problem, and it's frightening. I'm in Ireland, where the health service is riddled with problems and A&Es are a nightmare, but any time I've had to call an ambulance (several times through work and once in a personal capacity) it has always arrived within about 15-20 minutes. These were all in urgent-but-not-critical scenarios. The idea of waiting for hours and having to call several times just doesn't seem to happen here, at least not routinely.

(I've just looked it up, and the average response time in Ireland in 2022 was 27 minutes, which was apparently longer than previous years, and was seen as a big failing.)

fourelementary · 29/09/2024 08:19

It’s scary isn’t it? And I am so glad it wasn’t any worse for your dd @Nichebitch
we had similar with our child who suffered a badly broken leg at a sporting event- as she was “conscious and breathing” we were told there would be no ambulance sent out. We manoeuvred her into a car with a completely snapped tibia- and she was very fortunate we did not cause irreversible or life altering damage in that move… not to mention the agony or the unsafe subsequent drive- without seatbelt possible- to A and E.

whataballbag · 29/09/2024 08:24

Sorry to hear about your daughter, that must have been so scary for you both!

I work in ambulance control, and trust me, we (and the vast majority of other nhs staff) are just as frustrated, disgusted, upset etc with how things are at the moment as everyone else.

There are target wait times for each category of ambulance, and without listening to the information that was given at the time of the call, I couldn't say what cat your daughter would have been. Although if she was conscious and breathing, it would likely have been cat 2 or below.

The service I work for regularly has to decline low priority ambulance requests for people. It is soul destroying to hear call handlers saying 'unfortunately we do not have any ambulances available'.

There are multiple reasons things are so bad, a lot of onus is on the government, funding, low staff, a&e clogged up, lack of resources. But there also has to be some blame on Joe Public too. In your situation you 100% made the right call for your daughter, however it is more and more frequent that people are exaggerating symptoms to get an ambulance, and get a quicker response because they think they will be seen sooner in a&e.

IDontHateRainbows · 29/09/2024 08:27

I saw an overturned car on the dual carriageway recently with police and ambulance, road closed off etc.
Surely in RTA situations an ambulance is prioritised? Can't imagine drivers/passengers with terrible injuries waiting hours but who knows in 2024 Broken Britain?

Goody2ShoesAndTheFilthyBeast · 29/09/2024 08:29

Your poor daughter.

The whole of the NHS needs a complete overhaul but no government has the balls to do it.

It needs knocking down and rebuilding. It could work a lot better than it does.

There is a fuckton of money wasted in the NHS and it can be run so much better.

Pastachocolate · 29/09/2024 08:34

It’s dreadful and there is no way to sugarcoat it. And it is years - I had a dislocated broken ankle years ago and it would be 8+ hrs. Relatives somehow managed to get me to a car instead. I’m sure now it would be a longer wait. Then a few hours in waiting room. Nothing to do with the care of the staff who were great but incredibly busy.

The NHS needs funds but equally important is investment in social care. We don’t have enough care homes so that people who are medically well but cannot go home have somewhere to go. Often older or disabled people.
I am prepared to pay more tax, but I’m not a net contributor to the government due to illnesses I have. I don’t get benefits but would never be able to pay more than I’ve cost.

LovingCritic · 29/09/2024 08:39

MissMeMiss · 28/09/2024 23:55

Not sure why you would call 911 and expect any response

Telephone exchanges in the UK are programmed to connect 999 or 911 or 112 to the emergency service operator, makes no difference which you dial.

Tessabelle74 · 29/09/2024 08:44

NinetyNineOrangeBalloons · 29/09/2024 00:09

Oh really?

I just find it strange that anyone in the UK would try that (or be surprised at an hour’s wait for a non-immediately life threatening injury) that I assumed OP may be in a different country, with their own issues.

Edited

112 also gets you through as that's the emergency number in mainland Europe

mitogoshigg · 29/09/2024 08:47

@Happii

Most countries have an up front fee of some kind for non emergencies, eg I know in Finland you pay to see the GP

standardduck · 29/09/2024 08:48

I don't live in the UK, but that sounds completely insane.

Your poor DD. Glad she is better.