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Fewer ambulance 999 calls to be classed as 'life-threatening' | Fewer ambulance 999 calls to be classed as 'life-threatening' |
(about 1 hour later) | |
Fewer 999 ambulance calls will be classed as life-threatening and needing a super-fast response in the biggest shake-up of the service in 40 years. | Fewer 999 ambulance calls will be classed as life-threatening and needing a super-fast response in the biggest shake-up of the service in 40 years. |
The move by the NHS in England - and agreed by ministers - will result in about 8% of call-outs being classed as needing the quickest response. | The move by the NHS in England - and agreed by ministers - will result in about 8% of call-outs being classed as needing the quickest response. |
Currently half of call-outs are, but many are not serious or could wait longer for paramedics to arrive. | Currently half of call-outs are, but many are not serious or could wait longer for paramedics to arrive. |
NHS bosses said it would free up crews to reach the sickest more quickly. | NHS bosses said it would free up crews to reach the sickest more quickly. |
They said the targets that were being used now were "blunt" and "dysfunctional" and meant too many ambulances were being dispatched just to meet targets rather than prioritising patients appropriately. | They said the targets that were being used now were "blunt" and "dysfunctional" and meant too many ambulances were being dispatched just to meet targets rather than prioritising patients appropriately. |
The changes have been backed by medical experts after being carefully piloted on 14m 999 calls over the past 18 months. | The changes have been backed by medical experts after being carefully piloted on 14m 999 calls over the past 18 months. |
In one of the pilot sites, cardiac arrest patients received a response 30 seconds quicker than they did previously, the evaluation by Sheffield University found. If this was repeated across the country, it could save 250 lives. | |
Wales has already introduced a similar system, while Scotland is piloting its own version. | Wales has already introduced a similar system, while Scotland is piloting its own version. |
No risk to patients | No risk to patients |
Under the changes, call handlers will also be given four minutes before they need to send out a crew to assess what the patient needs - currently they have only 60 seconds. | Under the changes, call handlers will also be given four minutes before they need to send out a crew to assess what the patient needs - currently they have only 60 seconds. |
Combined with fewer patients being classed as life-threatening, the pilots suggest this will create an efficient system and will put no patients at risk. | Combined with fewer patients being classed as life-threatening, the pilots suggest this will create an efficient system and will put no patients at risk. |
Currently about a quarter of life-threatening calls do not end up needing hospital treatment, but the rush to hit the eight-minute target to reach them can see multiple crews dispatched - one in four "blue-light" calls are stood down before they reach the scene. | Currently about a quarter of life-threatening calls do not end up needing hospital treatment, but the rush to hit the eight-minute target to reach them can see multiple crews dispatched - one in four "blue-light" calls are stood down before they reach the scene. |
However, it does mean some patients who should have received an eight minute response, such as those who have suffered a stroke, could now wait 40 minutes. | However, it does mean some patients who should have received an eight minute response, such as those who have suffered a stroke, could now wait 40 minutes. |
Doctors, though, argue what is more important is that they get the right treatment in hospital - and this will now be more closely measured under the new system of targets. | Doctors, though, argue what is more important is that they get the right treatment in hospital - and this will now be more closely measured under the new system of targets. |
Prof Keith Willett, of NHS England, said one of the problems with the current system was that crews were being unnecessarily dispatched to "stop the clock". | Prof Keith Willett, of NHS England, said one of the problems with the current system was that crews were being unnecessarily dispatched to "stop the clock". |
"This has led to the inefficient use of ambulances, with the knock-on effect of hidden waits," he explained. | "This has led to the inefficient use of ambulances, with the knock-on effect of hidden waits," he explained. |
These hidden waits are essentially where a first responder bike or car arrives when an ambulance is needed. | These hidden waits are essentially where a first responder bike or car arrives when an ambulance is needed. |
Currently an estimated one million people a year - one in four of those who need transporting to hospital - find themselves in this situation. | Currently an estimated one million people a year - one in four of those who need transporting to hospital - find themselves in this situation. |
Under the changes: | Under the changes: |
The new system will also measure average waits for life-threatening and emergency cases - this is to ensure that every call out counts towards the target. | The new system will also measure average waits for life-threatening and emergency cases - this is to ensure that every call out counts towards the target. |
One of the criticisms of the existing system is that once the target time has been missed there is less incentive to get a crew to the patient quickly. | One of the criticisms of the existing system is that once the target time has been missed there is less incentive to get a crew to the patient quickly. |
The changes will be rolled out across the service by the autumn after pilots in three of England's 10 ambulance services. | The changes will be rolled out across the service by the autumn after pilots in three of England's 10 ambulance services. |
College of Paramedics chief executive Gerry Egan said he was "fully supportive" of the move. | College of Paramedics chief executive Gerry Egan said he was "fully supportive" of the move. |
"It is vital to patient care that paramedics are targeted to the most appropriate patients." | "It is vital to patient care that paramedics are targeted to the most appropriate patients." |
And Juliet Bouverie, of the Stroke Association, said even though stroke patients may wait longer for that first response, she thought the changes would be beneficial. | And Juliet Bouverie, of the Stroke Association, said even though stroke patients may wait longer for that first response, she thought the changes would be beneficial. |
"Under the current system, the first responder to a stroke patient could be on a motorbike - but this vehicle can't transport the patient to hospital meaning they have to wait even longer for an ambulance to arrive. | "Under the current system, the first responder to a stroke patient could be on a motorbike - but this vehicle can't transport the patient to hospital meaning they have to wait even longer for an ambulance to arrive. |
"By allowing ambulance call handlers a little more time to determine what is wrong with a patient, it ensures that stroke patients can be identified and the right vehicle sent out immediately to get the patient to a stroke unit." | "By allowing ambulance call handlers a little more time to determine what is wrong with a patient, it ensures that stroke patients can be identified and the right vehicle sent out immediately to get the patient to a stroke unit." |