Health Editor Emily Morgan witnessed first-hand the pressures ambulance staff are facing on a day-to-day basis
Recently it has made pretty grim reading, with record numbers of patients waiting in A&E for more than 12 hours and huge delays in ambulance response times.
It does though appear to be getting slightly less grim. Both response times and delays in A&E are better and the NHS claims this is down to sheer hard work and changes to working practices. I spent 48 hours with the South Central Ambulance Service and fully expected to be hanging around the door of A&E for hours on end, waiting for a bed to be free to admit a patient.
To my surprise, that isn’t what happened.
We clocked on at 6am and were off on a job immediately.
The first patient was an elderly man whose carer had found him with a bleeding mouth and uncommunicative. Kris and Tayla, the wonderful paramedics we were with, quickly assessed him and decided it was best for him to stay at home, so they called his doctor.
Within an hour we were on our way to another call, leaving the patient at home, knowing his GP would check on him later.
Derek was our next patient. He’d fallen at home and his wife couldn’t get him up. Kris told me frail people falling was one of their most common call outs.
It took us minutes to arrive at the house and the paramedics went in to assess him, a few minutes more and the door bell rang and in walked the community frailty team who’d been contacted by Derek’s GP.
Annabelle from the team knew Derek well, she briefed the paramedics, told them she was happy to take over and set about making Derek comfortable, assessing him herself. Kris and Tayla left.
The rest of their shift followed this same pattern; GPs were called, frailty teams put in place and social care packages hastily arranged. In ten hours, they took two patients to hospital.
For South Central this is the new norm. The service is working tirelessly with "local partners", to try find new ways of looking after and treating patients in order to avoid hospital.
The reason they do it is two fold, it’s better for the patients to stay at home where possible and it’s better for the hospital which is, by and large, full. They also operate a system called "Call before Convey".
It essentially means paramedics can call ahead to the hospital department most suited to the patient and book them straight onto a ward or send them directly for tests.
It cuts A&E out, freeing beds up for those who need emergency attention.
Kris and Tayla tell me it’s dramatically changed the way they work - gone are the days where they bundle patients into the ambulance and drive them to A&E.
They now make their own assessments, call relevant clinicians and in many cases don’t take their patients to A&E.
Did I see delays at Basingstoke and North Hampshire Hospital? Yes, of course I did.
By the afternoon A&E was full and staff were juggling beds to get more people in. Escalation areas were open all day, the waiting room was full and on occasions there were a number of ambulances waiting to admit patients.
Were staff busy, tired and stressed? Yes, I saw that too. But there weren’t trolleys in corridors, patients weren’t complaining and paramedics were only waiting for a short time.
I asked why this was the case, given the appalling winter they’re having.
I was told it’s a number of reasons; fewer patients are being brought to A&E, plans to speed up the discharge of patients from wards were working, extra areas to treat patients had been opened and for now, the flu and Covid season had peaked. This is not the story I had been expecting to tell when we were invited to spend time with the ambulance service but it is a story worth telling nonetheless.
The NHS is being forced to change and adapt to growing demand. We often hear of the failings, the delays, the queues and rarely of the successes.
There is quite obviously a long way to go but South Central Ambulance Service say this is a success. They are seeing an improvement in the service and they believe that will only get better with time.
A new modern day health service is now essential if we want to continue getting care free at the point of use.
It begs the question if the NHS is being forced to adapt, perhaps we too need to change the way we view the service and what we expect from it.
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