999 ambulance crews warn time wasters to watch the clock

With crews under pressure  even minutes spent on calls to minor ailments put lives at risk.

Wye Valley NHS Trust is gearing up for unrelenting – if not unprecedented – demand  over Christmas-New Year to the extent that “life-threatening emergency” may well define 999 response.

In that definition, the trust is backed by West Midlands Ambulance Service (WMAS).

Debbie Small, WMAS area manager for Herefordshire, said that for crews on the road 999 meant serious and critical illnesses or  patients that needed advanced medical treatment while headed to hospital such as choking, chest pain, stroke, serious blood loss or unconsciousness.

In the last year alone, WMAS received more than 28,500 calls in Herefordshire, a figure representing more than 15 per cent of the county’s population. 

A high percentage of those cases were non-urgent for minor ailments and injuries.

At the furthest extreme of those non-urgent 999 calls were “wart on a finger, “headache after a night out” and “stubbed toe”.

Paramedics and A&E staff accept that, by nature, they will often be a first contact for those who believe they need urgent medical attention.

But paramedic Chris Hughes said that, in turn, would-be patients needed to accept that – with the pressure on - every non-essential call has the potential to delay a response to a serious emergency.

A&E sister Jenny Weaver stressed that while no patient would be turned away, A&E “really isn’t the right place”  for minor illness or injury.

Over Christmas/New Year, then, patients who think their cold, flu, sore throat, stomach upset or hangover is an emergency may find the or pharmacist more receptive.

For minor cuts, slips, trips and falls the GP out of hours service or Hereford walk in centre are alternatives.

If urgent advice rather than treatment is required the first - and likely only - call should be to NHS 111.

Context to the current pressures crews were under came in a report put to Herefordshire Council’s health scrutiny committee in June this year.

By then, the Herefordshire Clinical Commissioning Group (HCCG) had been told that ambulance response to Red 1 calls, the most urgent, in the county became a “significant issue” over the past year.

HCCG buys and shapes health and care services, WMAS has the contract to provide ambulance services.

The scrutiny report put to council showed that while eight minute target performance picked up in February, it fell to 61 per cent in March, below the 75 per cent expectation.

In real terms, demand on the county’s 999 ambulance service is increasing year-on-year.

The period 2011-12 saw WMAS take an overall 19,528 calls from the county.

Figures for the past year show demand has jumped by some 20 per cent since.

All told, the service responded to 10,528 Red 1 and 2 calls across the county over 2013-13 – an average 28 a day.

Red calls are classed as immediately life-threatening and come with an eight minute response time.

Just over 66 per cent of Red 1 calls – cardiac arrest or life-threatening traumatic injuries – made the eight minute target.

Nearly 76 per cent of Red 2 calls – all other life-threatening emergencies – made the target.

Green calls, a category ranging from serious but not life-threatening to telephone assessment totalled 14,921 with target response rates between 95 per cent to 99 per cent.

Large parts of the Golden Valley and the north west of the county were identified  as “areas of concern” over Red 1 response performance.

There were also recognised Red 1 response concerns east of Ledbury and north of  Leominster.

Red 2 performance was stronger with concern recognised in responding to emergencies on the county’s borders.

At the time of the report, WMAS budgeted for 107 operational staff in Herefordshire with 97 posts filled.

On the report’s figures that’s 262 calls for each.