Driving to a&e is quicker than an ambulance

[Pinkerbells]

I had to call 999 for my DP yesterday. (For context, it was for a reoccurring condition, and last time he had the same symptoms, he was in hospital for a month, had 2 emergency ops and spent most of his time in icu.)
The ambulance came pretty quick with 3 crew members. They did the observations and decided that yes indeed he did need to go to hospital. The conundrum came in the fact that it would be quicker for me to drive him the 30 minutes to a&e than for him to go in an ambulance, as once they got him there, unless his condition worsened, they would have to sit with him in the ambulance for 3-4 hours waiting for him to be admitted. This would make 3 crew and an ambulance unavailable for this amount of time!

I drove him in and dropped him off, and he got seen in 20 minutes. Not 3 hours, or even 1 hour. 20 minutes!!!!!

AIBU to be gobsmacked by the the whole situation, (apart from the 20 minutes, that was awesome). Don't get me wrong, I understand things have to be different because of covid, and I know the NHS are really really struggling. But surely there is a more efficient way of processing patients that frees everything up quicker than that

I think personally unless I cannot physically get myself/relative to hospital I wouldn’t call ambulance. They obviously assessed him and deemed it the best option, I’d be glad of the heads up.

Either way, if you're able to drive to a&e it's far better than using an ambulance that will be needed elsewhere 🤷‍♀️

Did he need a bed to be seen in?

YANBU

It is really ridiculous. I think a lot of the way things are run in the nhs seem very awkward. I always think ( although just my armchair opinion) that there should be an overhaul of the systems they have to make them more workable (and money saving). Everyone seems to have a story where an nhs worker has basically said oh we have to do something awkward and long winded in your care (not their fault obviously they have to follow the rules given to them).

I hope your husband was ok and glad you didn't have to wait to long

Well if you can actually get in the car and travel to A&E that way then there is absolutely no need to call an ambulance.

What about people who (a) can't drive, (b) can't drive and keep the ill or injured person safe or (c) are out of their mind with worry about the ill or injured person and can't concentrate well enough to drive safely?

Where I lived as a kid, if you were taken to hospital in an ambulance and then didn't have to stay the night, you were charged for the ambulance ride. I knew someone this happened to after she got knocked off her bike. What makes it worse is that a couple of weeks later she did have to stay in hospital for a couple of nights after her original injury got infected (though that was not because of anything the hospital did or didn't do). I remember thinking then that the system was pretty unfair on anyone who didn't have another means of transport.

I worked for an ambulance service 20 years ago. It was the same then as it is now. At busy times, ambulances would queue outside A and E holding not very ill people outside until they could get them booked in.

People in general think that getting an ambulance to take them to hospital, even if its just for a headache, or a cold, then they jump the queue and get seen very quickly.

Ambulances get called too quickly, even by medical professionals, for reasons that do not need an ambulance. If someone is able to be driven or even take a cab to hospital, that should always be the option that gets used.

Ambulances aren't a taxi service though; if you can't drive and don't need an ambulance you should be getting an actual taxi. For them to take you to hospital costs about £250.

Unfortunate, but the NHS is under strain and doesn't have resources to unload ambulances immediately - I've seen this on the news on several occasions recently, so not sure why it came as a surprise.
In the circumstances, paramedics attending to ascertain that someone does need hospital treatment, but are well enough to travel in a car and the ambulance and crew going on to another call seems the most efficient use of resources.

I just feel sorry for patients stuck in an ambulance for four hours in a car park - with that wait dragged out even longer than it would have been because of effective queue jumpers arriving under their own steam rather than by ambulance.

If only ever call an ambulance if I thought someone needed medical attention before I could get them to a hospital. It's the same triage system regardless of how you arrive.

What about people who (a) can't drive, (b) can't drive and keep the ill or injured person safe or (c) are out of their mind with worry about the ill or injured person and can't concentrate well enough to drive safely?

They would probably be taken by the ambulance. OP is talking about a very specific situation where the person was deemed able to go by car.

Sounds like you should have just driven him there.

What they were politely saying was "it's a waste of our time to drive him there when you could drive him instead and let us help other people."

The whole "queues of ambulances with nurses bringing tea and coffee out to waiting patients" actually peaves me off. if you need an ambulance then surely you dont want a bloody cup of tea. I've been in a ambulance twice, once for an asthma attack and once for a fall down the stairs with the person unable to move their legs. There was certainly no need for tea. We have a massive problem in this country with people calling for ambulances when they aren't actually needed.

In all farness, apart from continuing to monitor him, the crew said there was little different they could do unless his bp dropped when they would start him on fluids. We were advised in the past to call for an ambulance, so I did this time too. The paramedics said we had done the right thing as the condition could have been much more severe, and this would not have been visible to the naked eye.

It depends what is wrong with you though - you could nearly always get to an A&E faster by driving than calling and waiting for an ambulance. However, by going yourself you than are waiting much longer to be seen by a healthcare professional.

If you turn up at A&E you will just be in a massive queue with everyone else, having to go through the receptionist then wait again, etc etc.

If you think you may be having a heart attack, for example, for god’s sake call an ambulance. The paramedics will start to diagnose you straight away in your home and can take you directly to the door of the room you need for emergency treatment, which could be done within an hour of you calling.

If you go to A&E yourself you could be sitting for hours, potentially in the wrong hospital which can’t even treat you.

So yes, don’t call an ambulance if you’ve broken your arm, but do call one of you think you’re about to die!

I don’t really understand you saying he was seen in less time as a “walk in” as opposed to arriving via ambulance.

At the hospital I work at, ambulances are only queuing while they wait for staff and/or space to become available to bring the patient inside & hand over their care safely.

Generally, anyone walking into A&E would still be waiting just as long (and probably longer) than the patients in the ambulances.

Although I can imagine arriving & collapsing in Reception or driving in with chest pain etc would obviously get you seen more quickly - but whether it would be safe to just go in the car rather than in the company of trained paramedics in those situations I’m not sure!

I assume ambulance was called (and sent) because op (and call-handlers) thought the condition serious enough that immediate medical attention was needed, and that he might go downhill en route to the hospital. Not called just to take him to hospital.

Maybe sometimes its technically quicker to drive, and in your case has benefitted in allowing a faster predicted/actual treatment time.

But while fortunately I've never had the experience, ambulances treat on route and can continue to treat while in the car park, which in some cases could be the difference, even if technically they physically got into the ward slower.

@Godimabitch

Sounds like you should have just driven him there.

What they were politely saying was "it's a waste of our time to drive him there when you could drive him instead and let us help other people."

The whole "queues of ambulances with nurses bringing tea and coffee out to waiting patients" actually peaves me off. if you need an ambulance then surely you dont want a bloody cup of tea. I've been in a ambulance twice, once for an asthma attack and once for a fall down the stairs with the person unable to move their legs. There was certainly no need for tea. We have a massive problem in this country with people calling for ambulances when they aren't actually needed.

I’m going to take a wild guess (based on my own experience at work) and say many of those patients may have been elderly patients who would be unable to drive themselves & probably do not have family close enough to help.

In my experience, a 90 year old lady who’s had an unexplained fall & therefore does need to be checked over at hospital, may very well love a hot cup of tea while she waits in the cold.

Maybe I'm easy to please, but honestly I think that's awesome in a pandemic.
They got to you quickly, assessed it, and then decided to prioritise having the ambulance free in case it was needed again, as it was possible. That's sensible. And then he was in and out of a&e. Perfect.

Hope your dp is ok op.
I was slicing an onion last night and actually thought ‘heron, slow down and concentrate, this isn’t time to have a stupid avoidable accident/injury’.

Someone in an ambulance with a trained crew is safer than someone sitting alone on a plastic chair in a waiting room.

This is not a new dilemma. And as you've pointed out, if someone deteriorates an route you want them in an ambulance not a car. Ambulances aren't just fast taxis.

Emergency departments are already shit at seeking and obtaining patient consent (unless you're unconscious/incapacitated, consent is still essential before anything happens, it's not an optional bonus), let's not encourage them to be even more abusive in the name of saving a minute or two.

I think that some folk are confused as to what an ambulance and crew does.

Some people need assessing properly before going, some will need monitoring constantly and a detailed hand over - those people are better going by ambulance, even if the handover takes longer.

Some people on assessment, will not need monitoring but still need to go, those are better taken by car if possible, as that frees up the ambulance crew.

Ambulance transport in does not = faster treatment once there, you are still triaged the same, you will wait the same as anyone else.

Some ambulance trusts/hospitals are running a shared system where one crew stays at the hospital and takes charge of all the trolly patients waiting to be handed over, freeing up the other crews to go back out.

This does only apply to the ambulances who have off-loaded into the hospital and not those who have nowhere to put their patient so they are all waiting on teh ambulance for room!

I hope your DP is okay.
Imo an ambulance should only be called if a patient needs immediate treatment or can't physically make it any other way.
Pre pandemic is wasn't unusual to see a queue of ambulance drivers with stretchers waiting on a hand-over.

ambulance crew are professionals and can look after a patient until the hospital has time to thats why there is a hand over and often a delay because they are in "safe hands" going in is sometimes faster because they need to triage you immediately