‘Concerning? Yes, absolutely. This is a risk to patients’

Transport Service (PTS) staff to 999 calls put at risk patients who had not been properly assessed.

Jamie McNamee, convener of Scotland’s largest union, Unite, said the situation was ‘absolutely of concern’ and called for the ambulance service to be better funded.

He said: ‘They [PTS staff] could be tasked to patients who have had no face-to-face contact with a clinician and inappropriately triaged as low acuity [requiring relatively few medical staff].

‘Evidence would suggest these are low numbers but, nevertheless, are an increased patient safety risk to those involved and we would not need to be sending these staff if we were appropriately funded.’

Figures released under Freedom of Information show

‘Not sufficiently resourced’

patient transport vehicles attended 261 ‘emergency incidents’ in 2017-18, increasing year-on-year from only 84 in 2014-15.

The FoI response said: ‘Please note that we respond to over 700,000 emergency calls every year. Our Ambulance Care Assistants receive clinical training and if they are the nearest resource, they will be sent to time-critical incidents (e.g. cardiac arrest). An A&E crew will also be sent to the incident.’

SAS could not say how many cases involved vehicles on their way to pick up patients, or had a patient on board.

Two ambulance care assist- ants crew the transport vehicles and can administer oxygen and use ‘shock box’ defibrillators. But they are not qualified to assess or diagnose patients or say whether or not their condition is deteriorating.

Official SAS job guidance says the assistants ‘provide high-quality care and safe transportation for non-emergency patients’.

Figures released in December showed the SAS had 486 such vehicles.

Unite argues the service as a whole is ‘dangerously overstretched’ and says the figures are a sign the service is understaffed and under-resourced.

Mr McNamee said while there might be valid reasons behind the increased number of PTS attendances, staff were sometimes sent to incidents they were not trained for.

The FoI figures were ‘a pointer towards the wider requirement to meet the capacity and demand for the SAS’.

Mr McNamee said he knew of occasions where transport vehicles had been sent to serious emergencies.

He said it was correct to send PTS staff with a defibrillator to patients suffering a cardiac arrest. ‘However ... we have identified instances where people have been inappropriately tasked to the PTS service.

‘My experience to date is that there is no clear intent to provide less than the service that is required but, nevertheless, we have identified a small group of staff who may well have had their patient risk adversely impacted upon.

‘How does the patient or the patient’s relatives feel when they’ve waited for a clinician to appear and a non-clinician appears?

‘Equally important, how do you think a non-clinician feels when they’re presented with a clinical circumstance they’re not trained to assess and nor are they able to assess any deterioration in the patient?

‘There’s no doubt in my mind that had we the appropriate number of staff on the streets, at the times we need them, the PTS tasking would be minimal and, I suspect, there would be little or no inappropriate tasking.’

A spokesman for the Scottish Ambulance Service said: ‘When a patient’s life is at immediate risk, it is vital that life-saving skills are deployed as quickly as possible.

‘That is why we always dispatch the closest resource available, be it a community first responder, a patient transport vehicle or a paramedic team. We ensure the first responder who has life-saving skills, such as CPR, has appropriate back-up.’

Scottish Conservative health spokesman Miles Briggs demanded a review.

He said: ‘This clearly shows the organisation is more stretched than ever, and that the SNP Government is not resourcing it sufficiently.

‘It is unacceptable for minibuses to be used so frequently in response to 999 incidents.’

‘Dangerously overstretched’