The eight-minute
target for ambulances to reach life-threatening emergencies is being relaxed in
a trial that simply lets paramedics arrive as quickly as they can.
It means patients
having heart attacks, strokes or seizures will not be guaranteed an ambulance
within eight minutes.
Amid a record number
of 999 calls and a severe shortage of paramedics, a report also urges ambulance
services to hire more call-centre handlers to advise more patients over the
phone, rather than dispatching emergency vehicles.
The eight-minute
target for ambulances to reach life-threatening emergencies is being relaxed in
a trial that simply lets paramedics arrive as quickly as they can.
The response time
trial is under way in three of the country's ten ambulance services – South
West, West Midlands and Yorkshire, which serve a total of 16million patients –
and could be extended nationally. But most of the public are unaware of it and
it has only been highlighted today in a report by the National Audit Office.
It was gradually
introduced in the three regions last year with no announcements, fuelling concerns
that the public have been deliberately kept in the dark.
The report reveals
that more than 10.7million calls were made to ambulance services in 2015/16, a
30 per cent rise in four years.
On top of this,
ambulance services are facing a recruitment crisis, with as many as one in ten
paramedic roles vacant.
This is having a
severe impact on ambulance response times, and many severely ill patients have
been left waiting more than an hour for an ambulance to arrive. The most
serious calls – including cardiac arrests, breathing difficulties, heart
attacks or strokes – are meant to get an ambulance within eight minutes.
In the trial, this is
relaxed for the slightly less critical cases – known as Red 2 – which include
heart attacks, strokes and seizures. These have been reclassified as Amber
cases and there is no fixed time limit – paramedics are urged to respond as
quickly as they can.
All Red 1 calls are
sent an ambulance in eight minutes, including cardiac arrests – in which the
heart stops, or for people who are struggling to breathe.
The trial will be
assessed in spring and if deemed a success, will be introduced nationally. The
report warns the eight-minute target encourages 999 operators to send
'multiple' ambulances or response cars to the same emergency, just to 'stop the
clock'.
Amid a record number
of 999 calls and a severe shortage of paramedics, a report also urges ambulance
services to hire more call-centre handlers (stock image)
Ambulance services
are fined if paramedics fail to reach 75 per cent of the most serious calls
within eight minutes.
On average, around a
quarter of ambulances are 'stood down' before they reach the scene because
another crew has already arrived.
The report says it
would be better to dispatch one ambulance in 15 minutes, for example, leaving
other crews free to respond to the most serious cases.
But Lib Dem leader
Tim Farron said: 'How can the NHS trial this without patient knowledge? When
people call an ambulance they expect it to come quickly.
'How can they
downgrade a heart attack to an amber call? It's life and death.'
Only one of the ten
ambulance trusts meets the response-time target of reaching 75 per cent of
serious calls in eight minutes, the report shows.
It also highlights
how ambulances are increasingly held up in queues outside A&E units that
are too busy to accept patients.
Last year, ambulance
services lost a total of 500,000 hours waiting outside A&E instead of
responding to other emergencies.
Professor Keith
Willett, NHS England's Medical Director for Acute Care, said: 'The ambulance
service is facing significant pressures partly because too many ambulances are
dispatched to simply hit targets rather than attend to those patients most in
need – with 25 per cent of dispatched blue light vehicles being stood down
before they reach the scene.
'That is why we're
carefully testing a change to the way in which ambulance services can
respond.
'It's an idea that
has come from doctors and paramedics, giving them much more control to do the
best thing for patients.
'These trials are
designed to make sure ambulances focus on the right priority – getting to the
most urgent patients in the quickest possible time, and improving the service
to all patients who dial 999.
'All ambulance and
A&E staff are working hard to keep handover delays to a minimum, with a
view to eliminating them altogether.
'These delays have
many contributory causes, and often reflect pressure on beds within the
hospital as a whole and a system that is struggling to discharge patients to
community settings.'
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