tag:blogger.com,1999:blog-3573632931588970083.post7085010772365358851..comments2023-10-22T10:16:40.522+01:00Comments on The Broken Paramedic: Dear Ambulance Staff: Six 111 Myths and MisconceptionsMat Westhorpehttp://www.blogger.com/profile/08553980835026556794noreply@blogger.comBlogger14125tag:blogger.com,1999:blog-3573632931588970083.post-81881822806831608232016-04-01T06:33:28.737+01:002016-04-01T06:33:28.737+01:00My particular beef is "Why does EVERY 111 cal...My particular beef is "Why does EVERY 111 call that results in an ambulance being sent have to have a 'blue light response'?"<br />I fully appreciate how difficult it is to triage from the other end of a phone line but come on !!! Ambulance crews are now attempting to cover vast areas due to A & E closures and having to do practically every job on blue lights is mind-numbing. Geriatric admissions that used to come under planned work are now all 'breathing problems' or 'not alert'. Even jobs to people that are uninjured are upgraded to an emergency response when invariably they have waited for too long. The stress levels are ridiculous when crews and other road users are in more danger than the person that supposedly needs an ambulance. A N Ambulancedrivernoreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-31829018181284432242016-03-20T11:45:24.907+00:002016-03-20T11:45:24.907+00:00Apologies, an overzealous spam filter was removing...Apologies, an overzealous spam filter was removing valid comments. They have now been restored.Mat Westhorpehttps://www.blogger.com/profile/08553980835026556794noreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-34482342659544250582016-03-20T11:37:13.767+00:002016-03-20T11:37:13.767+00:00Comment gone?Comment gone?Paulnoreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-75476376257433796272016-03-19T23:13:38.089+00:002016-03-19T23:13:38.089+00:00Following freedom of information requests it is ev...Following freedom of information requests it is evident that EEAST has not been conducting many exit interviews for leavers, yet remarks and concerns raised online on various forums and news stories have identified that staff leaving the trust are more open in their information and willing to whistle-blow, name personnel and identify themselves in their statements and criticism.<br /><br />Informants for CQC inspections and investigations can also include leavers who have departed the Trust within the last few years for whatsoever reason. If anyone is in this position and wishes to assist inform the ongoing CQC inspection if they can contact the CQC confidentially by telephone or email or using an online contact form, I believe your honest open input may be useful.<br /><br />Following results of the previous inspection the CQC may be especially interested if staff have evidence they have been bullied or discriminated against in any way. For example, impropriety involving disciplinary, grievance, sickness or capability proceedings such as the way your sickness has been managed following stress or hysterectomy and the conduct of managers and human resource personnel. <br /><br />Another concern from the previous inspection was patient safety concerns due to delay in available transporting resources and call response distance. <br /><br />I am sure the CQC is interested in good stories as well as bad. <br /><br /><br /> <br />Paulnoreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-45039126155410513402016-03-16T11:24:16.357+00:002016-03-16T11:24:16.357+00:00Comment posted yesterday disappeared?Comment posted yesterday disappeared?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-33238054932224308192016-03-15T22:41:17.480+00:002016-03-15T22:41:17.480+00:00Speaking with my paramedic colleagues, though havi...Speaking with my paramedic colleagues, though having their concerns most do not agree with the personal vindictive comments made on your blog aimed at 111.<br /><br />Following the story about worst performing hospitals being ‘named and shamed’. Many commenters have pointed out that many of the ‘worst performing’ hospitals are in areas where neighbouring hospitals have been closed and social care funding reduced. It makes you wonder if they will start naming and shaming ‘worst performing’ ambulance trusts next. <br /><br />Along with the story about poor performing hospitals there has been a substantial increase in news stories of patients not receiving an ambulance within an acceptable interval of time and the story about the biggest annual rise in deaths for almost fifty years - coincidence or linked? Is difficulty accessing health care, incorrect diagnosis, poor triage, lack of beds, poor treatment and delayed transport increasing death rates? <br /><br />The services encouraging leave at home policies and solo responding the most are some of the ‘worst performing’ when it comes to response times and re-contact rate (a later ambulance having to attend and convey the patient) and serious incidents (mostly deaths) especially when leave at home is encouraged without adequate training, safeguards and referral pathways. <br /><br />Were we providing a better service and improved outcomes when we attended all calls within a reasonable timeframe?<br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-16645393231786389462016-03-10T23:57:53.428+00:002016-03-10T23:57:53.428+00:00All the hatchet jobs and personal attacks on 111 a...All the hatchet jobs and personal attacks on 111 are unnecessary and going a bit OTT. Is the ambulance service call handling (AMPDS) any better? The ambulance call handlers are not clinically trained and as far as I am aware receive less training than 111 call handlers. The ambulance service actually manages many of the 111 services across the UK and some of them are the worst performing or have been caught out downgrading calls inappropriately!<br /><br />The workload would likely be the same or worse without 111 but at least some of the callers are signposted to the correct pathway. I am a paramedic and I have heard the same complaints over time levelled at NHS Direct, GP surgeries, Hospitals, Ambulance Services and Out of Hours GP services. The phrase “inappropriate attenders” has been levelled at patients attending GP surgeries, A&E, minor injuries, urgent care centres, out of hours clinics and calling 999. The NHS is required to provide for anyone seeking its service or advice, I can’t think of any other service industry that would criticise and try to put off anyone from using their services (except maybe the police).<br /><br />One possible problem with having one telephone number for the Out of Hours GP and an advice/signpost line is that some of the calls that the GP may have actually dealt with if it had reached them are diverted by the pathways system or if someone has telephoned for advice only the system may pick something up and signpost incorrectly.<br /><br />We’re better working together to do our best for the patient rather than moaning that ‘so and so’ should be dealing with it when ‘so and so’ is underfunded, under resourced, underpaid, overworked and probably has a lack of referral options exactly the same as you. <br /><br />Welcome to Jeremy Hunts NHS in Tory Britain.<br /><br /> <br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-75127732461811505472016-03-10T10:25:19.904+00:002016-03-10T10:25:19.904+00:00An example of the ridiculousness of the 111 system...An example of the ridiculousness of the 111 system and some of its call handlers:<br /><br />I recieve yet another call from 111 that could and should have been dealt with by one of the GPs sitting in the same room as them.<br /><br />I then ring 111 and explain that I am from the ambulance service and ask that they actually send a GP out. I am told to await a call back that could, from personal experience, take an hour or so (time during which I could actually be out doing some real emergency work).<br /><br />The call handler then reads off his or her script telling me that in the menatime if the patient deteriorates then I should ring back or call an ambulance!<br /><br />So what bit of the fact that I have already told you I work for the ambulance service did you not understand? Do you not actually think for yourselves?<br /><br />I remember you from your days on the road Matt and personally I would be very surprised if you wouldn't have been one of the most vocal about 111, should you have to experience the sort of absolute tosh that gets put our way every single day.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-6550833242211257272016-02-27T19:07:20.456+00:002016-02-27T19:07:20.456+00:00Well written Matt. We all know that telephone tria...Well written Matt. We all know that telephone triage is a nightmare. One of the things that I think would be useful, and which I believe is being addressed, is ambulance staff having access to your notes. Instead we end up attending these 111 calls 'blind'. Access to the telephone triage notes would assist us in understanding your clinical reasoning and would also stop us asking the same questions all over again!<br /><br />In the days when we ECPs where handling all the OOP calls I would often get sent on jobs that seemed, initially, to be complete nonsense. Fortunately I was able to discuss the call with the 'hub' GP en-route. Very often it would be a case of the patient giving a confusing history. I was then the GP's eyes & ears on the ground. You're right though, nothing beats actually being able to see the patient.Magwitchhttps://www.blogger.com/profile/02329504964096653848noreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-52785411522689527312016-02-24T23:11:46.146+00:002016-02-24T23:11:46.146+00:00As a paramedic, yes we as a crew get annoyed when ...As a paramedic, yes we as a crew get annoyed when attending patients who do not require us. However, I and most of the colleagues I’ve spoken to do not agree with the personal vindictive comments made on your blog aimed at 111. The commenter making comments about ‘non-clinically trained’ call handlers fails to mention that 999 call handlers are ‘non clinically trained’ and have probably received less training than a 111 call handler. MPDS and other 999 systems are equally ‘risk averse’ also what seems to have passed them by in their sarcasm of 111 loading the ambulance service with unnecessary calls is that many 111 services are run by the ambulance service (some of the worst performing). Also some services have been caught downgrading calls causing deaths. <br /><br />The services encouraging crews the most to leave patients at home (without adequate training, safeguards and referral pathways) are some of the worst performing when it comes to re-contact rate (a later ambulance having to attend and convey the patient) and serious incidents (mostly deaths).<br /><br />Similar attitudes were expressed against NHS Direct, lets not demonise our colleagues in other areas when the reason for the shite we are all in is general lack of funding and resources (GP, hospital beds, social care beds, home care, ambulance clinicians, mental health services etc). Constant cost saving and allowing private providers to compete and cut costs to third world levels are the cause. The government is attempting to run the NHS on the cheap so they can privatise and make money out of their health care investments, the result is a cheap NHS. <br />Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-52840987057403557082016-02-22T11:01:30.218+00:002016-02-22T11:01:30.218+00:00Very good piece Mat, thank you for that. I have be...Very good piece Mat, thank you for that. I have been working for 111 for almost 3 years As a Clinical Advisor\Trainer and this pretty much covers all the points that I would make. <br />I have been following the Daily Mail's systematic and calculated abuse of our service - particularly Health Advisor (Call Handler) colleagues and find the level of inconsistencies, innuendo and simple lack of understanding of our role, completely staggering. I wonder if it is anything to do with the fact that they tried to “embed” one of their undercover reporters in a centre and got caught out very quickly. Give a dog a bone eh……<br />I smiled knowingly at the picture of our colleague having a doze. Its 03.00hrs and you are on your 30 min break. Some “sign out” and like to get up and get out of the call centre for a brew and a wander, others like to do a bit of Egyptian P.T. at their station. <br />Personally I’m all for a reporter being fully trained as a Call Handler (the full 10 weeks) and then work on for another 6 months, at least, to get a true picture of what we do and what complex situations we, as a team, face on a daily basis. <br />Anonymoushttps://www.blogger.com/profile/12975840392796359190noreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-73638817979822511872016-02-22T10:58:23.840+00:002016-02-22T10:58:23.840+00:00This comment has been removed by the author.Anonymoushttps://www.blogger.com/profile/12975840392796359190noreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-34872885912643301012016-02-22T00:33:59.442+00:002016-02-22T00:33:59.442+00:00Thank you for this. I wish a lot more people parti...Thank you for this. I wish a lot more people particularly paramedics would read this and think when they call and rant about us.<br /><br />From a 111 call handlerAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-3573632931588970083.post-25238498154394999022016-02-21T10:33:46.313+00:002016-02-21T10:33:46.313+00:00Thank you for this, as a Sr clinician (RN), I have...Thank you for this, as a Sr clinician (RN), I have had the pleasure of the jeering from ambulance staff of all levels. I was once front ending when there was a spike in incoming calls and a paramedic called to ask for a GP visit, He was really scathing about the competence of the call handler who had sent him to the address of someone who had chilblains(his opinion) and like you , I was not allowed to give my status. I was struggling to find a record of the call, which was met with "Typical, and tutting when I asked him to reconfirm the demographics , WHILE this was happening the Patient piped up, I don't know what 111 is , I rang 999 for an ambulance. I didn't laugh, or gloat, He did not apologise but he lost all of his bluster. I did suggest at the end of the call that maybe he could come and spend a day with us and see how we work before he condemned us out of hand in future. We all work for the best interest of the Patient , nothing else should matter. Anonymoushttps://www.blogger.com/profile/05198998409811919477noreply@blogger.com