The Sunday Telegraph
LONDON — Ambulances will no longer be sent immediately to seriously ill patients following a secret review of 999 calls.
NHS bosses have scrapped rules that state victims of serious health emergencies should be sent transport able to take them to hospital.
Instead, trusts could hit government targets in many cases by sending out paramedics in cars; even if it means that seriously sick and injured patients are left waiting for hours before an ambulance can take them to a casualty department.
The change was introduced quietly by senior ambulance officials last month after what they described as an “informal review” of the 999 system. It can now be disclosed after Department of Health documents were obtained by The Sunday Telegraph.
Patients’ groups and ambulance staff said they were appalled at the decision by the department’s Emergency Call Prioritisation Group, which was taken without consultation in the last weeks of the Labour government as part of attempts to manage rising demand for emergency care.
Katherine Murphy, of the Patients Association, described the rule change as “dangerous beyond belief”. She said it would encourage ambulance trusts to risk lives in order to meet targets. The Association of Professional Ambulance Personnel also expressed “deep concern”.
In millions of emergencies classed as “serious,” including those involving victims of major trauma or stroke, the commitment to send vehicles “capable of transporting the patient in a clinically safe manner” has been removed.
It means trusts can hit an NHS target to respond to calls in 19 minutes by sending cars out to patients who then have to wait for an ambulance to take them to hospital.
Mrs Murphy said: “I am absolutely appalled. We have been warning for a long time about the risks of putting the target before the patient, but the dangers exposed here are beyond belief.
“It seems extraordinary that they could make a change on this scale without any consultation with the public. This will clearly put lives at risk; we are talking about serious calls. These patients don’t just need a quick response - they need a full response.”
Under the latest guidance, the response required for cases identified as “immediately life-threatening” remains the same: a paramedic should be sent within eight minutes, with full ambulance back up in 19 minutes. The change affects calls classed in the category below, known as “serious” of which there are more than 2.5 million a year.
Trusts still have a 19-minute “response time target” in such cases, but the transport which arrives within this time does not have to be capable of carrying the patient to hospital. While rapid response vehicles can carry patients with minor injuries, accident victims requiring special equipment and seriously ill patients in need of monitoring can only be moved by ambulance.
An additional problem is that most trusts use “solo responders” to drive some of their cars who could not attend a sick patient while driving, experts warned.
Under the old rules, 999 control rooms could only dispatch a car to patients in the “serious” category if they had already assessed that they could be safely conveyed without an ambulance. Jonathan Fox, of the Association of Professional Ambulance Personnel, said he was deeply concerned about the patients who could be left without proper help.
He said: “These are serious calls - those who have had a stroke, elderly people with fractures who need to be moved very carefully, people who have been in a road accident and need a body board. “A lot of these cases will turn out to be life-threatening, and a lot of the medical situations need close monitoring.” Ambulance bosses are trying to find ways to cope with rising demand for emergency services, with the number of calls increasing by more than 250,000 a year.
A Department of Health spokesman said the Government was set to examine “the whole area of NHS targets”.
He said: “Patient safety is the priority. We expect ambulance services to provide the most clinically appropriate response to Category B patients.”
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