DOOMED!

Well, extended licensing laws are in, which I’m afraid will mean more disorder on the streets, couple that with the seasonal increase in illness, and the ice on the roads that means I can’t drive as fast as I normally can and what you get is an increasing failure to reach our government’s benchmark time.

Remember the Great and Powerful God ORCON?  Where we have to reach most high priority calls within 8 minutes?

We aren’t on target for it this year, and unlike other years I don’t think that “extra effort”, as our management call it, will save us.  There is a shortage of ‘flu vaccinations, so more at risk people will get ill, we’ll be going to more alcohol fueled violence because of the new licensing laws.  It is thought that there will be a colder than average winter, so, because of ice, our vehicles won’t be able to drive as quickly and as safely as normal.  And Agenda for Change has hit morale hard especially given the uncertainty of payment for overtime shifts (which are needed to cover staff shortfalls).  Oh and more people are calling us for more crap reasons every day.

We are doomed.

But worry not, patients won’t be doomed, remember, this eight minute ORCON time has absolutely no basis in health, or prevention of death.  If your heart stops then you have, at best, five minutes to get it going again, after eight minutes, I’m afraid you are more than likely dead, and are going to stay that way.  Most calls clinically either need a “faster than five minutes”, “faster than half an hour” or “Sometime in the next couple of hours” response.  Eight minutes is some figure plucked out the air.

So don’t worry, all it means is that the best Chief Executive the LAS has ever had will lose his job, and we won’t get given as much money to fund the service.  After all you wouldn’t want to fund a failing service would you?

Stupid $&%*£^&*!!! government.

All I can do?  Get there as quickly and safely as possible, and make sure the patient doesn’t get any worse.  I can only do what I can do…

34 thoughts on “DOOMED!”

  1. May I ask a layperson question?If CPR isn't started within the first five minutes of someone's heart giving out, does that make it pointless to try it?

    I've only done a basic first aid course – would my skills be enough?

    Girl

  2. There's not a lot us customers can say to that, except please keep going – we need you! Apologies from the normal folk on behalf of the stupid, the bureaucrats, the pissheads and the time-wasters.

  3. I would disagree over extended licensing hours meaning an increase in alcohol-related problems.I've recently spent a while in Australia, where they have 24 hour licensing. Most bars, pubs and clubs are open most of the day – until the very small hours (6am) if not the full 24 hours. The result is that people come and go as they please. They start and finish drinking when they want – not all finishing their drinks at closing time and getting turfed out onto the streets. In all my time there I think I saw one fight on the street, and that was at about 7-8pm. Very rarely did you see the 3am waves of drunken people staggering around the streets as you do in city centres across the UK.

  4. I concur with the anonymous Australia visitor. In Iceland we have slowly moved from beer not being banned (yes it was for decades) and then lengthening opening times.When the beer was allowed the doomsayers said now no one would be sober ever. They were wrong.

    When opening times were made flexible the doomsayers said we would be hounded by drunken hordes. They were wrong.

    In the last decade that these two big changes have been ongoing our drinking habits have indeed become more European. People consume as much or slightly more alcohol (as measured in alcohol %) but do it over a longer time and in a more civilized manner.

    Back when everything closed at 3am the downtown Reykjavk would become a seething mass of puking people (since they just downed lots of alcohol 5 minutes earlier), fighting people, urinating people and all the gory stuff.

    Now the downtown is easy-going during the night since you can always walk into the next club or pub when you feel like it, take a taxi when you want to (instead of queing for hours like when 3am was the time everyone wanted a taxi) and just enjoy life.

    Now the doomsayers are warning us against allowing lighter spirits (beer and wine) to be sold in stores (we have state controlled alcohol stores, like Sweden does) because then everyone will be dead-drunk. I'm not buying that argument just like I didn't buy the other two and like I'm not buying the British Isles becoming the capital of stupordom when people can dictate their drinking hours.

    The first few weeks might show a rise in incidents as people throw themselves head first into it, but then they'll realise the benefits and you will become more European.

  5. Heres hoping you're right, IMHO all this licensing law is a little too late. We have such a binge drinking culture now and it will take a fair amount of time to turn it around. Its hellish some weekends in the 'burbs of london town, not only the drunk and vomiting but the emotional wrecks and violence that go hand in hand with one too many bacardi breezers. I for one am not looking forward to this. On the plus side, i can go for a vodka after a late shift 🙂

  6. I live in Spain. Bars are open all the time.The Spanish really like their drink (boy do they ever), and there are statistics to prove it. Yet there is little fighting, puking, stumbling around, shouting, etc. It's difficult to say why exactly. For one, being pissed drunk is actually (surprise, surprise) not really approved of. Not like in London, where stumbling around the city after the pub closed shouting and singing and making the most of not having any inhibitions is accepted. Sometimes people grin and laugh at the drunken bugger who just got on the tube. Not here. By all means, have a drink, have three, have a smoke, a line of coke, whatever, but please don't stumble around. It's just seen as very unappealing, and anyone trying to impress the ladies or to be cool around his mates would think twice before looking like a fool.

    Having said that, there is of course a drinking problem too here, but of a different kind. It is the “botelln” phenomenon, where young people meet in a park or in the city centre with a couple plastic glasses, ice, a bottle of spirits and some fizzy drinks to go with it. Not that they are particularly rowdy, but they are noisy, messy, and end up peeing in people's doorways.

    None of this has anything to do with licensing laws, I don't think.

    In the long run, drinking in the UK is bound to be more sensible – but it will take time. What about having more food in the pubs? That would curb the drunkenness. The say the “tapas” in Spain originated from a very old law stating that all drink should be served with a piece of bread with meat, this to taackle the problem of horse-carriage drivers getting too drunk. The size of the bread had to be large enough to cover (“tapar”) the glass or jug of wine, hence the name, “tapa” (cover). That's one thing I really like about life in Spain, and which I found tough going in the UK: food is everywhere here. In the UK, pubs seldom had any food. You went there after work, drank on an empty stomach, and got drunk. It was almost as if eating got in the way of drinking, and more importantly, got in the way of getting drunk. I still managed to get the hang of it, and enjoyed my pints on an empty stomach. But in truth I'd rather have a bite (even just a bit of ham or cheese) with my beer… makes the evening last longer, and keeps me on my feet.

  7. Agreed, 8 mins silly number.As for starting CPR, always have a go. The casualty may have collapsed five mins ago but their heart may have not stopped until just now.

    Agenda for change seems like CHANGE and people hate the uncertainty of change. I've been following some of the comments on A4C and I still would love to join a service and become a paramedic. I have a degree and a doctorate and twenty years as a scientist and I still don't make 30K p.a. and if I don't take a lunch break the company still takes half an hour off my timesheet.

  8. I suspect for most places, it wouldn't be much different to normal. At the moment in Blackpool we don't have Syndicate open (biggest nightclub in UK for those who haven't heard of it), though it is opening on the 26th. In other words back to the 3am closing, and the usual problems.Attitudes have to change, because as it stands, it is the drink until you collapse mindset that is causing the trouble. When that changes, then we will become more 'European' in drinking habits, and 'hopefully' the violence will come down, which should mean less work for Tom and all the other emergency services.

    Perhaps one day.

  9. Apparently they are going to change the ORCON standard from 8 minutes from getting the address and chief complaint to X minutes from the very start of the call. That is why they've changed the way we take the calls in control. Chances of ever meeting the ORCON targets again are going to go out the window unless everyone in London miraculously learns to speak English overnight.

  10. Hear Hear!!You are much appreciated Tom. I wish it weren't the case that 95% of politicians and 35% of the general population are morons – but I'm afraid it's true!

    At the end of the day you're saving lives – and that's rather more important than petty government targets and new labour doublespeak.

  11. just because they are down for 5 mins doesn't mean they haven't been breathing and circulating in that time. Also how do you know they have been down that long, people are terrible at judging time (my biggest pet peeve from working fast food), especially when stressed.You have two choices, you have a go and hope that they can be brought back or leave them and know that they won't.

    However small the likelihood its still better than nothing

  12. I suspect (and indeed hope) that the ultimate result of the licensing change will be a reduction in drunken binges, but I'd be surprised if we didn't have an increase in the short term, as people take full advantage of their extended oppertunities for idiocy.

  13. Hi TomI have to stick my head above the parapet and admit to being a Health Service Manager (am also a registered Nurse). Thnaks for appreciating that it's not neccesarily managers to blame for the b****cks you have to deal with to meet targets enforced upon us by the government. I was going to carry on by having a rant about the government/ crazy targets/ running the NHS and its staff into the ground but apparantly I'm meant to have a work life balance so I'm going to put the kids to bed.

    Love your site and have recommended it to loads of NHS Managers to make sure they keep a grip on the real world

  14. Yes, sympathise with you Tom- eight minutes is insane. Its thirteen in MAS for a code 1 and whilst we usually make it within, the outer lying branches struggle and that drags down the average. We also get hammered for our hospital clearing times- we have 20 minutes from when we arrive at hospital with a patient and when you can sit at triage for 10 mins on occasions there's not much time left for transfer to bed, doing paperwork and cleaning/restocking the truck!

  15. Question. Here in the States, anyone who sells alcohol to an obviously drunk person can be held liable if they go out and do something dumb, or horrendous. There is a case now, in New Jersey I think, where the franchise who sold six beers at one time to one man, who lots of people said was obviously drunk, is being sued by the family the drunk drove his car into. Is it the same in the UK?

  16. no, that's not the case in the UK – as long as the person served is over 18, there is no comeback on the bar that served them.Most bars won't serve people who are too drunk but in the UK that generally means “too drunk to talk anymore”. If you are sober enough to be able to order it and the bar staff can understand, chances are you'll be served. If you then get into a car and drive into someone. the only person held responsible is you…

    I remember from when I was in Australia that in some states it's illegal to serve someone who is already drunk but I was never sure how that was enforced, or how you made that call – I got drunk a lot and was never refused service.

  17. Having more food in pubs might be a good idea to reduce drunkenness. But unfortunately, in an unrelated government scheme, someone decided that it might be a good idea to ban people smoking in pubs that serve food, but not in those that don't. So inevitably when that happens, many pubs will /stop/ serving food just so people can smoke there.

  18. Hi Tom, I was wondering if Newham's extremely large muslim community meant that there are less drunks in your area than most?JK..

  19. What I'm concerned about is the first weekend of the licensing laws being relaxed coincides with the first snow and ice of winter. Lots of scrapes, bumps and frozen vomit I think…

  20. those two replies say exactly what i was going to say, so i won't reiterate too much.However my experience of city centre drinking in scotland (edinburgh has great licensing hours) are exactly that of the chap/ess in australia- that because there is no immediate focus of people onto the streets, problems don't seem to occur. I've drunk in central edinbugh and glasgow for four years and never ever seen anything close to the kind of violence- or the kind of blootered drunks- that we keep being shown on the telly this week, as prophecy of the end of england!

    could it be that for once the politicians have done their homework and realised that extended licensing isn't the end of the world?(unless of course an eternity of 11pm closings have damaged the english pub psyche so much that everyone wil be staying on till 3am and that'll just shift the fight's later?)

    however, you have my sympathies for the next few weeks where people 'enjoy' their new freedoms. sympathies indeed. keep up the good work.

  21. come to scotland! (or ireland, seeing as we don't start till march).when the smoking ban comes in pubs are going to have to start serving strong coffe and amazing tasting food anyway, as otherwise they'll have nothing to counter the smell of stale beer and oxters!

    mmmmtapas….

  22. You get 8 minutes to get there? We get a nice round ten minutes to make our police emergency calls in my force. Mind you, not every police driver is trained to respond to calls, and I'd presume that every paramedic is? Or do you get paramedic drivers who aren't authorised to speed and use the light and sirens too?A non mouse

  23. Personally I'm pinning my hopes on Darwinian selection. Free up the alcohol supply so the bingers drink themselves to death, or at least incapacity, before they get round to reproducing and the next generation will be more sensible about it.

  24. Our driving training consists of 3 weeks driving around the countryside in a 14 seater van.That's it.

    Blue lights and sirens from the first time you set foot in a real ambulance.

    No additional training for the fast car, although we do get assessed, which takes oh…one shift.

    Every copper I speak to is astounded by this.

  25. And I'm astounded too. You'd think someone high up would recognise it's bad PR for the service if drivers cause or are involved in accidents while responding to an emergency.

  26. Here in Swissland, you have to have 'winter tyres' in the winter, which have softer rubber and deeper threads, thus better adherence in cold/icy/snowy conditions. Might cut a few seconds off your journey time. (Just have to find that extra few hundred quid!)

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