Paramedic speaks out over ambulance failures

​A paramedic from Lewis and Harris has spoken to the Gazette about the system, claiming “one size does not fit all” and regularly leads to long waits, even when a local ambulance crew is available nearby.

Coincidentally, the problems have been highlighted this week by a letter from Lochs Football Club, recounting two episodes in which the arrival of ambulances has been delayed through the workings of the centralised system.

There are three call centres – Inverness, Glasgow and Edinburgh. Island calls are mainly handled in Inverness but are passed to the other centres if Inverness is too busy.

The issue, the paramedic explained, is down to the way calls are triaged, particularly those of lesser urgency which are assigned to the queue to receive a phone call before an ambulance can be tasked.

Calls of this level of priority typically include falls and will be assigned to the queuefor a callback from an advanced paramedic practitioner who will then decide on what action to take, such as whether the patient should be put on a different pathway – such as to be seen by a GP – or put into another queue for an ambulance to be requested.

Advanced paramedic practitioners, who are tasked with making these triaging telephone consultations, have to work through a queue of calls in the centralised system and are not attached to any particular ambulance stations, so may not be able to match the calls to local availability.

The island paramedic, who spoke out on condition of anonymity, claimed that, while this system arguably works well in urban areas where there is a high volume of calls, it does not necessarily serve the needs of the islands community, where a large elderly population means cases such as falls and possible fractures are common.

They said: “It’s a good idea in big cities because there are too many calls coming in for the amount of ambulances, but our problem is, we are sitting on station, sometimes for hours, while people are lying on the floor.

"People have dislocated hips, knees, ankles, elbows… people have seizures… and they’re not getting ambulances straightaway.”

They added: “What we’re finding in quiet locations here is that people are being left in pain, quite often out in the cold, lying on the ground, and because they have to follow the same procedure as the mainland, or as busy cities, they don’t send the crews as quickly as they could.

“We have complained and we have said to management that we really need to have a different system, because we are turning up at jobs where the patient is in quite a bit of distress or in pain and they’ve been sitting waiting for two or three hours and the family are a bit miffed with us.”

A UNISON spokesperson said: “We have been saying for some time that the current triage system is far from ideal for remote and island communities. We would certainly be supportive of looking at ways to revise the system.”

A Scottish Ambulance Service spokesperson said: “For those patients that require an immediate ambulance response, such as immediately life-threatening conditions, we will always dispatch the nearest and most appropriate resource. The Western Isles like other remote and rural locations are excluded from escalation when we experience system pressures on the mainland.

"For other types of patients, remote clinical assessments have been successful in delivering better patient-centred care and we are working to optimise the management of these across Scotland and all island settings. The median response time for these in November was 13 minutes for our highest priority patients and 31 minutes for others in need of assessment.

"Currently, 42% of emergencies in Scotland are managed at point of call, without the need for unnecessary attendance at hospitals, freeing up resources for high priority patients in need.”