[Closed] Panorama - Dial 999.. and wait..

if youre seriously ill, hit by a motor vehicle, have cut your fingers off, you would like an ambulance to turn up quite fast, not to have the same ambulance taxiing some drunk to hospital, so youve got to wait, and sometimes get more seriously ill.

Same with the fire and rescue service,you want trained and qualified people to turn up and help, from a local fire station, not 20 miles away, because the one nearest to you has been closed and the site sold.

For anyone who has called any of the emergency services and you or your family are suffering in pain or your house is on fire, you want them there asap, and they used to be , but due to the cuts and lack of staff those responce times are geting longer and longer.

But one thing is for sure theyre usually always very proffesional in there duties .

So hardly propoganda.

For anyone who has called any of the emergency services and you or your family are suffering in pain or your house is on fire, you want them there asap, and they used to be , but due to the cuts and lack of staff those responce times are geting longer and longer.

I'm sorry you're wrong - the government said this morning it's got nothing to do with the cuts, it's to do with them not prioritising the correct services or some other bollox.... 😉

Speaking of my own recent example it took about 25mins for the ambulance to turn up & they turned up a couple of minutes after the first response paramedic - could they of got there faster? I don't know, but I was mightily relieved to see them when they did so they could start giving me pain relief!

Easy to sort that out, if youre drunk and need an ambulance, they charge you or your credit card or get a taxi to hospital, that should stop a lot of abuse .

legitimate concern over cuts

This^

and we haven't begun to see the worst of the cuts yet.

I'm a paramedic, in this area they have closed the small local ambo stations due to financial pressures and just got less bigger ones. The management reasoning is that they have cars in each smaller town. Now this is all well and good if a para on a car can help you. However if you are in a bad way sometimes the only thing that is going to help you is getting to hospital and a para on a car is no use. What you need is an ambulance. Some of the places we cover may get a car to scene in under 5 mins but the ambulance may be 40 mins away followed by another 40 mins to hospital.

But remember that the paramedic in a car got there and that hits the government time target!!!!!

Same with the fire and rescue service,you want trained and qualified people to turn up and help, from a local fire station, not 20 miles away, because the one nearest to you has been closed and the site sold.

you want them there asap, and they used to be , but due to the cuts and lack of staff those responce times are geting longer and longer.

Now in an era of fire-brigade strikes, ambulance crews not responding to dying patients because they were on a tea break (despite not having been on a shout all morning) and fly on the wall documentaries that don't necessarily always present the police in the best light - I can see why people might be a bit more sceptical about the position that public servants are always trying their best.

But remember that the paramedic in a car got there and that hits the government time target!!!!!

and that same paramedic while possibly help save the patients life has to explain repeatedly to concerned relatives, why the nearest ambulance is 40 minutes away or possibly longer.

Let us hope that those that vote for cuts in the emergency services are put on a data base for delayed responce, just to see what the cuts they made are doing to real peoples lives.

Round here all the small hospitals have either closed or emergency care provision centralised.

The result is you could have a journey of an hour to hospital AFTER being scooped up by the ambulance to get to the nearest A&E.

The only alternative is the Air Ambulance which gets no public funding and even has to pay VAT on it's fuel!

If they are going to close hospital A&E and ambulance stations it's about time central funding started to help fund more Air Ambulance facilities.

I can see why people might be a bit more sceptical about the position that public servants are always trying their best.

After your little input I can see that you might well hope that people are sceptical about paramedics and firefighters trying their best, but I suspect that in reality most people have more faith in paramedics and firefighters than they have in David Cameron and his ideologically motivated cuts.

You dont need a police station in every town, police are mobile, they have cars, and are usually only needed in a fight or theft situation,perhaps have retained police oficers or first responders like in the fire and ambuance services, where as if your having a CVA, a heart attack or a serious amputation or road crash, or even your house is burning down, with your family trapped then you need the emergency services quite quickly, in a fully equipped vehicle staffed by trained staff.

There saved a load of cash already.

mmm... asap is a vague term, they will always get there as soon as they can, whether that is as fast as they would have done in the past is a bit more subjective. There have always been finite budgets, and limited resources. There may or may not have been methods of prioritising calls or tracking the response times. There may or may not have been people left waiting or having badly trained, under equipped people coming out but 20-30 yrs ago we just accepted everyone was trying their best and that was all we could expect.

No, we are taking longer to get to incidents. years ago we used to have attendance times, where we had to get there within a certain time.

Now its all risk based now Very High Risk > High Risk > Medium Risk > low Risk > Very Low risk. These risk times attract different attendance times.

?ALL CRITICAL INCIDENTS (LIFE RISK) Risk Category Attendance Time for 1st Fire Engine Attendance Time for 2nd Fire Engine

Very High Risk 1st appliance >Less than 5 minutes: 2nd appliance >Less than 8 minutes

High Risk 1st appliance >Less than 8 minutes: 2nd appliance > Less than 11 minutes

Medium Risk 1st appliance >Less than 15 minutes: 2nd appliance Less than 18 minutes

Low Risk 1st appliance > Less than 20 minutes: 2nd appliance >Less than 23 minutes

Very Low Risk 1st appliance > Less than 25 minutes: 2nd appliance > Less than 28 minutes

High risk areas tend to be more socially deprived areas and city centre, low risk areas tend to those areas higher up the social ladder suburbs etc.

We could also set up a simpler police foprce called PCSO,eg security guards, and then slowly amalgamate parts of the traffic dept from different forces and make them one unit and privatise them.

Then create the serious crime squad or whatebr theyre called this week, and again privatise them.

Privatise the forensics,

and all the support staff in the stations and put them in call centres.

So that just leaves the bobies on the beat, easily transfered to a higher PCSO grade, then CID could be given to a security firm to run.

Strangely most of the above are being done by stealth or are already there.

Now in an era of fire-brigade strikes, ambulance crews not responding to dying patients because they were on a tea break (despite not having been on a shout all morning) and fly on the wall documentaries that don't necessarily always present the police in the best light - I can see why people might be a bit more sceptical about the position that public servants are always trying their best.

High risk areas tend to be more socially deprived areas and city centre, low risk areas tend to those areas higher up the social ladder suburbs etc.

😈

IIRC Sun Alliance Insurance started out as a private fire brigade. You got a cast iron plaque to put on your house (a bit like the old AA grille badges: there is a very old house near me that has one) so the fire brigade knew it was 'ok' to started putting your house-fire out.

Perhaps the government are after wealthy folk going back 150 years and having the choice to pay for their own fire brigade service that gets there a bit sooner. 😆

there is saving cash and there is saving cash...it is only ink on paper at the end of the day. seems we can spend loads on war bombing Afghanistan's peasants but funding british taxpayers who's jobs it is to save our lives when we need them most is a step too far ?!? time to get millionaires out of power if you ask me

neninja - If they are going to close hospital A&E and ambulance stations it's about time central funding started to help fund more Air Ambulance facilities.

bruneep - No, we are taking longer to get to incidents. years ago we used to have attendance times, where we had to get there within a certain time.

Now its all risk based now Very High Risk > High Risk > Medium Risk > low Risk > Very Low risk. These risk times attract different attendance times.

project - You dont need a police station in every town, police are mobile, they have cars, and are usually only needed in a fight or theft situation

ernie - After your little input I can see that you might well hope that people are sceptical about paramedics and firefighters trying their best

Then create the serious crime squad or whatebr theyre called this week, and again privatise them

...and give the contract to G4S, who bathed themselves in glory with their sound management of Olympic security.

ambulance crews not responding to dying patients because they were on a tea break (despite not having been on a shout all morning)

Prioritisation or triaging is definitely one of the factors which will improve services but there are so many other factors which need to be addressed ie. everything from primary care, to A+E and the public perception of what is actually an emergency.

Over the past 2 weeks my service have been testing responses designed to put the patient first rather than just meeting targets (which I have to say they were very good at) and the difference has been huge from my perspective as an RRV Paramedic as I am only getting activated to life threatening emergencies. While this means that I am sitting around some of the time, it also means that I am available to get to seriously ill people rapidly, whereas before I may have been tied up 75% of the time with non-urgent cases.

ps. I've just got home from a 13 hour shift so hopefully I'll be able to watch it on iplayer

Over the past 2 weeks my service have been testing responses designed to put the patient first rather than just meeting targets (which I have to say they were very good at) and the difference has been huge from my perspective as an RRV Paramedic as I am only getting activated to life threatening emergencies. While this means that I am sitting around some of the time, it also means that I am available to get to seriously ill people rapidly, whereas before I may have been tied up 75% of the time with non-urgent cases.

Good to hear - If I don't need someone urgently I don't want them there urgently (unless it hurts 🙂 ) people need to understand what emergencies are.
If we had a police station/ambulance station & fire station in every town I'm sure people would feel better until there was a crash on the road at one end of town and a fire at the other.

In any serious improvement exercise you need to work out what you need and how to use it most effectively.The world has changed since most of the infrastructure was put in population changes and risk factors etc.

ambulance crews not responding to dying patients because they were on a tea break (despite not having been on a shout all morning)

Blimey where was this? I might put a transfer in.

poly - Member

you need to put up taxation... ...and that needs to be 'across the board' not just saying 'times are hard the rich must pay more'. Sadly I don't recall any political party seriously offering this - since politicians play into the hands of the public I blame them...

So you haven't heard that one of the first things this government did was to bump VAT up to 20% then ?

That's despite the fact that the Deputy Prime Minister fought the election on a 'no increase on VAT' platform.

The 'Tory VAT bombshell' according to Nick Clegg :

[img] [/img]

And yes Poly, VAT is one of those nice "across the board" taxes which doesn't just target the rich - it also hits pensioners, the disabled, the unemployed, etc. So you should be very happy.

Although it would appear tonight that the disabled aren't hugely happy with the Chancellor :

[url= http://news.sky.com/story/980423/george-osborne-booed-at-paralympic-games ]George Osborne Booed At Paralympic Games[/url]

[i]"The cabinet minister is booed as he takes part in a medal ceremony at the Olympic Park - while Gordon Brown is loudly cheered."[/i]

"The cabinet minister is booed as he takes part in a medal ceremony at the Olympic Park - while Gordon Brown is loudly cheered."

How things change, at least with memories like goldfish people will forget this quickly too.

Did Gordon do a little comedy routine or something?
Fixed the worlds finances, set UK up for life, insult an old lady...

Or did he just do the I'm not him line

How things change

Why, was there ever a time when George Osborne was cheered by the disabled ?

Why, was there ever a time when George Osborne was cheered by the disabled ?

No but there was a time when Gordon was booed how did he jump in the popularity stakes or was it because he was stood near Osbourne

.... was it because he was stood near Osbourne

Well if you read the article you'll see that Gordon Brown was at a different venue to George Osborne, so no.

how did he jump in the popularity stakes

Presumably by not being George Osborne ?

Drac -

http://www.bbc.co.uk/news/uk-scotland-north-east-orkney-shetland-14475044

and another one (although I believe this one had been 'busy' all morning!)

http://www.thecourier.co.uk/News/Politics/article/14751/alex-salmond-s-pledge-on-ambulance-tea-breaks-after-martyn-gray-s-tragic-death.html

Ernie, I don;t remember any party openly claiming they would increase tax (the party that does will get my vote for being honest/realistic).

VAT wouldn't have been my obvious choice for this reason:

But compared to the deficit it is not enough on its own. So you either increase other taxation (income tax being the obvious one) or make cuts. The basic rate of income tax is lower now that has been since before Thatcher was in power...

From Poly's link

An SAS spokesman added, "Under the policy, all NHS staff are entitled to an undisturbed break during their operational shift.

"This can prove challenging in rural ambulance stations, which operate with smaller pools of staff than urban stations.

"This is a complex issue and we continue to work with the Scottish Government to find a solution to the challenges that the policy creates."

This looks to be more like a fault with the system which needs sorting out. More staff to cover brakes looks like the costliest option. Flexibility seems like the better one. It all depends where the balance is. If you are flat out all shift every shift then you are understaffed. If it's once or twice a week then you probably have to live with it as part of the job.

As for paying for stuff generally increasing what you take and reducing what you spend seems like a good one.

Capping C2W at lower tax rates maybe?
What about all this VAT avoided by shopping online in Germany?

I've not seen the program (just got in after another 10 hour shift became a 13 hour shift).

The only point I'd like to challenge is "ambulance crews not responding to dying patients because they were on a tea break (despite not having been on a shout all morning)".

I get one, 37 (soon to be cut to 30) minute break in my 10 hour shift, from which I am often late off my 2 hours or so. One break in 12 hours to go to the toilet, re stock my vehicle, eat some food (We're not allowed to eat in the vehicles), complete paperwork, check work emails etc. "Tea break" is a daily mail term used to demean workers by suggesting it is a meaningless luxury. I'm not paid for my break so why should I work for free? Add in the reality that the majority of "life threatening emergencies" are not, at what point does it become acceptable for people to be allowed a break?

Rant over, I'm going to bed, I've not had a chance to sit on station doing nothing tonight!

Re the above issues- if you do some more digging into the story you'l lfind that the guy in question was not actually asked to attend the incident. The service in question and the Scottish Govt did not actually announce this, it was the family of the lass concerned that had wanted to listen to the call transcripts and went public with the info.
I would also point out that the SAS and the Scottish Govt have now ammended our tea breaks in that our working week has been reduced from 40 hrs total where 2.5 hrs were unpaid breaks (btw- the fact that they were unpaid meant we werent actually at work when on our tea breaks cos we werent being paid..)
We now work a 37.5 hour week and do not have protected meal break windows- ie, we still work 11.5 hour shifts but are never sure when we will get a break- sometimes not at all.

So many issues surrounding the problems we've had- as alluded to above- triage systems, calls from other NHS areas, quality of calls from public etc..We just keep getting busier and busier but are being asked to do more and more for the same wages (ah the wage freeze) with less resources.

I came into this job because I want to try to and help the folk in my community, even if in a small way- I admit folk might always be driving at warp speed (if safe to do so) but I always treat every job as an emergency until I know its not and resent the implication that that might not be the case.

(Rant over).

I meant folk might not be driving at warp speed btw..

So you don't think it is appropriate to concentrate the resources on areas of greatest risk? People in rural areas have always had a "second tier" fire service, longer distances to stations and call out delays waiting for retained crews to arrive... Or do you think the fire service should not adapt to the changing world it finds itself in (falling number of dwelling fires)

So we have less severe fires within low risk areas do we? Fires don't care what your social area is!

I attended a fire within a low risk area. 1st in attendance crew of 4 under 5 mins. ( all well in the govt target dept) The fire was well developed my 2nd appliance was coming from a retained station some 13 miles away. As IC of that I took the decision that I would wait for further resources before committing the crews into the building.
That was seen by the public as we stood outside and did nothing! I am responsible for my crews, I am always told not to deploy until I have sufficient resources for the crew safety. Those resources took over 25mins to arrive by that time the house was a shell.

Not commenting on the Ambulance break story as that was a relative of a work colleague who died.

Fair play Bruneep. Can sympathise with you in the having to wait issue.
Happens to us too when there's too high a risk and we have to wait on others.
For the record, I haven't seen the program yet but will do so once this run of shifts is over as I was kept late again today and sleep is more important.
Just wanted to respond to comments made about tea breaks and taking too long to get to jobs..

Watched it on iplayer and as expected it didn't appear to be very well researched and the 'shock horror I had to wait ages' cases, where they interviewed people who didn't get an appropriate response time, were fairly poor examples. Is that really the best they could find?

It did try and get across the fact that police and ambulance services were operating to capacity and above and that has to be a good, as the general public have every little perception as to what really goes on.

althepal said

We just keep getting busier and busier but are being asked to do more and more for the same wages

I caught the last 30 mins or so last night, they concentrated a lot the Police, glanced over the Fire just mentioning how they attended big jobs and can make it in time, then finally a small piece on the Ambulance stating how we don't make the times.

They did mention that the workload for Police and Ambulance has grown and that doesn't help but they really should have shown by how much. I work in a rural town and we now even struggle to get our breaks, the unpaid ones where we are not allowed to attended call outs it's not a choice we can't attend, regularly doing 10 hours plus with a just few cups of water from the water fountain at the hospital. My shift is from 7am to 7pm and supposed to get 2x30 minute breaks during that time. I'm lucky if we're finished on time, if I finish before 8 I see that as a good thing.

I not expecting sympathy it's a job I chose but has changed massively since I started almost 23 years ago, the unnecessary calls from the public and even Dr's has increased. Add to that the lack of resources in rural areas meaning people just ring 999 and if we do transport it's at least a 50 miles round trip.

I had a 999 call out for me Sunday morning and was fortunate enough to have the paramedic with me pretty much straight away.

Does anyone know what proportion of police and fire budgets come from council tax?

poly - Member

Ernie, I don;t remember any party openly claiming they would increase tax (the party that does will get my vote for being honest/realistic).

It is very clear that you were stating that taxes needed to be increased but that no politician was prepared to do that.

The Tories put up taxes, they always do - under Thatcher the UK tax burden increased significantly.

Of course they don't 'openly claim' that they will put up taxes - they like to hoodwink the electorate into believing that they are the party of low taxation ! When in reality they are the party of low taxation for the rich, and higher taxation for everyone else.

But no one should be on any doubt that the Tories will put up taxes, whether they openly admit that they will or not - increased unemployment and tax cuts for the wealthy has to be paid for.

Besides, the Liberal Democrats had a huge nationwide poster campaign warning everyone of the Tory VAT bombshell, so I don't know why you appear to be oblivious to the fact that this government has increased taxes.

I'll just tackle one point

Round here all the small hospitals have either closed or emergency care provision centralised.

My understanding is that the actual outcomes for patients are significantly better with experienced, dedicated and better resourced trauma teams, rather than numerous, smaller A&E departments which don't carry the same resources or experience.

My understanding is that the actual outcomes for patients are significantly better with experienced, dedicated and better resourced trauma teams, rather than numerous, smaller A&E departments which don't carry the same resources or experience.

Maybe for Trauma yes but given that everything has to be transported to these hospitals, easily an hours journey, crew are often taken away from an area for around 3 hours. This may be for a minor injury that could have previously been treat at a local Casualty which now won't treat the patient. Mean time the Trauma patient in question has to wait for a response because the ambulance is transferring the patient with the minor injury.

This is why they are prioritising responses as I mentioned above workloads and unnecessary call outs are putting pressure on the few resources we have. The services are looking at various ways to deal with this but they also have to save money so makes it very difficult. As a side note government funded Air Ambulances are not the answer at all.

That is true in many cases zulu, particularly major trauma.

It is however, another reason why the ambulance service is so stretched, as instead of getting a patient to a local hospital within a few minutes, they may have a journey of many miles and then have to get back again to provide cover for that area. Ask Drac 😉

Edit: He beat me to it 😀

[devil's advocate]Back when we had 3 round-the-clock Casualty departments (as they were then known) within five miles of the city centre, if you were hurt enough to go there, but not so much that you needed an ambulance to get you there, you had what the government likes to call "choice".

My understanding is that the actual outcomes for patients are significantly better with experienced, dedicated and better resourced trauma teams, rather than numerous, smaller A&E departments which don't carry the same resources or experience.

Indeed, although one of our now-closed Casualty departments had a great reputaion for managing complicated fractures, much of the expertise from that department went up to the big hospital that didn't close.

The same principle of concentrated expertise also follows for hip/knee replacements, dialysis and all manner of other complicated procedures and care pathways that are currently being sold off to "any willing provider" across multiple sites and employers/agencies/organisations. All in the name of "choice". 👿

Entirely fair points

I read the random acts of reality blog since the start, and very much got the impression that the main problems he encountered (in london) were LOB jobs that had been allocated priority based upon the call centre computers (bad cold = difficulty breathing = priority) - is that still the case, or have they improved things now ?

(Drac, bearing in mind that I lived in Kielder for a couple of years, you'll understand that I can see your point 100% - to be honest, we pretty much knew that we were on our own for a good while if anything happened, obviously before the community responder scheme)

Or why my wife's work is so short staffed that they had to transport a patient 70 odd miles away.

1 Ambulance 2 ambo staff 1 midwife fuel etc. she was 1 hr late home no overtime for that. Its happening daily at her work. Worse if they have to take the air ambulance to edinburgh/glasgow as they then have to make their own way home if the air transport is required elsewhere. Dumped in another city by your employer.

.

Very understanding living in Kielder Zulu, Bellingham being the nearest station which is now a single manned crew.

I read the random acts of reality blog since the start, and very much got the impression that the main problems he encountered (in london) were LOB jobs that had been allocated priority based upon the call centre computers (bad cold = difficulty breathing = priority) - is that still the case, or have they improved things now ?

I'm on the road here in London and I can honestly say that nothing's improved.
They try and mess about with the triage system and when they downgrade one load of rubbish, they upgrade others. One of the biggest culprits are GP's. They claim that everyone they call an ambulance for needs an immediately sense as the condition is immediately life threatening. Very rarely is that the case, more often than not they just want the mildly ill person removed from their surgery.

I'm not sure what the answer to the problem is. The service down here seems to think that micro-management along with bullying staff is the answer. Needless to say, it's not working for them.

We are currently losing a huge number of staff to outer counties services as well as losing them to sunnier climes, at the rate we're going now, the problem will not get worse.

Over the past 2 weeks my service have been testing responses designed to put the patient first rather than just meeting targets

I think this is a huge issue for my work. It seems to have lost its focus that its a service to the public and trying to be run more like a business with targets to meet ... which ultimately is a goal driven by the government for the service to be 'accountable' and have measured improvments ... even though the measurements are not a true reflection of the service provided.

currently being sold off to "any willing provider" across multiple sites and employers/agencies/organisations

This - especially given that these dumbass reforms are being fudged in alongside existing efficiency-savings.

In my part of the world, emergency surgical admissions has [i]always[/i] been busy - but now the trauma lists are getting ridiculously backed-up, with fractured NOFs etc being cancelled 2 or 3 times in a row (i.e. elderly patients are being repeatedly starved for theatre). And A+E is increasingly rammed (whether inappropriately or not) - as services are fragmented, I suspect people will feel they have nowhere else to go.

Hiving-off elective activity was always going to have a knock-on effect on emergency capacity & workforce training - indeed, Lansley & his DOH minions were [i]specifically[/i] warned about the likely consequences. I hope new boy Hunt is prepared for what is coming his way... 👿

loved the responce from the fire person about the new landrover fire engines they carry 1 minutes worth of water.

ok for washing a bike tyre then.

a big fire in deeside, north wales last week, so they sent vehicles from all over north wales, instead of asking cheshire just down the road, or merseyside to send some, as they have a few more,that probably left a major chunk of north wales without cover,

To add some perspective, my mother had a health incident in the middle of the night in their beach house about an hour drive north of Wellington, in NZ. My dad called the emergency services, and was told to stick her in the car and drive to the nearest hospital, as that would be quicker then the ambulance could get there, and did they have their credit card with them ??

Town I grew up in only had a volunteer fire service, a big siren went off at the bottom of the valley and we would run to the window to watch the neighbour run out of his house in his dacks, run to his car and fly off down the hill.