However good the NHS is, it is not a lot of things; it isn’t social care, it isn’t a hotel and it most certainly isn’t a miracle worker. I work as an emergency care assistant on ambulances at the weekend. I can see the amazing things the health service does, but also why it sometimes appears to be falling apart at the seams. The NHS is stretched to breaking point every day. There are a lot of reasons for this and some of them are easy to see.
I’ve lost count of the number of times I have been called to patients who aren’t really patients at all. They are desperately in need of help, but not medical help. They need social care. Or social housing. They need their basic needs to be met, but not an ambulance crew. It’s just that there is no one else who they can call on a Sunday afternoon when, for example, they are at the end of their tether. When the loneliness hits hard, the prospect of not seeing a friendly face for another week is more than they can bear.
In the past this would have been dealt with by ringing another family member, or by a carer or a respite centre to give the family a break. These days, though, families are spread far apart and cuts to local authority budgets mean social care has been decimated. There is no one to call. There is no relief or respite in sight for a lot of these people and so, in desperation, they call an ambulance.
In turn, because the ambulance crew can see that the family cannot cope, that it’s just too much, we have no choice. We take them to hospital in the hope that given a few hours of space the family feels better, more able to continue in the thankless task of caring. We put a plaster over society’s failure.
And so there goes a hospital bed. A nurse, a doctor, all of whose time is taken up, instead of looking after the sick. There goes the protected NHS budget – the one that the government has pledged to increase. Only it’s not really an increase or protected at all, because now, instead of the money being spent on social care, and coming out of local authority budgets, it is coming out of the NHS one.
Then there are the lost souls. Those who drift, who sofa surf or sleep on park benches. Many of them mentally unwell but not acutely so. They don’t need a hospital, they just need somewhere warm and safe. It takes a cold-hearted person to leave someone on a park bench when you know they have nowhere else to go and it is -3C outside. Yet again we, the ambulance crew, paid for by the NHS, spend our time and your money phoning around charities, forgotten contacts in our patient’s phone, in the hope that we can find them a warm bed for the night. If not, due to cuts in social housing, there being no easy access hostels, we take them to the warm waiting room of the hospital. As we sit there sticking plasters on the plight of the homeless, another cardiac arrest call goes unanswered. Another person dies.
Other patients are just too old; their bodies far too weak. Sometimes it happens slowly, other times it is quick. I recently went to a patient who was in his 90s and barely lucid. His daughter insisted he had been fine until he got pneumonia and was taken into hospital for a month.
There was no point telling her that maybe it was just his time to go. That he had lived longer than most people, that the hospital she was blaming for the state of her father was probably to blame, only not in the way that she thought. Years ago, her dad wouldn’t have been taken to hospital to be treated for the pneumonia that nearly killed him. He would likely have just died at home. Instead we dragged him off to A&E for more interventions. When he isn’t restored back to full health, no doubt his daughter will claim that the hospital killed him. Blame, it would seem, is easier than the truth. Sometimes we just need to allow people to die and not play God and attempt miracles.
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So far, we know of 54 babies whose parents say wouldn’t be alive today if it wasn’t for The Chokeables, St John Ambulance’s first aid film teaching people how to save a choking baby in just 40 seconds.
We’re delighted our film has won charity film of the year, announced at Bafta on 15 March. So what’s the secret of its success?
Before making the film, we carried out research that revealed parents are the people most interested in first aid and what they worry about most is their baby choking. Over 40% of parents had seen it happen, 58% said it was a serious concern and yet 79% didn’t know what to do.
Our previous campaigns had been aimed at getting people to take first aid seriously but our audiences just weren’t taking the next step and learning it.
We realised we needed to teach directly – beam the advice into parents’ lives in a way they couldn’t ignore. And the tone needed to be spot on. Parents don’t want to be browbeaten and made to feel guilty. It’s hard enough being a parent. What we needed was an upbeat, engaging, shareable lesson.
Enter the geniuses at Bartle Bogle Hegarty. They realised that the lesson would come across best if taught by common household items that could potentially choke babies – the kind of things most parents would find under their sofas, like a toy or a pen lid. They crafted a script around the idea that these characters were so fed up with babies choking on them that they have decided to teach parents what to do.
We used animation to make the topic less scary, and pulled in the big guns with David Walliams and Johnny Vegas voicing the characters.
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This was all quite a feat considering the film needed to be 40 seconds long. Our tip with charity films is the shorter the better, to get as many people as possible watching to the end, but also to air it on TV in a cost-effective way.
I wanted a name for the campaign to help parents connect with the characters, and identify the campaign easily so it could trend on social media. Heaps of chocolate and one brainstorm later, The Chokeables was born.
When it came to sharing and promoting the film, we developed close relationships with key media to help create a buzz before we released the video. We focused in particular on those who could help us reach a high proportion of parents, such as ITV’s Good Morning Britain and Mumsnet, as well as nationals like MailOnline and the Mail on Sunday. Facebook was crucial as mums use it to share parenting tips, and we also worked with the mums who’d saved their babies so that even more parents could find out what to do.
Social media was key and we created a Thunderclap so people could mass share the video, flashmob style, as well as social media competitions to increase further engagement, such as a messy baby photo competition with first aid kit prizes. We also produced a whole suite of baby first aid advice videos to inspire further learning.
We entered The Chokeables into the inaugural Charity Film Awards, when entries opened in 2015. The awards have been set up to recognise the best videos created by or on behalf of UK charities, whether for raising awareness, changing attitudes and behaviours or fundraising.
Over 375 charities entered for the first round of public voting. More than 43,000 people voted and the resulting shortlist went to a panel of judges. They whittled it down to the finalists, including household names such as the RSPCA, Barnardo’s, the RNLI, Alzheimer’s Society and Great Ormond Street children’s hospital.
A second round of public voting for the people’s choice award has seen more than 66,000 people vote for the winner – the Soi Dog Foundation’s film about Cola the dog, who was given custom-made prosthetics after his front legs were amputated.
To win the overall award for film of the year for The Chokeables is just incredible. We’d put everything into this and hoped it would make an impact, but the success has knocked us sideways. Not only have we taught millions of people how to help a choking baby but it’s helped people feel that St John Ambulance is relevant to their lives.
The video continues to receive millions of views whenever it’s re-posted on social media. I love these stats but nothing beats getting a message from a mum who has saved their baby thanks to our video. There’s no greater reward than knowing we’ve reassured parents and helped all those babies.
Emma Sheppard is head of communications, St John Ambulance. The Chokeables won film of the year at the 2016 Charity Film Awards.
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Staff at one of the country’s biggest ambulance services had to log emergency calls manually overnight because of technical issues in the control room, delaying response times.
It is understood London ambulance service’s computer system crashed, forcing staff to record details of calls by pen and paper for nearly five hours on one of the busiest nights of the year.
A spokeswoman said staff were trained to deal with such situations and were able to prioritise responses to those in greatest need.
The deputy director of operations Peter McKenna said: “Due to technical difficulties, our control room was logging emergency calls by pen and paper from 12.30am to 5.15am.
“Our control room staff are trained to operate in this way and continue to prioritise our response to patients with life-threatening conditions, using the same triage system as usual.
“We also have additional clinicians on duty to offer control room staff clinical advice if it is needed.”
The pressure on the NHS ambulance services is increasing. Recent figures showed that of the UK’s 13 ambulance services, only Wales was reaching emergencies within the target time of eight minutes. They also showed that the number of patients waiting for ambulances for more than an hour had almost tripled in the past two years, and that ambulance crews were wasting more than 500,000 hours queuing outside hospitals.
Keith Willett, the director of acute care at NHS England has called it, “a system-wide problem … it is about an increase in demand for urgent healthcare need. Of all the parts of the healthcare sector, the ambulance service has seen the largest increase in demand at 7.3% in the last year.”
Paramedics too have reported working under tremendous pressure as a result of increasing demand. Many say they continue working well past the end of their 12-hour shifts, and rarely get meal breaks. So what impact is this having on patients?
Share your experiences
We’d like to find out what it’s like to receive care. We also want to hear from those working in the service about their daily challenges. What have patients experienced? What impact did it have? What parts of the service are effective and what’s not working so well? What worries you about the future?
Share your views and stories in the form below. The information you give us will be confidential and we will be in contact with you before we publish any contributions.
One side-effect of the change in hospital roles and closures (Thousands of beds to go in NHS shake-up, 19 November) is the unmentioned increased expense on the ambulance service and the charity sector.
If the NHS makes journeys to hospital longer, more ambulances and crews will be needed and, in rural areas, emergencies will place even greater calls on the air ambulance. While the NHS provides the paramedics for this latter service, the helicopters are only kept in the air by public fundraising. Living in the Yorkshire Dales, we recognise the quality of ambulance services but, even now before the cuts, Northallerton A&E is an hour’s road trip from Hawes, and Middlesbrough trauma centre even longer even with the help of blues and twos. Much of the journey is over roads that are winding, poorly maintained and dangerous in winter.
Once the patient is there, they might like visitors. That’s three separate buses each way from Hawes to Northallerton (Middlesbrough is virtually impossible by public transport in a day).
Is this really saving money or just passing the financing buck to ambulance trusts and the charity sector, and making the beneficial effects of having loved ones visit even more expensive and difficult? John Loader West Witton, North Yorkshire
• In your report of the proposed changes to hospital provision in Cumbria, distance was mentioned. Some women living south of Whitehaven would be expected to travel more than 50 miles for consultant care. Such a journey would mean negotiating Sellafield with shift workers leaving, and a journey on the mostly single-carriageway A595 may be behind slow-moving tractors. If women from my home suburb of Cheam in south London were expected to have their babies in Brighton there would be an outcry. At the very least there would be a dual carriageway to get there. Janet Mansfield Aspatria, Cumbria
• Total hospital bed numbers per 100,000 population for the year 2014 were: Germany 823, France 621, EU average for 28 countries 521, and the UK 273 (figures rounded to whole numbers). Yet a huge reduction is bed numbers is proposed. With this low base of bed numbers, there is no evidence whatsoever that increased community resources will decrease the need for hospital admission. It’s just that patients won’t get the life-saving treatment they need. Morris Bernadt London
• Join the debate – email guardian.letters@theguardian.com
• Read more Guardian letters – click here to visit gu.com/letters
It’s 6.45am at Camden ambulance station in north London, and the day shift is just beginning. Andy Donovan, who will drive the ambulance I will accompany for the next nine hours, is making me a cup of tea. His more senior paramedic partner, Dean Lowes, is running a few minutes late. When he does arrive, Lowes looks very sorry for himself: he’s got an ear infection, picked up on a friend’s stag weekend in Budapest. Lowes is the ambulance’s first case of the day. They nip off to the nearby Royal Free hospital in Hampstead to get some ear drops. Paramedic, heal thyself.
All this delays us for more than an hour, and we’re not ready to “go green” – telling the London ambulance service’s call centre near Waterloo station that they are available for a job – until after 8.30am. Lowes, who along with Donovan is featured in the BBC’s new three-part series on London’s overstretched ambulance service, is suitably embarrassed. “This never happens to me,” he says. “I’m never ill.” But full marks for at least getting here. Crewing an ambulance is challenging at the best of times.
Soon after going green, our first assignment comes in, flashing up on a monitor at the front of the ambulance. It’s just about as unpleasant as it could be. One word: “HANGING”, and the location. It is a “Red One” – the top-priority call sign, meaning life-threatening. Lowes and Donovan’s speed of reaction is electrifying. One moment, Lowes had been playing a Kings of Leon track on his mobile and saying how much he liked the band; the next, the ambulance is tearing south towards King’s Cross.
The call comes through at 8.49, and we get to the scene five minutes later. My heart sinks when I realise it is student accommodation. Two policemen are arriving simultaneously, and we all head up two floors in the lift to a stuffy, antiseptic white corridor. I go up with the policemen, who are bemoaning the fact their car was the closest to the scene. “You had a feeling it was going to be a funny day,” one says to the other. “You said you had a feeling in your bones.” “Yeah,” says the other with a grim laugh, “I should shut the fuck up.” In situations like this, black humour is sometimes the only way out.
Lowes, as senior paramedic, is first into the little study-bedroom. He has to decide if the student, who appears to have hanged himself, is dead, or, in the official language they use, to declare “life extinct”. It takes him just moments to satisfy himself that he is. The student is pronounced dead at 8.57. I can’t bring myself to look at the body – the young man is fully clothed – for too long. What strikes me most is how peaceful he looks, and how red his hands are – the blood drains down to the hands and feet, a sign he has been dead for several hours.
Within minutes there are half a dozen police on the scene, taking a statement from the traumatised fellow student who discovered the body, talking to the staff in the hall of residence, looking through the young man’s possessions to establish his identity. It has ceased to be a medical emergency and become a police inquiry – and a personal tragedy for the family who do not yet know what has happened. It appears the young man, who was 23, was anxious about a dissertation he had failed to deliver. What a terrible, pointless waste.
This is a shocking beginning. A suicide by hanging is rare. It is the first Lowes has witnessed. “He looked like a wax dummy,” he says as we wait downstairs while he does the paperwork to certify the death. “It’s when you see his passport and the picture of how he looked when he was alive that it hits you. That humanises it.” Having been a body, he becomes a person. “I try not to look at a dead person’s effects too much,” says Lowes, “because you start to build a little story about them.” “You can’t go into it too deeply,” adds Donovan. “There’s a lot of stuff you lock in the box.”
A paramedic team leader turns up. He doesn’t say so, but Lowes and Donovan know he is there for their welfare – to make sure that having to deal with the young man’s death has not affected them too severely. “If you want to take a bit of a break, that’s fine,” the team leader tells them. They don’t particularly, although they do have a fag standing next to their ambulance. The morning is hot, and people stroll past the student block, laughing in the late-summer sunshine, not realising that inside a promising young life has been extinguished.
By 11am, they are ready to roll again. They go green, pressing the button that declares the ambulance available, and in a second – literally – their next assignment flashes up. It’s another Red One – a cardiac arrest in West Hampstead, a couple of miles to the north. The siren screams, I lurch around in the back of the ambulance feeling sick, and Donovan swears at the vehicles that block his way, costing him vital seconds that could mean the difference between life and death.
Call handlers at the emergency operations centre in Waterloo. Photograph: Glenn Dearing/BBC/Dragonfly
The job is undeniably exciting, or at least seems so to me. Horrible, of course – no one wants to discover dead bodies – but also fascinating because of its unpredictable nature. You have no idea where you will go next or what you will have to deal with. “That’s the beauty of it,” Donovan had told me earlier. “You never know what you’re going to from job to job.”
It’s like roulette, I suggest, and he tells me that is exactly what they call the last job of the day. If you go green with, say, half an hour left of your shift, the call centre will play “red roulette”. Instead of giving you a less urgent call (categorised from C1 to C4, depending on the degree of seriousness), they will give you something life-threatening. It seems mad, but the logic is that whatever you do is likely to take hours – every callout seems to generate a mountain of paperwork – so you may as well go to something that is worth your while. A practical, if heartless, way of looking at it. Paramedics often work 12-hour shifts, and I can’t imagine what it’s like to get a final Red One at the very end.
We get to West Hampstead in about six minutes. Another ambulance is already on the scene, as well as team leader April Barter, who has come by car. I bumped into her earlier at the ambulance station in Camden, and she was complaining about having nothing to do that morning. Now she has something to do. A man in his 60s has had a cardiac arrest – a heart attack in which his heart has stopped completely – and the struggle is on to save him.
The man is lucky. I hadn’t realised where we were when we arrived, but then it dawns on me – it’s a bridge club, and dozens of middle-aged and elderly card players are watching the paramedics’ attempts to revive their fellow participant. Even before the first crew arrived, some medically trained members of the club had starting giving him CPR (cardiopulmonary resuscitation), that pounding of the chest that aims to kick the heart back into action. Without their prompt action, he would be dead. The paramedics continue the CPR – by now his chest looks as if it has caved in, but apparently this is quite normal – and administer defibrillation, an electric shock designed to correct his heart rhythm.
After half an hour of attention, his heart is functioning again and he can be taken to hospital. He is still unconscious, but has a reasonable chance of surviving. His bridge partner, who tells me they had just played a very successful rubber, offers to go to hospital with him, while his wife is given the news at home. There is an impressive calm at the club as the man is carried out. Who knew bridge could be an extreme sport – or bridge players so unflappable?
A cardiac arrest involving two crews generates an especially large volume of paperwork, and we are stuck outside the Royal Free for more than an hour while all the forms are filled in. Soon after we deliver the man to the hospital’s heart centre, Barter tells me he has regained consciousness. “The fact he’s awake, his eyes are open, he’s moving around tells us his brain has more oxygen. Although potentially it has been starved of oxygen for a short period of time, that’s a really positive sign and it’s a potentially good outcome for him. That’s a massive lift for us. Good times.” She says she is “buzzing”. “If I can make a difference to one person in a day, then I go home happy,” Donovan told me earlier. It looks as if he and his colleagues have made that difference today.
It is that difference, rather than the material rewards of the job, that attracts Lowes and Donovan. “You don’t do this job if you want money,” says Lowes, who is 37 and comes from the north-east of England. “It has other benefits. You go home and you sleep at night. You don’t take any work home with you. You might take some kind of emotional stuff away at the end of the day but, as far as the working day is concerned, once you’re finished, you’re finished.”
Lowes, who is a fully qualified paramedic, tells me he earned £36,000 last year. Thirty-year-old Donovan, a friendly, buoyant east Londoner who is one rung below his partner in terms of clinical qualifications, says he earns £20,000 a year basic, which rises to about £28,000 with the inner-London allowance, rest-break compensation (they will typically work through their breaks) and overtime, lots of overtime. They are contracted to work 37-and-a-half hours a week, but can do up to 56. Without the overtime, they would struggle financially. The staff need the relentless pressure on the service to earn enough to live.
The upside, apart from the drama of the job and the satisfaction of saving lives and helping people at moments of crisis, is the flexibility. “There are a lot of other things out there that I wouldn’t want to do, sitting behind a desk being one of them,” says Donovan. “At least in this job you’ve got a little bit of freedom. Once you’re out on the road, you’re your own boss.”
While the paperwork for the cardiac arrest case is being done, I talk to Gary Nicholls, one of the paramedics in the first crew to arrive. He has clocked up almost 24 years on the job – Lowes and Donovan have each done seven. “You never know what the next call is going to be,” he says. “That’s what keeps us interested. But it doesn’t matter what comes down on the screen, we can always deal with it. The workload can be relentless, but your colleagues are there to get you through the shift.”
The London ambulance service was put into “special measures” last year because of a number of failings, including staff shortages, poor response times, lack of leadership and concern that the service was ill-prepared to deal with a major terrorist attack. The cynic in me thinks the BBC series – and my ride in the ambulance today – are part of the PR fightback, and maybe they are, but there is no doubting the commitment of the dozen or so paramedics and backup staff I meet. This is a service under pressure, but by no means one that has lost heart. Nicholls really does believe they can deal with anything, including his first job that day – chasing a naked man who it was feared was high on drugs across Hampstead Heath.
It is already well past 1pm. The complexity of the jobs, the paperwork and the fact that you need a bit of a breather mean crews will only do four or five callouts in a nine-hour shift, and six or eight in a 12-hour one. Just before 1.30pm, Donovan and Lowes go green again. This time it’s a Red Two – slightly less urgent but still potentially life-threatening, a woman in Kilburn with chest pains and breathing problems.
She is sitting on the stairs of her house when we arrive six minutes later. She looks remarkably well, and within about two minutes of arriving Lowes has diagnosed an anxiety attack. She had a heart bypass operation five years earlier, and clearly fears a heart attack. She has already been to hospital for a checkup that day, and now wants to go back, despite getting the all-clear earlier. It is unlikely there is a serious problem, but Lowes and Donovan can’t take any chances, so take her to the Royal Free. It’s not their most productive couple of hours, but they talk to her respectfully, calm her down, deliver her to A&E and fill in a fresh set of forms.
It’s now 3 o’clock, and we’re on our way back to Kilburn. This time they’ve received a less urgent C2 call, after an earlier Red One to another fatality was aborted. The monitor in the ambulance advises “man in his 70s with severe behavioural change”. When we get to the flat, we find an elderly man close to collapse – probably through dehydration – and his wife at the end of her tether. She thinks he has undiagnosed dementia, and there are suggestions he can be violent towards his family, though today he can barely raise himself from the sofa.
It is an example of the social work side of paramedics’ work. They check him over physically, but he is in reasonable shape apart from the dehydration. What he may need very soon is a place in a care home. That is the shadow that falls across the conversation Lowes has in the corridor with the man’s wife – the sad but all-too-common conclusion of a 50-year marriage – while Donovan talks to the man’s son about sport.
As their appearance in the BBC series shows, they are very good at being de facto social workers, counselling the anxious, the elderly, the confused, the demented. “When I first started this job, going into people’s homes took a bit of getting used to,” says Donovan, “but because you’re wearing a uniform, in the eyes of the public you’re a goodie. You’re welcomed into most situations, whether it’s for social reasons or for emergencies.”
Lowes calls the man’s GP, who promises to come round. For the moment, there is nothing more that can be done. More paperwork and another cigarette in the afternoon sun. The shift is drawing to a close, and the crew do not fancy any red roulette. There is a general callout for an ambulance, any ambulance, to go to Victoria station, where a girl has fainted. They decide it’s too far and head back to base. That’s enough excitement for the day.
As we drive back to Camden, their monitor is reporting that University College hospital has been temporarily closed, St Mary’s in Paddington is accordingly under severe pressure and the Royal Free is “breaching” – A&E is missing its waiting targets and patients are being left in ambulances longer than they should be. It’s going to be quite a night shift, and Lowes and Donovan are happy to be out of it. But tomorrow they will be back, and who knows where the spin of the roulette wheel will take them?
Ambulance starts on BBC1 at 9pm on 27 September.
In the UK, the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Hotline is 1-800-273-8255. In Australia, the crisis support service Lifeline is on 13 11 14.
If you were to call for an ambulance, most of you wouldn’t realise I exist. I’m an ambulance dispatcher, which is different to the call handlers you speak to over the phone.
Even though I rarely speak to callers directly, it is a stressful job. We are under incredible pressure to send the right resource to the right patient, hit government waiting-time targets, and deal with paramedics on the radio who often forget how many calls we are juggling every day.
When your call comes in, it is coded via a computer system. If it’s red 1, that means cardiac arrest. Red 2 could mean chest pain, breathing problems, fitting, or an unconscious patient. We try our best to get the nearest resource to you as quickly as possible and are set a target by the government to be on the scene within eight minutes of these most serious calls. We don’t always manage that.
Other calls will be categorised in the green 1 or 2 category – this might be falls with an injury, broken bones, road traffic collisions, headaches, or bleeding, for example. In most cases, these requests for help are held with me until I can allocate an ambulance. If your call is categorised as a green 3 or 4 – this might be non-injury falls, abdomen pain, headaches – you’ll most likely get a call back from a clinician to arrange the most appropriate help. Heartbreakingly, if you’ve fallen, that means you could wait on the floor for hours before we manage to send someone to help.
There is a shortage of resources and the unions that represent paramedics put even more pressure on dispatch teams. They argue that a paramedic who will have to work 30 minutes past the end of their shift to see the patient and potentially take them to hospital should not have to take an emergency call. This means that some may not go on a call for the last hour or more of their shift. We might have to send a team that’s an hour away, when there is an available ambulance much closer, because of such rules.
Our guidelines state that we should rarely use paramedic cars for less serious calls – they should mainly be used for red 1 and 2 calls that are subject to government targets. But an incident that was initially low risk can easily become more serious, and this delay in sending help is having dire consequences. We continue to see an increase in fatalities from calls coded as green once our crews arrive.
These incidences are not reported on, because there are no targets for these calls. Every time it happens, we dispatchers are left wondering if we did everything we could, if we could have found a car to send to you sooner. If we had done so, perhaps you or your relatives would have had a better chance. Paramedics will often get feedback when there is a serious incident, but we rarely hear anything. We also never see changes implemented to prevent such incidences in the future.
The pressure in my control room has become so severe that it is damaging staff wellbeing. Our concerns for patient care are rarely listened to by management and the overall morale is incredibly low. There’s a high turnover of staff and many of my colleagues end up off sick with stress.
I’m an NHS ambulance dispatcher. I am overworked and undervalued. I try to do my best for you, but I’m sorry my service often fails when you need it the most.
This series aims to give a voice to the staff behind the public services that are hit by mounting cuts and rising demand, and so often denigrated by the press, politicians and public. If you would like to write an article for the series, contact kirstie.brewer@theguardian.com
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Mr Buscombe’s ordeal began when his leg started out swelling up and his doctor named for an ambulance to consider him to hospital.
He was sitting in the back seat of the motor vehicle as it travelled at speed in direction of Plymouth, but without the blue lights flashing.
“I was in terrible pain,” Mr Buscombe stated. “The leg was swollen and my toes had been starting to go black.
“We have been going at really a speed when the ambulance came to an abrupt quit. It was not fairly an emergency cease but ample to make my seatbelt lock.
“All of a sudden the door slid open and there was a girl standing there in the roadside.”
Mr Buscombe, who has 3 grown up sons with his wife Sandra, stated the woman looked “worse for wear” and was sporting a just skirt and a blouse regardless of the foggy and rainy weather.
He explained: “They looked like they’d had a couple of beers and missed their lift back residence.
“The female began asking me all sorts of queries – who I was, what was incorrect with me. I explained ‘how the hell do I know, I haven’t been to hospital yet’.
“I couldn’t think what was going on. The paramedic in the back with me looked as baffled as I was.”
The ambulance continued to Saltash on the Devon-Cornwall border and pulled in excess of yet again, in which the two hitchhikers jumped out at a garage, Mr Buscombe explained.
When it reached Derriford, Mr Buscombe was checked more than and put into another ambulance, which took him to the Royal Cornwall Hospital in Truro to see professionals the place medical professionals he was advised his leg could be treated with injections rather than getting to be amputated.
He was discharged the following day, but returned to have an angioplasty and stent inserted into his leg.
Mr Buscombe stated: “The blood clot was in the main artery above the knee. The pieces can break away, travel in direction of the heart and destroy you in a split second.
“It was a race against time to conserve me and my leg and however the driver was messing around offering individuals lifts – it truly is just not on.
“If he was concerned about these individuals he could have named the police.
“There are a whole lot of worthwhile medication in the back of an ambulance and for all he knew these two could have been armed with a knife or anything.
“I have the utmost respect for the work the ambulance men and women do and the care I acquired from the medical doctors and nurses at the Royal Cornwall Hospital was exemplary.
“I would not want anyone to get rid of their jobs above this but it cannot be allowed to come about yet again.”
It is believed the ambulance might have stopped since the crew considered the couple had been in a road traffic accident or at threat due to the fact of the negative weather.
An ambulance support spokesman mentioned details would not be disclosed until finally the investigation was finished.
He explained: “The Trust has received a complaint from Mr Buscombe relating to a schedule transfer from his residence deal with to Derriford Hospital, Plymouth, in the early hrs of Sunday, April 6th.
“The Believe in takes all complaints seriously and has began an investigation to establish exactly what occurred in the course of the transfer.
“After this investigation has completed we will be writing to Mr Buscombe again to inform him of our findings and the final result of the investigation.”
Mr Gouldburn had undergone shoulder surgery days before his death in April last yr and had been visited by a medical doctor that day right after he complained of feeling unwell to his wife Pamela, 70.
The medical professional could not discover anything significantly wrong, but provided to send him to hospital – which he refused.
Nonetheless, Mr Gouldburn collapsed at his property in Hartlepool at close to ten.20am, prompting his carer to get in touch with 999, telling get in touch with-handlers about the doctor’s earlier go to.
Despite explaining that Mr Gouldburn could not move, his situation was not deemed to be a “red” emergency and was allocated a 60-minute response time, the inquest heard.
At around 12.20pm an ambulance arrived, but it was a St John automobile manned by less-educated medics.
Realising the seriousness of the predicament, a car with an eight-minute response time was requested and sooner or later an ambulance and quick response car arrived.
Even so, it was also late – despite making an attempt for 10 minutes to conserve his existence, Mr Gouldburn was pronounced dead quickly right after.
Speaking at the two-day inquest, a dispatch manager for the North East Ambulance Services stated on the day Mr Gouldburn fell they had been going through a large degree of urgent calls.
Lynn Corrigan stated ambulance drivers had been hit by delays in admitting individuals to North Durham hospital due to a lack of offered beds.
Mr Donnelly asked her: “Is what I’m hearing you never have sources to meet demand?”
Mrs Corrigan said: “Yes, that’s correct. It is a nationwide dilemma.”
Dr Jan Lowe, a pathologist, informed the inquest Mr Gouldburn had an underlying heart situation, but that it was manufactured worse by the stress of becoming on the bathroom floor for so prolonged.
Mr Donnelly ruled the retired instructor died of organic leads to – his underlying heart illness – but his death was aggravated by a “lack of timely and proper medical intervention”.
Speaking of the ambulance service’s lack of assets, he extra: “The consequence of that would look to be that instances such as Mr Gouldburn are likely to be a unhappy consequence of the lack of sources.
“It would appear to be a consequence of stretched assets, probably performing the greatest they can, but folks are not receiving the support they may feel entitled to sometimes.
“My concern is the time it takes for deployment and when that does attend it is manned by a charity.”
Mr Gouldburn’s family expressed anger at the ambulance service’s “failure” to grasp the seriousness of the scenario right up until it was as well late.
Speaking after the inquest, they said: “This should by no means happen once again to anyone.
“We simply want recognition from the trust that a mistake was produced, and that the believe in failed a amazing guy.”
“He gave his existence to helping others and the trust failed him in his moment of require.
“We hope they will make sure as greatest they can this will never happen once more to an additional household in Hartlepool.”
Tom Howard, head of the North East Ambulance Service’s make contact with centre, admitted Mr Gouldburn did not obtain the degree of care he should have.
For the duration of the inquest he told the pensioner’s stepdaughter, Joanne Dobson, and her husband, Colin Dobson: “Mr Gouldburn did not receive the degree of care that he ought to have done. The 60 minute target was not met.”
He additional: “It is a resource issue which we have already had explained.
“It is very unfortunate, and I’m actually sorry it has took place.”
Mr Gouldburn was a phase-father of four and had nine phase-grandchildren and 3 stage-fantastic-grandchildren.
He served in the merchant Navy as an engineer, but invested most of his existence working as a instructor at a unique demands college.
Mrs Keeling, 33, explained: “It was a good day for Ellie’s asthma. She appeared definitely fine. I asked if she had her inhaler with her and she said yes.
“She desired to go to the sports activities day so I was persuaded.”
Mrs Keeling said her daughter named her just following 7.30pm to tell her mom her asthma had received truly poor. She then referred to as 10 minutes later and said: “I can’t walk and I can’t breathe.”
“When I arrived I could see Ellie on the floor unconscious with her eyes broad open,” extra Mrs Keeling.
The youngster collapsed at RAF Brampton near Huntingdon, Cambridgeshire on June 25 last yr and an ambulance was called at seven.44pm.
But a contact handler wrongly sent the paramedics to RAF Wyton – 7 miles away – and it did not arrive right up until 8.03pm. The bases had the identical postcode.
Mrs Keeling, of Ellington, added: “The cadet was extremely clear in his mobile phone contact.
“He stored saying its RAF Brampton. I heard him say: ‘No, you happen to be in the incorrect RAF base.’ He was quite distressed.
“I talked to Ellie and I advised her to preserve breathing. She was gasping and it was a lengthy time just before the ambulance arrived to be by her side.
“They seemed extremely slow receiving out of the motor vehicle. They just strolled over to us.
“The products kept failing – the oxygen cylinders kept running out. It seemed like chaos.
“My mother and father arrived by then and my dad held Ellie’s hand.”
The teenager was pronounced dead an hour later.
The inquest heard ambulances had been sent to the wrong air base on two preceding occasions in 2006 and just eight months earlier in December 2012, because the two bases had the exact same postcode.
Since the child’s death the two bases have been provided separate postcodes.
Michael Smith, 19, the cadet who created the 999 call, informed how he repeatedly asked the call handler to send the ambulance to RAF Brampton, not Wyton.
He stated: “I was making an attempt to calm her down and she was very panicked. She was shouting ‘I’m going to die.’
“I called the ambulance and I told them it was RAF Brampton in the village of Brampton. I mentioned there had been two distinct stations.
“I had to uncover the postcode on my telephone. The lady asked if I was in RAF Wyton and I mentioned no, Brampton.
“Then she mentioned an ambulance was on its way.”
The inquest heard the transcript of the 999 phone in which the operator reassured Mr Smith, saying: “There is no require to panic sir. We’re properly on the way.”
Mr Smith responded and explained: “The lady asked me if we had been close to a white tower and I realised they’d been sent to to Wyton.
“I explained ‘You’re in the wrong spot.”
The East of England Ambulance Services has been extensively criticised more than delays in current months. Crews are supposed to reply to the highest priority instances inside eight minutes but this journey took 19 minutes.
On the day she died, Eloise had not taken part in the sports activities day but had been asked to jog a short distance to a sports activities area.
A statement from her greatest buddy Kayleigh Parker, 14, explained how Eloise collapsed and pleaded with the cadet leaders to call an ambulance as she struggled for breath.
She mentioned: “A single of the sergeants asked if we had been Okay to jog. Me and Ellie were laughing and saying how unfit we were.
“Then I observed Ellie having issues with breathing. I asked if she was Ok and she said she imagined she was having an asthma assault.
“Ellie went blue in the lips and she stated she needed an ambulance but practically nothing occurred.
“Then following she referred to as her mum she mentioned she necessary an ambulance once more.
She added: “While we were waiting for the ambulance to arrive Ellie became blue in the encounter.
“She was panicking and stated ‘I’m going to die’ three instances. She threw her water bottle and kicked the floor – it was frightening to view.
“I bear in mind him telling the ambulance to come to RAF Brampton – then I was taken away.”
The table below shows how every ambulance service is doing, rating the survival rates from worst to greatest:
Mr Thayne stated: “It truly is completely frightening and entirely needless. We have an NHS which should be as good in any element of the country and we should not have a postcode lottery in terms of this quite acute issue, the cardiac arrest.
“I estimate that we ought to be saving twice as many lives a year, or about 2,500 men and women.”
He said more men and women would survive if much more crews arrived in time or have been equipped to carry out resuscitations.
Variables affecting failure could incorporate slow response instances, diverse health-related procedures at the scene, and the availability of defibrillators.
Mr Thayne also accused the Government of publishing “misleading” figures on ambulance performance, especially with regard to the survival of cardiac arrest patients.
At present, statistics show survival charges but not the amount of attempted resuscitations.
Mr Thayne mentioned: “When these figures first came out in the middle of 2011/12, when I saw people figures, I immediately wrote to the NHS Statistical Workplace and explained, ‘This is not the way this ought to be presented it is misleading.’ And they ignored my remarks.”
The figures recommend South Western Ambulance Services is trying to resuscitate nearly three-and-a-half instances as a lot of cardiac arrest individuals as the South Central Ambulance Service NHS Basis Believe in.
Even so, the Government statistics demonstrate the South Central cardiac arrest survival rate as 41%, in contrast with 25% for South Western.
“It strongly suggests to me that the South Central crews are not receiving to people in enough time to try resuscitation,” explained Mr Thayne.
“Yet their survival costs appear significantly far better than these of their counterparts in the South West who are trying a lot of far more resuscitations.”
Mr Thayne informed the BBC poorer performers were getting substantial survival costs in element since they have been trying to resuscitate fewer folks.
The figures present the South Western crews are trying resuscitation on 848 folks per million head of population, compared with 243 in South Central.
Professor Jonathan Benger, national clinical director of NHS England, said: “There has been variation amongst ambulance trusts considering that assortment of ambulance clinical good quality indicators started out in April 2011.
“The causes for variation are multifactorial and meticulously analysed by ambulance trusts, as nicely as in published investigation. Variation may come up from distinctions in the interpretation of the definitions and techniques used for evaluation, the good quality of information collection, verification and returns.
“Regional demographics and person patient variables will also lead to variation in outcomes, as will the treatment options offered in hospital. It would be entirely incorrect to suggest that all variation can be attributed to one particular single element.”
A spokesman for the South Central Ambulance Services explained: “This data suggests that we may possibly have fewer cardiac arrests in the South Central location, and regional variation in cardiac arrests has been recognised previously. When we do resuscitate, a substantial quantity of our sufferers survive.”
An 85-year-previous lady with heatstroke died soon after a two-hour wait for an ambulance for the duration of last week’s heatwave, the ambulance union says.
Ambulance Workers Australia’s (AEA) Victorian secretary, Steve McGhie, says ambulance companies went into “meltdown” during final week’s heatwave.
“Even during reasonably quiet instances Victoria’s ambulance services is woefully inadequate. However, last week the technique went into meltdown,” McGhie said.
Hundreds of paramedics have been expected to converge on the Ambulance Victoria headquarters on Wednesday above their ongoing industrial dispute.
Paramedics reported delays of 7 hours and in depth ramping, in which a transported patient has a long wait in the automobile on arriving at hospital due to the fact there are no obtainable care areas or beds.
A single elderly patient waited nine hours on a stretcher for a bed at Northern hospital and no crews had been free of charge to attend a motorbike accident patient, who had skin missing from his encounter and a leg fracture, the AEA explained.
A spokesman for state wellness minister David Davis said the Coalition inherited an ambulance system in crisis and had since injected hundreds of thousands to recruit a lot more paramedics.
Ambulance Victoria chief executive Greg Sassella mentioned the organisation had been negotiating in very good faith to attain a meaningful enterprise agreement and wage improve end result.
He explained it remained in voluntary conciliation with the unions and their following meeting was scheduled for the end of this month.
The ambulance union claims its paramedics are the lowest paid in Australia and they could go interstate and earn almost $ 30,000 much more for carrying out the very same work.
The deputy opposition leader, James Merlino, explained the tragedy was however another instance of an ambulance program in crisis.
“Response times for code 1 emergencies have blown out every single yr of this government,” Merlino said on Wednesday.
“The government are however to acknowledge they designed the crisis and are but to react to it.”
The Welsh ambulance service chief mentioned a amount of improvements had been because March 2013, when Pring died. Photograph: Christopher Thomond
Overall health chiefs have expressed “deep regret” that an elderly guy died much more than forty minutes right after his wife first dialled 999 and asked for an ambulance to come to his aid.
Fred Pring’s wife, Joyce, rang for support 3 far more times as her husband cried out in ache but in the course of her fourth contact informed the operator: “It is as well late now, he is gone, he was 74. There is nothing at all you can do for him now. You are as well late, I am sorry.”
At the end of his inquest in Ruthin, north-east Wales coroner John Gittins stated modifications must be created to aid reduce the chance of potential deaths.
He said even though it could not be established with certainty that Pring, who had heart and pulmonary disease, would have lived if the ambulance had reached him sooner, it was “probable” that he would have at least got to hospital alive if the ambulance had met its target response time of eight minutes.
In a joint statement, Elwyn Price-Morris, chief executive at the Welsh ambulance service, and Professor Matt Makin, healthcare director of Betsi Cadwaladr University health board, mentioned: “It is with deep regret that on this occasion there was no ambulance offered to send to Mr Pring in a timely manner.
“It is our responsibility to guarantee we have a safe, powerful and higher-good quality urgent care program, and with each other we are operating tough to minimize any delays in transferring patients to hospital. We have presently produced a quantity of enhancements considering that March 2013 [when Pring died].
“We are strengthening the coaching for on-call managers and making sure that handover and choice-generating procedures are clear for all employees across our organisations. We are also revising operating practices to make sure that we have proper staffing amounts for the duration of intervals of large demand.
“The urgent healthcare method across Wales is facing unparalleled strain, with high demands on the two the ambulance services and on hospital emergency departments. We are taking a variety of actions to guarantee that our active ambulances and emergency departments are offered for people who want them most urgently.”
The efficiency of the ambulance services has lengthy been higher on the political agenda in Wales. In November it emerged that a patient had waited in an ambulance for much more than 6 hrs before currently being admitted to a Welsh accident and emergency department.
After the inquest Joyce Pring, who is from Flintshire in north-east Wales, explained: “I sincerely hope that my husband’s death will lead to enhancements in the way the Welsh ambulance trust and the hospitals manage their providers.”
