An increasing reliance by ambulance trusts on fast-response cars means some ambulances are taking longer to reach seriously ill patients, Channel 4 News has found.
Dial 999, say ambulances, and it’s increasingly likely that you’ll be sent a car or a motorcycle as trusts use quicker, cheaper vehicles to respond to calls in government-set deadlines, writes Channel 4 News Northern Correspondent Morland Sanders.
Yet paramedics have told Channel 4 News that the reliance on so-called fast-response vehicles is putting the lives of some critically ill patients on the line, and it can’t even be guaranteed that the person behind the wheel is a qualified paramedic.
Flynn Thomas pushes a toy ambulance across the kitchen table. He’s imaginative, bright and like any three year old boy somewhat robust in his play but as his mother watches on she’s close to tears.
Amy is recalling how ill Flynn became in September this year when he collapsed at the family home. She rang 999 and a paramedic duly arrived in a car after twelve minutes but the paramedic quickly realised that Flynn was too ill to be treated at home, he needed an ambulance to take him to hospital – that’s when the waiting began.
Amy Thomas said: “It was 50 minutes before the ambulance arrived, watching him slowly dying, it was the most horrendous thing I’ve ever felt in my life, don’t want to ever feel like that again.”
After nearly an hour Flynn was eventually on his way to A&E and is now back to being a healthy boy.
The ambulance trust responsible said the main reason for the delay was an unpredictable rise in 999 calls in the area that evening.
Yet some frontline staff say waiting tens of vital minutes for an ambulance to arrive is becoming increasingly common. The reason, they say is a combination of more 999 calls and the decision to answer them with a growing number of fast response cars.
Jim Petter, for the College of Paramedics, told Channel 4 News: “The ambulance service’s response is to put out as many people on solo response cars as possible meaning that at peak times there isn’t an ambulance to send quickly to back those people up.”
Official figures show that 60,000 emergency ambulance call-outs have failed to meet government response targets since April this year.
And Channel 4 News has been told it’s the increasing number of cars that may be to blame.
So we decided to look at the figures over the past three years. Nine out of 11 trusts provided data.
We found that in four of those trusts ambulances are taking longer to reach the most seriously ill patients and we discovered that three of these have increased the proportion of cars.
Among these three trusts, on average, more than a third of the emergency fleet are now cars, incapable of taking a critically ill patient to hospital.
Paramedics we’ve spoken to say the emphasis on cars can put lives on the line. One who works alone in a car agreed to speak to us on condition of anonymity, for fear of losing his job.
One parademic told Channel 4 News: “The main concerns are we respond to incidents and when we require a backup ambulance it can take up to 45, 50 minutes on some occasions. The majority of the time it’s quite good, but there is lots of occasions when there isn’t enough ambulances around.
“Lives are put at risk. At the moment I’m ashamed to be an ambulance man because there is too much time lost.”
The trusts say they are trying to meet a government target to attend life-threatening calls within eight minutes, which is based on clinical evidence, cars help them to meet this. But it’s who is manning these cars which has been highlighted to Channel 4 News as another potential threat to patient care.
It is widely considered best practice that these rapid response vehicles should be staffed by a paramedic. But it now seems clear that frequently they are crewed by a lower clinical grade member of staff called an ambulance technician, someone who is less capable of keeping a critically ill patient alive.
“If you send out a solo response of a lower clinical grade and then they don’t get back-up quickly, that becomes a problem because they can’t continue to manage that patient in the way that they should be,” says Jim Petter of the College of Paramedics.
Even the umbrella organisation representing the trusts, the Ambulance Service Network, didn’t seem to be aware that cars were crewed by technicians.
“My understanding is that the people in who are solo responders are paramedics. I would say that the best practice would be to have paramedics as solo responders,” according to Jo Webber, director of the Ambulance Service Network
But this best practice is something that parts of our ambulance service are seemingly falling well short of. We’re told technicians are working alone in cars and a number of trusts say they plan to increase fast response vehicles over the next few years – despite those on the frontline telling us that both policies mean lives could in fact be lost.