Here is a question. Describe an ambulance.
For most people it would be a big white (or yellow) box with blue flashing lights, when you dial 999 it turns up and two ambulance people put you in the back of it and it trundles (or rushes if you are sick) off to hospital.
Not for much longer.
In the near future the LAS will send a lone person in a car to anything that doesn't obviously need an ambulance (I'm not sure about the exact policy for who gets a big ambulance as well, I think it's being worked out). That person on the car will then decide if a 'big' ambulance is needed or if the patient can be treated by a GP/ECP/Walk-in centre.
The numbers I have been given by one of our managers is that the number of 'cars' will increase from 70 to 210 across London while the number of 'big' ambulances will be reduced from 350 to around 250.
I can understand what our management are thinking, as anyone who has read this blog for any time will be able to see, a lot of our calls don't require ambulance treatment. In an LAS report half of our patients don't need hospital treatment and in fact only 10% of our calls are life threatening.
As I've mentioned in Monday's post we are getting our budget cut so we need to 'think smart'.
There are problems with this approach though. I (and many others) are of the belief that everything goes to hospital, it only needs one person to die at home (even of an unrelated cause) and if you are the last healthcare person to see them then it is 'your fault'. We will no longer be able to do that, the expectation will be that the people on the cars will be refusing ambulances to people. Refusing an ambulance, especially if you are on your own may well increase the number of assaults on crews, not to mention the (governments) 'Patient's Charter' says that if you demand an ambulance, then you get an ambulance…
I would assume that those going on the cars will get extra training, which costs time and money and will be a slow process.
I also wonder if going on the car will be a volunteer position, because if so I doubt that the cars will be fully manned resourced. A lot of people (myself included) would go insane working on our own for any length of time.
It could work – I hope it does because we don't have the government support to provide more ambulances. I have a sneaking feeling that it won't.
I just wish I had a better (quick fix*) idea.
*My long-term fix would be to hugely increase health education in schools, but the results of that would take a generation to come into effect, no good for a government looking for re-election.