Dr Tony Copperfield talks us through an incident that shows the gravity of the ambulance waiting time crisis
I’m writing this in real time in a hurry, partly because I’m in real time, in a hurry, but also to convey a sense of the frantic, breathless and shattered NHS we work in, something which has come into sharp focus for me as I’ve just seen a man who walked into the surgery with chest pain, sweating and breathlessness, and sats of 84%, who is clearly having an MI and is now waiting, on oxygen, in our emergency room, but who – according to ambulance control, after two increasingly desperate phone-calls from us – may have to wait up to six hours for an ambulance, which means I’ve had to resort to the slightly unconventional plan of asking his elderly dad to take him in by car, and I’m trying to contact A&E to forewarn them of his imminent arrival and during the 10 minutes I wait for switchboard to answer and the half an hour I also wait for someone in A&E to respond to a bleep or ringing phone, to no avail, I click on to Pulse and read that the NHS intends to initiate lung cancer screening, which is like putting icing on to a non-existent cake and oh, hang on, my patient smokes, he’ll probably get his screening invite before he gets his ambulance, which will at least increase his choice of death, and while I continue to wait I see a three year old who is very poorly with pneumonia and, blow me, sats of 87%, yes, my oximeter is working, I checked it on myself and it’s 100% because by now I am hyperventilating, 15 minutes later I get the paediatrician on the phone and he says I assume you’ll get an ambulance for her, and I laugh but not in a good way.
Dr Copperfield is a GP in Essex. Read more of his blogs here
Back in 2019 I got a call from an A&E Dr who phoned the practice specifically to tell me off after I told a pt with (it turned out) an MI to make his own way to A&E instead of calling him an ambulance.
Turns out I was just ahead of my time!
I had a paediatrician complain when I sent poorly child with parents in car from OOH in one hospital with no paeds 15miles to another hospital with paeds. I think they were deflecting their reluctance to admit as didn’t believe was that ill. Then angry because so ill should have been an ambulance. Yeah right 8 hrs to get an ambulance transfer as would be viewed already in a place of safety. Which is not correct. But people still call ambulances for stuff we used to just get ourselves there.
An overpromised inert grey system. Too big for itself – no rules or regulations; just a lost ship. Treating IBS and panic attacks equal to bowel cancer and schizophrenia – not.
There’s now a shortage of paramedics for the ambulances and pharmacists for the pharmacies… happened since the introduction of the PCN system….
Steve Barclay and HMG seem to have stopped listening on this one
Remains to be seen what providers and ICBs can achieve with the extra money pledged
Re staff going to PCNs may be some truth in this but they move due to frustration at the conditions they have to work in on front line
MPs are quick to complain on behalf of their constituents when around access and waiting time GP OPD and for those on WL but ignored the warnings of the effects of austerity on the NHS over 10 years and introduced the Lansley reforms
Daily mail et al have enabled the rhetoric
And so it begins. Brush up on your acute medicine everyone, primary care is now the new A+E
(whilst also dealing with chronic disease and minor ailments).
Coppers – the sad thing is…:I’m not even shocked any more. This has been going on for 18 months now
We have had to take kids in our own cars with oxygen support. I have also called my husband to help lift an elderly man off the pavement after a fall, into my car, and back to his house, for me to administer first aid.
We are working and living in an utterly broken system
I took a patient into hospital 10 days ago in my campervan connected to a defib in the back looking like he was about to arrest. No ambulance turned up for an hour. When I called back 999 they told me to only call back if he arrests.
The same kind of thing happened to us last week. 999 ambulance called at 4pm for poorly patient with sepsis with lousy sats. No ambulance by 6.30pm and surgery about to shut. After bartering on phone ambulance pitched up at 7pm and left at 7.30pm, hence Dr and staff 1 hour late home. Dr asked paramedic, ‘is this your first call today?’. ‘Yes’, came the reply. ‘and probably our only one as we’ll be parked outside A&E forever’! Shortage of paramedics there may be but shortage of beds is the main present cause of no ambulances. Expect this scenario in your surgery sometime soon, if it hasn’t happened already.
A true reflection of the stressful environment we are in. I would laugh but it really is so stressful. Lack of staff due to the excess pressures. The lung cancer initiative is very well put. The icing on a non existent cake. Meanwhile, I have a ton of sponging illegals demanding scans, medications, investigations and referrals. They know their rights. I think charges need to be brought in to resuscitate the Major System Failure. A new abbreviation for multi source feedback MSF.
Most GPs have been burnt by this in recent years. If you ever want to admit a patient from your surgery, you never call an ambulance. Drive them to A&E yourself, with nurse in the back, ask a relative to do the same if not as desperate, or drop them home and call 999. But short of a cardiac arrest, NEVER summon an ambulance to surgery, as soon as they know there’s a “doctor on site” you’ll be there until Christmas.
I have been clear speaking with ambulance control many times that I finish work at 6 and will not be able to look after this patient sat in reception beyond this. They always turned up on time. Take their name, remind all calls are recorded. Stand your ground. Driving patients in your own car opens up a Pandora box if anything goes wrong.