… I think the expectations in question are reasonable and commonly held, and yet dead wrong. Read on, because this may one day be useful.
In January of this year, while staying in a large English city, I called 999 as I thought that my 12-month-old daughter swallowed a pill of codeine, a strong painkiller used by my wife. (Talk about terrible timing - my wife just took a flight to be with her dying mum, and left me holding the childcare fort). Fast forward to the happy end: she never did. Furthermore, had she swallowed the codeine pill, this would not have been be a life-threatening emergency: according to the A&E doctor, they would put the child under observation.
I did not know that at the time, and acted on the belief that my child’s life was in danger. I did not have a car, and chose to call 999 - instead of ordering an Uber and taking a 10-minute drive to the nearest A&E - based on another assumption: that a case with a baby in danger would be highly prioritized by 999, and that an ambulance (with resuscitation equipment and medics on board) would arrive quickly. It helped that I was in the city’s centre.
The ambulance arrived at my door 58 minutes later. By that time, I was already at A&E. I ordered an Uber after 30-plus minutes of waiting, and 3 follow-up calls to 999, with me occasionally screaming at 999 operators.
Let’s approach those expectations. You might think that when somebody calls 999 and tells the operator that a 12-month-old child just swallowed a 30 mg pill of codeine phosphate, a medical professional would be contacted and determine how serious the problem is. In this case, the answer would be “not very”; I would be reassured and advised to go (but not rush) to A&E for observation.
It does not work like that. 999 operators are not medical professionals, but more regular people, relying on approved case-disposition pathways/algorithms, where you are asked a yes-or-no question 1, then depending on your answer you get asked question 2 or question 3, etc. It makes sense statistically - unfortunately, it did not make sense in my situation, where the ingestion of a poisonous substance had taken place less than a minute ago, and no symptoms would yet be apparent. No matter - the operator insisted that we stick to the script. This is where the screaming started.
Before or during the screaming, there was a request to escalate, and it is either that request, or one of the follow-up calls, or simply the clock marking X minutes after the first 999 call, that triggered another event. Remember my hopes about a doctor? It turns out that a doctor’s advice was sought, but a clinician was not available. A “safety net” scenario was activated, and an ambulance was sent out.
… with second-highest priority, assigned by default in “safety net” cases. And then a top-priority case (like a heart attack) happened in the city, and the ambulance was diverted. The ambulance that arrived 58 minutes after my call was its (eventual) replacement.
What is the lesson here? I think it’s: lower your expectations about 999. Understand 999’s triage process and be prepared to play along - or don’t waste your time in a case like mine, with no symptoms at the time of the 999 call. Do not expect a doctor to be available. Do not expect preferential treatment for a child. (At least I have no evidence to the contrary based on my subsequent, face-to-face conversation with the representatives of the ambulance service). Overall, strongly consider getting to A&E using your own transport. 999 will only approve, as this will free up an ambulance for someone without that option.