I'm single at work at the moment (which means I don't have anyone to work with – and so am sitting on station twiddling my thumbs), so I thought I'd tell you all about the great God ORCON and how he rules the life of every EMT/Paramedic in England. (Also I recently read This which explains the horrifically complicated system in one state of America).
This is really boring – so I'll not be hurt if you don't bother reading any further.
The ambulance service has only one main target to reach, that of ORCON. ORCON was started in 1974 and governs how fast we are expected to respond to “Cat A” calls. (See here for a description of “Cat A”)
Essentially for every Cat A call we have to be there within eight minutes.
It doesn't matter what actually happens to the patient – just so long as we get there within eight minutes. For example – If we get to someone who has been dead for two days within eight minutes, that counts as a Success. If we get to a heart attack in nine minutes, provide life saving treatment and ensure that their quality of life is a good as possible, that is a Failure.
For those who don't live in London , lets just say that traffic is often heavy – there are “sleeping policemen” and tiny sideroads. We have 300+ languages spoken in London – which may delay getting the location we are needed at. We are hideously overused and understaffed, we face delays at hospital due to overcrowding and delays on-scene because of the ignorant people we have to attend to.
Doesn't matter – all that matters is that 8 minutes deadline. If we make 75% of all calls in 8 minutes we get more money from the government, which means more staff, vehicles that work etc… If we don't make 75% then we don't get any more money and we continue to struggle. This year it looks like we are going to make it, but only just.
there isn't any reason behind eight minutes being the time we need to get to people – brain death occurs after 4 minutes or so, trauma – while needing to be treated as quickly as possible – has the “Golden hour“. The current rumour is that it is how long MP's have to vote when the “division bell” rings in parliment.
Who knows? No-one I have spoken to has any decent answers.
Well, that should be the last of my posts on the boring “day to day” running of the London Ambulance Service.
You may all rejoice now.
Heh – Just came across the “See Me Rot” webpage…erm…oh well…