There is no ambulance service anymore

and then you get the 12 hour wait at A&E!

In my experience, triage once you are at hospital is working. I understand all areas of the NHS are understaffed, under resourced, underfunded. But when I got my son to A&E we were rushed straight through to resus with a team of staff. The waiting room was packed, but those in desperate need could get attention.

NHS111 includes staff who are not health professionals. Its a system that is based around assuming the worst and has quite a low threshold for telling you an ambulance is needed. Medical professionals re-assess and prioritise.

Ambulance transfers are for when someone is in a critical condition/needs immediate access to equipment etc.

Its almost always faster to drive someone to A&E yourself if you can.

When DD has needed ambulances & a&E etc (we are talking baby unable to breathe urgency) we've never waited long.

If we really want to get technical:

"Nominal is a common financial term with several different meanings. In the first, it means very small or far below the real value or cost. In finance, this adjective modifies words such as a fee or charge. A nominal fee is below the price of the service provided or presumably easy for a consumer to afford, or a fee that is small enough that it does not have any meaningful impact on one's finances."

£50 would have a massive effect on the finances of some people.

Not sure that was the point of this thread though.

I don't understand how ambulances are being used for things that could be dealt with at a pharmacy. Are these people lying to the 999 operators? They asked many questions to us and also insisted on speaking to DS each time they were called (3 in total as the school were told he was high priority so called after 90 mins as he was in so much pain). They were very thorough on the phone with the questions.

Exactly, my ex company did a lot of work for the 111 & 999 service, they of course get idiots ringing up but ambulances aren't despatched for no reason.

My DD can look out of her ward window and see the rows of Ambulances waiting to get patients into AE, she is under tremendous pressure to release patients who are not safe to go home and now has to deal with the new border system where patients queue in ward corridors on trolleys from AE in the hope of getting a ward bed and with no extra staff, these patients just dont get cared for.
min 6 week delay in getting 4x per day at home care package, so med fit patients have to stay in Hospital.

Fund and staff adult social care and 70% of the NHS probs would vanish inc Ambulance service.

I can speak as someone with massive insight into this problem, as a 999 operator for another emergency service so have dealings with the Ambulance on a daily basis. Yes there are the social care problems which are causing the delays at the hospitals but the biggest cause of people not getting ambulances starts and ends with the way the Control Rooms are managed and the scripted nature of their call handling. This is an alien concept to me as we have complete freedom with what we ask. Ambulance Ops are unable to use any common sense and the questioning can be very misleading when it comes to making an accurate assessment of what is wrong with a patient and whether they are deserving of an ambulance. A large number of people calling for an ambulance do not need one but will be categorised for one to attend. Whilst there are clear potential litigation issues if something should go wrong SOMETHING has to be done with they way their 999 calls are handled. It is not the fault of the staff working these lines but the fault of the management of the scripting.

An example - ambulance request assistance with a caller who is on category 2 (category 1 being the most serious) who has suffered a serious electrocution and is surrounded by water and whose heart doesn’t appear to be now bearing normally. A quick call back to the casualty confirms they have wet floors due to cleaning and have received a small “spark” when switching a light on. Now calmed down after Initial scare and heart no longer racing. No ambulance required. I could ask the right questions because I am allowed to but the scripting of the Ambulance Control meant they come to this conclusion. Everything is a tick box. This is one of thousands of instances I have come across and it has to change.

And the OP is right - there is no longer a functioning ambulance service.

@Sirzy : I would hope that under such a proposal, anyone in receipt of PIP etc would not be charged (like prescription charges etc where some people are exempt): obviously this is hypothetical, but this is a suggestion modelled on how GP access works in Australia (from what I’ve read)

But if as @MedPara suggests an ambulance costs £500 (which I can well believe) people who call an ambulance to avoid a £20 taxi are doing none of us any favours

No doubt there are many many reasons it’s hard to get an ambulance (over use by 111 & broken adult social care being 2 clear ones) but abuse of the system really rankles

The whole service is being run into the ground by government targets. Beds and hospitals have closed over the years and in case u haven't noticed, the population has increased. Doesn't matter how many nurses and doctors they employ, if there isn't the beds there for them to go into then they have to wait no matter how much you privatise and throw money at it. Not to mention but social care funding has been cut dramatically over the years so there isn't anywhere to discharge people to!

my friend was left on a cold pavement for hours with a badly broken leg which traumatised her.

I don’t think you have as much insight as you think you do. It’s the classic unconscious incompetence…..you don’t know what you don’t know.

Pathways is rubbish yes, but we’ve had pathways for years. It is really not the biggest problem. Clinicians working in the call centre cancel loads of ambulances after calling people back to ask more questions. We never used to have that. The biggest problems are call volume (which rises year on year with no increase in staffing and resources) and lack of social care and poor staff retention.

They usually advise this anyway don't they? They did when my baby was struggling to breathe.

I think you are misunderstanding what I meant. He said to ring and ask them to attend rather than go to MIU or A&E. I am assuming that they cannot do that now. Not here anyway. If they can’t get to strokes for hours I would assume there is no capacity to provide a minor injuries treatment at home for those who struggle to access A&E or MIU.

Just to thank the ambulance crew who came out to DS who couldn't breathe & had chest pain in the night a week ago. I was warned it might be 40 mins beofre they got to us, they certainly weren't over that time. Very helpful, went to hospital, parked up outside for a while, not excessive though, and a cubicle was ready for DS when we went in.
Many many tests, painkillers, saw a doctor the next morning, which was fine, test results have to come back. Diagnosed & back home the same day. I'm not naive enough to think everyone has the same experience, just wanted to say to NHS staff how grateful we were.

It's very dependant on the time of day where we are and more so on the day itself.
So weekends or Friday night? Good luck waiting for that ambulance if it's anything past 6pm.
That being said I know someone who needed an ambulance on a Saturday morning, the paramedics were there in minutes and patient admitted to hospital, into a ward with a treatment plan and discussion with surgeon before the end of the day.
We're in the northwest, greater Manchester region.
I also know someone who had to wait 8 hours in a friend's yard when she fell and broke her hip so it's very different experiences.

It's a bloody nightmare and much discussed where we are.

One of the major problems with this situation is that the patient not only has a broken leg, they’re also likely to have crush injuries on the back of their body caused by lying immobile on a cold hard surface for hours. When it comes to recovery the leg can be fixed, but not the muscle death caused by lack of blood flow while lying on the ground. It’s a very slow process of rehabilitating the patient and rebuilding muscle, which wouldn’t be necessary if the ambulance had come quickly before the crush injuries developed.

Pickledeggnog

It isn't just difficult to move a 90y (or anyone!) with a broken back. It's potentially very dangerous and could cause life restricting injuries to them!

As I said before, ambulances aren't just for imminent life threatening conditions, such as a heart attack. They are also there to help prevent more serious damage being done. Yes, someone might not die, but they could be permanently disabled by being moved into a car.


We need for more funding into the whole system.

Ambulances are delayed at A and E as can't drop off, as A & E is full.
Other services need to be in place for some patients. If you want any of the a and e/a,balance type programmes a lot of ambulance and paramedic time is also,taken up with social care and helping people with mental health crisis.

Little point tbh.
It's not uncommon from what I can gather from medics I know of.

PIP doesn’t work that way - it’s not means tested and on its’ own doesn’t exempt the claimant from routine charges, ask any PIP recipient how many times they’ve been told ‘that’s what PIP is for’. As an example a friend who was trying access collection of medical waste from her local council was told she would have to pay for the service - as ‘that was what PIP was for’. The cost of the service is twice her PIP award. Amazing how far some people think it will stretch.

I agree. My late husband, aged 67, fell and fractured his femur on a cold February night on our front path. He lay in agony for four hours before the ambulance came and spent much longer in hospital because of the additional trauma caused by the wait.

My partner has several health problems and we called 999 after he experienced difficulties. The call handler said he needed a paramedic to attend - after assessment it was decided he did not need to go to hospital and he was treated at home. I don't think it could have been categorised as a minor injury but I think it illustrates the point that this does still happen.

These are awful, and I’ve heard of this so many times.

It’s clearly a really poor outcome for the patients, but it also must increase costs to the NHS overall? If somebody spends extra days or weeks in hospital and then needs a rehab package afterwards just because they spent longer on the floor than they should have, the extra cost must run into thousands.

How is this more cost effective than having more ambulances and sending them quicker? If they can’t unload at hospital quickly, at least the patient is on a bed, not the pavement, while they wait. Treatment can also be started, in some cases, in the ambulance.

Have the costs of this been modelled and compared to those incurred under the current way of doing things (badly)?

Re costs caused by delays my neighbor spent 30 hours in A&E his wife drove him there when told of ambulance delays. They finally diagnosed a stroke. His rehabilitation will be long and very expensive.

It's not a great result for the patient or the health board