999: Out of Time, Tonight, Monday 16th November, 8pm

Published: Monday, 16 November 2009, 4:32PM

With many NHS Ambulance Trusts failing to meet their targets for responding to 999 calls, Tonight’s Morland Sanders investigates the consequences of employing ambulance crews with lower levels of training.

When nine-year old Bethany Dibbs suffered severe head injuries in a car collision, her father says he was told she was just minutes from death. The two-man ambulance crew first on scene believed they needed the support of a Paramedic to transport her to hospital. But they were told by their control room that the nearest crew containing a Paramedic was taking a meal break, and would not be disturbed to attend the life-threatening emergency.

So an ambulance technician on scene was faced with a dilemma - would he let a young girl possibly die in the street, or would he break the rules, call his colleagues directly and get help to transport Bethany to hospital? He chose to make the call and rang the local ambulance station. His lunching co-workers cut short their break and dashed to the rescue - the seriously ill Bethany was quickly transported to the nearest A&E and she's since made a slow but strong recovery.

South West Ambulance Trust, which covers the region where Bethany lives, says it is currently reviewing its meal break policy. But this is just one of a series of cases across the country where an ambulance crew has not been called to a serious emergency because staff were on a break. This nationally agreed policy of mandatory breaks is just one factor that makes it harder for many Ambulance Trusts to meet their government target of attending 75 per cent of Category A life-threatening calls within eight minutes.

The Department of Health for England says it is trying to improve the service provided by its Ambulance Trusts, both in terms of response times and the abilities of those who crew ambulances.

A key part of that policy is phasing out the role of ambulance Emergency Medical Technicians (EMTs) - often highly experienced lifesavers, but crucially not able to offer as many medical skills as a paramedic. EMT's are being encouraged to train up to paramedic standards and the government's vision is for ambulances to be crewed by one paramedic and an Emergency Care Assistant (ECA) - a new role in which a driver with six to nine weeks medical training backs up the paramedic.

The new ECA role has proved controversial with some frontline emergency workers - and the ambulance staff unions have voiced concerns that it is a cost saving exercise, that will prove detrimental to patient care. The Department of Health in England says, ultimately, re-allocating resources in this way will allow a greater proportion of operational staff to train to paramedic level or beyond which will, in turn, result in patients receiving a higher level of care. Tonight looks at a recent national ECA pilot scheme to see what lessons have been learnt so far.

Websites:

UNISON - http://www.unison.org.uk/ UNISON is Britain and Europe's biggest public sector union with more than 1.3 million members.

GMB  - http://www.gmb.org.uk/ GMB is a campaigning trade union and is a general union - which means that anyone can join us. GMB has almost 600,000 members working in every part of the economy. One in every 32 people at work in the UK is a member of GMB and GMB is organised in 34 of the UK's biggest 50 companies.

Association of Professional Ambulance Personnel - http://www.apap.org.uk/ - 'The Association of Professional Ambulance Personnel led the way 28 years ago and is the ONLY certified independent trade union to cater specifically for ambulance personnel.  As a union run by ambulance staff, we have a particular understanding of the experiences encountered by our members and a vested interest in resolving ambulance service issues, we are considered by many as the ‘Voice of the Ambulance Service'.

Department of Health - http://www.dh.gov.uk/en/index.htm - The government department providing health and social care policy, guidance and publications for NHS and social care professionals

The Great North Air Ambulance - http://www.greatnorthairambulance.co.uk/ - The Great North Air Ambulance Service provides, maintains and improves air ambulance cover across The North East of England, North Yorkshire and Cumbria, with its fleet of three aircraft based at Durham Tees Valley Airport, Otterburn DTE Northumberland and Carlisle Airport.