To think that dd should have been a priority case?

[Edenviolet]

Dd2 has type 1 diabetes.

Last night she had a series of hypos which we treated and then another which would not respond to treatment. Her eyes were rolling and she was not fully conscious. We phoned 999 and thought they would come quickly.

We had to wait an hour and in that time phoned them back twice as she was so unwell. It was terrifying. We thought they would prioritise her or send a rapid response paramedic (the ones in a car not ambulance) but nothing. We were told they didn't know when somebody would be available.

When they finally came they took dd to hospital and she is now fine but when dh was there another child had just been taken in from an ambulance with earache, apparently the drs were not too happy and made this child go with his parents to wait in the waiting area but it mad me wonder how efficiently 999 calls are being prioritised.

I want to complain but I don't know who to contact. I am just so shaken up as took it for granted they'd arrive within minutes.

I assumed frankandfurt was a mistype and should have said didn't want to pay for taxi.

I had to call an ambulance when labour started with dd2 as I didn't feel contractions until ready to push. She was born in the ambulance but I wasn't taken to a&e but the maternity unit, just because you are in an ambulance doesn't mean they take you to a&e.

There is also a big problem ATM with ambulances trying to get patients into a&e but they are having to queue to even get through the door. The current a&e pressures are almost unprecedented and will only get worse throughout the winter.

Yet another reason why patients need to be educated on what accident and emergency actually means

There should be special transport for people in jacks position, so the emergency transport doesn't get used as paramedics call 'materna-taxis'

I feel like I need to defend being in an ambulance that the maternity unit dispatched to me. My labour lasted 20mins from start to finish and the hospital is 30mins drive. I didn't need a taxi as my husband was following in the car so transport wasn't an issue. What was needed was urgent medical help which is what the ambulance service is there to provide.

Sometimes it's easy to say that it is or isn't urgent other times its not. Did my dd need to go to a&e when her ear was bleeding? It's not always as black and white and threatening to charge people for bad calls will hit vulnerable people badly because they'll become too scared to use the service.

When I was in US, I needed an ambulance. It cost me almost $500 for the ride. That was extreme, but I think there should be some charge for ambulance services.

Jacks I think it was perfectly sensible for you to be in an ambulance in labour - as you say, transport wasn't the issue and there was (obviously!) a medical need. That's the type of call that needs an ambulance - it's what they are there for.

My feeling is, what would have happened if that ambulance couldn't get to you because they has to deal with someone who, like I said previously, had tooth ache?

Time wasters like that, I'm sorry to say, should be fined at the very least. It would probably be against their human rights to be hauled through the streets wearing nothing but sandwich boards saying "I'm a drain on the NHS", and possibly a little extreme, but you get my drift. (Before I'm flamed this is tongue in cheek!)

There needs to be education en masse. I've said for many years that all school leavers should do a minimum if 3 months working in the NHS, just to see what goes on and to gain some sense of how they can help themselves/ how to properly access services.

We're now faced with a situation where those with the most need are not able to access services - sometimes because the system is clogged up with the worried well. And until we teach people that, for example, having tooth ache does not mean that you need an ambulance, then the system is fucked.

But where do you draw the line? Someone before mentioned charging ambulance rides for people with hypochondria - that is a mental illness and the patient may not necessarily understand that they are well. Why should they be fined for being ill even though it isn't physical?

How do you define emergency? If your child wakes up with blue lips but recovers before the arrival of paramedics, then what? Or if your broken leg turns out to be a bad sprain? The reverse is true, sickos exist and construe minor ailments as emergencies - it would still happen, just people would have to justify it (and let's face it, I doubt the sorts of people who use ambulances as taxis would start to consider whether they are morally justified in doing so just because there was a fine).

Unfortunately (usually from the patient's POV) medicine isn't as clear cut as emergency/non-emergency. I don't think separating genuine time wasters from innocent ones could be done ethically - unless you want to allow fining people with gut feeling as evidence... you'd also be cutting out and delaying access to treatment for overly cautious patients who were too concerned about misusing the service and fearing penalisation.

It's just not feasible. I think education is a much more workable solution.

Good point olidus, perhaps education as a first line then fines for "repeat offender"?

Drawing the line is difficult, but the whole point re accident and emergency is that they see patients who have had accidents or if there is an emergency. Hypochondria isn't necessarily either of these. The two examples you gave, blue lips / bad sprain - yes, these are definitely urgent and should be treated as such. The chap who turns up in a&e because he has had a splinter in his finger for 3 weeks? Not so much.

It's not just misuse though causing the problem. The child that was born in the ambulance is now an adult but only just and in that time the 3 nearest a&e departments have been closed. It now takes roughly 2 weeks to get an appointment at the local gp surgery or you can try to fight for an on the day urgent appointment. The local miu refuses to look at ill people which means if they can't get into the gp then the next stop is a&e, in my area that can mean having to get 3 buses, I dread to think how much a taxi would be. Services have been cut back which makes it harder for people to access things like a doctor or dentist but a&e is always there as a fall back, maybe we need to ask why people go there with a toothache rather than their dentist.

Recently I called 111 as my son was having breathing difficulties and the (non medically qualified) call handler said we needed an ambulance. He has been in this position on many occasions and 111 have sent ambulances before, but it definitely wasn't needed this time - plus we had a car and I could get him to A&E myself. I asked to speak to someone medically trained and he agreed I could take him myself - it would have been a waste of an ambulance and all because it was basically a computer programme telling the handler what to say/do. The OP's experience sounds terrifying so worrying to think ambulances as being sent out unnecessarily.

I understand jacks - then you have the bloody GP receptionist who refuses to book an urgent appointment because the patient on the other end of the phone hasn't taken a paracetamol so how could it possibly be urgent disclaimer, I was a GP receptionist for 3.5 years, this was an extreme act of stupidity from a person who should not have been left to breathe unsupervised (not me, I hasten to add!) Navigating the system at the best of times is extremely stressful for patients, then you're faced with useless saps like these.

The whole bloody lot needs a shake up. Yes, there are patients who genuinely use services sensibly, and there are those who attend a&e simply because they don't know where to turn. But there are a significant minority who take the absolute piss.

Looking at the wider picture, it's not just A&E. It's everywhere. Like the woman who was referred for IVF (who, as the GP had referred, had to be seen ) because she and her partner had 5 children together and they wanted a 6th? And they wanted NHS funded IVF? I shit you not. Even though she was not entitled to NHS funded treatment, she still had to be seen at a cost of £170.

Then we have people who genuinely needs help, like the ops dd, and services are so misused that she has to wait an unacceptably long time for an ambulance.

Jacks please don't feel you need to defend, I'm just saying there should be a stand by service for maternity related incidents, for those who haven't got family or taxis won't let them in. And many people actually ring ambulances when they're in the early stages of labour (unlike you) not understanding that birth is NOT a medical emergency and most of the time does not warrant an ambulance.

Where I live you pay a lot to use an ambulance, but you can claim the cost back through your insurance. The system seems to work well.

That's really interesting cerisier - where are you? Sounds very sensible

patients who have had accidents or if there is an emergency. Hypochondria isn't necessarily either of these.

But that's part of my point fourfox, the nature of being a hypochondriac may mean people are unable to judge whether they are having an emergency and therefore they shouldn't be penalised for using the services.

Agree more with the idea of education first, fining later. Your point re: sprained/broken leg vs guy with splinter is what I meant about it being problematic to separate the two categories ethically - but it is easy to do on paper at least, which is perhaps all the bureaucrats care about. Which raises another point:

How would the applications for fines work? Presumably they would have to be submitted to admin for chasing up by somebody, and not only is the written word subject to interpretation and perception (which could be used against "innocent" patients by cash-strapped trusts) but who would file the reports? Is it another job for the doctors to do? Or would the hospital have to employ form filler outers (and would this cost outweigh the amount pulled in by fines vs no increased staff but organising education campaign?)

The more I think about it the more I think it wouldn't work

I don't know what area you are in but you can contact the service or patient liaison. Depending on what triage system they use, it would have either been an 8 or 20 min response
Judging from the time it took, I'd imagine it was triaged a 20 min and every available ambulance was on a higher priority call
I would have thought they would have stayed on the phone with you though

I work on a labour ward and I often have to try and put people off calling an ambulance. They ring up sayi g they think labour has started, they lve an hour away and can I call them an ambulance. I tell them they need to find someone to bring them in, a friend, neighbour, etc. they swear blind there is no one at all, they can't afford a taxi.

I reluctantly call an ambulance. Last one turned up in an ambulance and her mum and gran walked through the door with her and the paramedics. When I quizzed them how they'd got here (as I knew the mother and gran hadn't come in an ambulance), they'd followed the ambulance in their car!

Makes me so mad.

Don't be too harsh on the family whose child had earache.

We called 111 for DD who had a high temperature which wasn't responding to medication and was listless. She gets tonsillitis and we wanted an appointment with the out of hours GP.

What we got was a paramedic in a rapid response car, to basically come and give her another dose of neurofen and take her temperature.

3 hours after we first called, we had our appointment at ooh. But if they had been too busy to see us, or if double doses of medication hadn't started to perk DD up a bit, I can well imagine that 111 might have sent us to a&e.

If you had severe head pain, visual disturbances and numbness in one side of your body you might reasonably believe you were suffering a stroke or other similar problem. When you get there the doctor suspects migraine. Would the mumsnet lawmakers slap a fine in this instance or would you think ok this non medically trained person didn't know what was wrong with them and called 999 like the adverts tell you to. In quite a few cases I suspect the time wasters don't know they are wasting time until they have been seen. Obviously not the same for hoax callers etc.

If I was told there was an hours wait for an ambulance I would get myself/my child to a&e myself.

I dont think most people realise how few ambulances are on the road at any one time and how many of them end up with drunken idiots on them instead of genuinely sick people.
My DH is a paramedic and was attacked by one of these druken idiots st the weekend which meant his ambulance was out of use until the police arrived to deal with it. Probably in that time he could have been to two genuinely ill people.

I agree that 111 is adding to the burden. It's now the only way to access ooh gp and dental appointments here, but the standard advice seems to be go to a&e. You have to argue until you're blue in the face that a&e isn't necessary and that an ooh appointment the following day will be fine. They don't seem to be able to grasp that requires medical attention before Monday isn't the same as requires immediate medical attention.

Improving 111 and educating people on what constitutes an emergency would be helpful. Perhaps it could be part of compulsory first aid teaching at school?

we had an issue when my fil suddenly went grey and collapsed in a restaurant

staff called an ambulance as we thought he was very unwell

luckily a nurse in the restaurant (eating her meal with her family) very kindly came over, helped him come round and did a couple of basic tests on him

when the ambulance finally arrived they did a few tests and decided it was heat exhaustion and stress and so we took him home and not to the hospital

they have closed our local a and e so its a good 40 min drive to the nearest one, so we thought keeping him still and calling an ambulance was the best bet

interested to know if you think this was time wasting or not

I don't agree with fining. It would put people off who were not sure they were bad enough and wouldn't put of those who call for nothing.

Collecting fines would be costly and some people would end up paying £2.50 a week.

I do think OP you should write an open letter in your local paper tot he parents of that child.

I also think there should be a publication of reasons for calling the ambulance published weekly, so;

Mr J, age 52, suspected heart attack
Miss C, 12, broken leg
Mr H, 44, wanted a pizza

Presumably the nurse thought he was in need of medical attention and so didn't tell you to cancel the ambulance? Not unreasonable then.

I agree with sashh. My main concern would be people who are frail or vulnerable not wanting to call an ambulance when there is a legitimate reason to.

I've been transported to hospital by an ambulance once when I didn't need it (I didn't have a whole heap of choice - I was unconscious, but it could have been avoided if any one of the people I was with had the confidence to put me in recovery and elevate my legs until I was awake again.)

Once I didn't call an ambulance when I was in the early stage of shock. I needed rehydration, so was justifiably in hospital, though I should have been able to prevent the shock happening. I'm glad I didn't call an ambulance for that one. It was bad enough that I'd let myself get so ill in the first place, though my Dad who gave me a lift was really cross with me for not calling one. That was a fun journey.

I also organised my own transportation when DD was ill. That's the one that really scares me. She had septicaemia and if our car had been stopped in traffic, if my Mum had decided to take a shower before coming out to pick us up, then it would have been too late. She was literally in treatment and fighting for her life within half an hour of getting to the hospital. 45 minutes would have been too late.

The problem is, I've almost been over-educated in not calling an ambulance unless you might die that second. I wasn't aware of how quickly a 10 month old could start to fail. That occasion was already tough, because I was overruling the decisions made by the GP who had seen her three times that week and written it off as just a cold. If I had the extra concern of 'and also, they might fine us...' then we're wasting yet more precious minutes.

Both times DS needed to go to A&E to be checked out, he was very much walking wounded, so it was fine to be on a bus.

An additional issue that might make people favour an ambulance is that parking at hospital is nightmarish and expensive. I have been in the position of simply not having taxi money (and digging under cushions for bus fare), and knowing that there wouldn't be any place for me to park a car at the hospital. The stress of having a sick child in the car, while simultaneously looking for a place to park is too much. Both times DS had to go to hospital, we've gone on the bus - a trip that takes an hour. Not comfortable for him, but my attitude is that if he can manage it, he should (poor boy).

I'm not saying people shouldn't drive - I'm saying that parking at hospitals needs to be addressed, and this might reduce some of the load on the ambulance service.

So I think there should be something to prevent misuse, but not necessarily an automatic fine. Or perhaps there could be fines, but not for people over a certain age, or for babies under, what, 1? 2? Or with an permanent condition, or a disability?

Basically, a system that doesn't penalise those who are vulnerable.