To think this waste of NHS resources is abhorrent?

[TootYourOwnHorn]

My little boy woke up in the middle of the night with severe croup, struggling to get a breath. This has happened before and we were told to call an ambulance if it happens again. So we did. We were told several hours wait and to take him in ourselves. Not ideal as the hospital is 30 minutes away but luckily we do drive, although it was a rather scary drive. Would've thought that a child with severe breathing difficulties would've been a priority but there you go.

Anyway, the issue is that as soon as we arrived at the hospital we got a phone call to say there was an ambulance outside our house. We told them we'd taken him in as advised, then they said "well next time you need to cancel the ambulance". As far as we knew they hadn't sent one as we'd agreed to take him in ourselves. So due to the lack of communication they've wasted an ambulance, the cost of that ambulance and the waiting time for someone else who needed it! This is insane to me. The call handler also didn't know the difference between a rash and mottled skin. Surely more training is needed here, this isn't ok? I would never waste an ambulance like this, and I'm a bit offended that she suggested so! But more offended at the absolute waste of resources.

I genuinely think the issue isn't lack of resources, but how they're managed! Not sure if I should bring this to someone's attention so it doesn't keep happening.

@jengachampion that's ridiculous! To not even tell you it's coming or check if you still needed it!

You could contact the patient liaison team and highlight your concern and perhaps ask for clarification on the process when someone calls and then makes their own way. I suspect it was probably highlighted in the control room at the time by the shift manager and the call handler will undergo regular audits of their calls so if they are making errors or misinterpreting anything on a regular basis it’s likely to be picked up and addressed. It isn’t something that I know to happen often to be honest. The communication/response to finding you had made your own way seems a tad inappropriate so you could make them aware how it came across to you without calling it a complaint.

Re. The treatment aspect, I’m not sure how old your DC is but all under 2s should be conveyed to hospital regardless of improvement, plus children with any remaining stridor (i.e. the barking cough) amongst a few other things so it’s unlikely they would have discharged on scene. There are also legal aspects surrounding the administration of dexamethasone for us as it doesn’t fall into the legal schedules of the meds regulations that authorise us to administer it. We have to use a different part of the law to be able to do it and give it under under a Patient Group Direction (PGD) and it’s very strict. We must follow the directions exactly and are not allowed to deviate at all, so if the PGD states if we give it we must convey to hospital then is what we must do.

My DS is a severe croup sufferer and I have found the quickest route to getting the steroids is via out of hours GP services just in case you need to do this again. If you don’t have a walk in clinic in your area, 111 can usually get you an immediate appointment with an out of hours GP. We still have to drive almost as far as the hospital for that but there is almost no wait. The last time my bum didn’t even hit the seat in the waiting room before they called us in as the GP heard the stridor from her room. When we have used A&E for this before we were basically left to fend for ourselves in the waiting room for hours which wasted so much time that the steroids could have used to get working. It was terrifying. The last GP who gave us steroids for croup said ‘if it gets worse then call an ambulance’ and I remember thinking ‘I really bloody hope I don’t need to rely on an ambulance turning up quickly’. It’s a sad state of affairs

@PostItInABook thank you. Thats really helpful, like you say I don't want to make a complaint as such. The way we were spoken to on the second call was inappropriate I felt, although I wonder how much they knew about the first phone call and understand that it must be frustrating for them if they think people are wasting ambulances.

I had it in my head that he'd be given it at home before, but perhaps not, it's been a while since the last episode. He's 6 if that makes any difference.

@PonkyPonky thank you. We'd usually call 111 and they're pretty good at telling us which ones going to be quicker, this time he had a really bad case and honestly think he could've done with some oxygen. Our children's a&e is brilliant so luckily didn't wait more than 5 minutes.
It's very sad isn't it, and it's so much worse when it's children I feel.

Exactly this.

My youngest suffers with croup terribly & are always told to phone an ambulance l, the first time I had never experienced croup or fully knew what it was, I genuinely thought my son was dying.
It took until the 9th time before I knew if I'd be able to make it there myself by how he was and the fact my husband was home and my 8 yo had to be woken up and come with us to a&e so that 1 could drive 1 could check our sons breathing. Every time before then I was alone with either 2 kids 1 of who couldn't breathe or just me and the toddler with croup i could not put him in his car seat and srive like everything's ok. We're at a fortnight ago was his 17th time in 2.5 years and only 3 of those have i not beeded the paramedics and I am not ashamed to say so. The paramedics give half of his recommended dose of steroid and because he was under 5 had to go to hospital for the rest. That half a dose helped a lot until a doctor authorised more and because of this he got an urgent ent referral from an a&e doctor who wasn't meant to do referrals but couldn't believe he was there again so ill

Nobody should ever be made to feel guilty for calling an ambulance for their child. The automated system will triage and categorise them the same as with adults. If the system says yes an ambulance will be sent. If the system says hmmmm you’ll likely get a call back from a clinician to do further triage and then either discharged over the phone, alternative pathways offered or actually yes we’re sending an ambulance.

Totally agree in waste of resources. Similar here on Wed evening. Ambulance arrives on blue lights and r paramedics (one training?). We didn't call them, but correct address. Turned out to be our lodger who also hadn't called them, but had spoken to his GP earlier that day. Assume doctor had called ambulance (?). But 9 hours earlier? Lodger was fine and has flown back to his home on holiday this evening.
Also, other lodger calls ambulance at drop of a hat. Hypochondriac. But always gets fast response, maybe because she always phones at 2.30am and waits for me to answer door.
When NHS allocated more money, first response is always 'we need more managers'. Well manage then!

which senior management roles would you get rid of out of interest? And why?

and please don’t say diversity managers as firstly they’re very rarely senior management of at all and secondly in medicine different ethnicities can react differently to medicines so this needs to be centre to treatment plans plus a multi ethnic local population needs people who understands different cultures in the workforce to help improve patient experience. If there is one profession where diversity managers are really valuable it’s healthcare.

I would have thought is was more waste or resources phoning an ambulance in the first place. If it were my child, I would have been in the care without a second thought, regardless of it being 30 mins away.

Unless you’re lucky enough to have a rapid response paramedic in a car around the corner, you’ve wasted more money than the nhs has.

We suspected my dad had sepsis and called for an ambulance three times on Tuesday and they had no emergency vehicles available. He did indeed have sepsis. So we took him to A&E ourselves with sepsis.

I can’t understand why you called 999 if you didn’t want an ambulance ?

Try reading the post again, slowly?

And when doctors do have to do any admin / management tasks they complain bitterly that they’re having to spend time on that instead of on treating patients.

The roles of matron and ward sister still exist anyway.

This!

I saw how MASSIVELY wasteful the Nhs is as my mil got treatment over the years. She had 14 zimmer frames at by the end as they wouldn't take old ones back. She also received so many medications she handed them out to her friends. I tried my best but go nowhere trying to sort that lot out.

You handed out prescription medications to people? I hope you have cover for distribution of drugs illegally…….

I mean, you could have just driven him yourself in the first place.

THAT'S the waste of resources.

This.

After the first experience of croup in my first kid I didn't bother with hospital for the rest. A mega steamy bathroom for a bit did the same job.

There's no way I'd go now the state things are in.

*Yes the usual suspects will be along to say how wrong that was in 5...4...3...

That's not a universal NHS experience there, that's your trust having particularly bad processes. When my DH was having treatment he had to organise his blood test the day before and then everything else would happen within the space of a couple of hours after the doctor had checked the results and made sure he wasn't having any weird reactions. To have a series of managers sign off every single time on a drug which it has presumably already been agreed is going to be supplied is an appalling waste of time and I would be inclined to write to the trust formally about it if you have the energy.

Hope your OH and you are both doing ok.

I agree.

I was really annoyed at the waste when I broke a limb in another county and went to minor injuries. They said I should go to my local fracture clinic the following week and so I did, only for them to refuse to see me and say I had to go via my GP or A&E. So I duplicated all the same tests at my local A&E that I'd already had the week before at minor injuries. I just really feel that was a pointless waste because the two hospitals didn't communicate.

Yep, my OH has cancer and gets a monthly supply of chemo and other drugs. One of the chemo tablets costs a few hundred per tablet, the other costs over a thousand. Thing is that he doesn't take all the drugs issued. He'd agreed with the oncologist to take a smaller amount. But the oncologist says it's "too hard" to change the prescription to issue fewer drugs, so he's building up quite a cupboard of excess expensive drugs that are just piling up month on month. He must have thousands of pounds worth in there now and it just keeps growing. He keeps mentioning it to the oncologist who, frankly couldn't care less - her answer is that her dept have "the funding" for the normal/full doses so it doesn't cost her department anything to keep issuing them, and it's "too hard" to change the prescription as it would involve a meeting with her, the business manager and other NHS managers to re-evaluate his treatment plan and change the dosage.

Not only is it a mammoth waste of money, it's also worrying that his NHS medical records are wrong as they indicate he's taking more drugs than he really is, so we've made such a note in his "emergency" section of his phone and in his medical information bracelet so that if he ends up in A&E, they'd be aware of what drugs he actually takes rather than what the system shows he takes!

Absolutely agree with this. The big problem is that attracting good and competent people from the private sector who know how to run organisation's efficiently is nigh on impossible. Why would they go and work for the NHS when they can sit at home several days a week, likely earn more and have nowhere near the amount of stress?

Definitely not wrong - you know what to do to alleviate the issue. Problem is, too many get frightened over the smallest of things. Call solves a lot of problems, as does cold air (for frebile convulsions), and rest.

That is poor management and exceptionally wasteful of the doctor. Another reason they need to be monitored.