Huge 999 shake-up means slower re­sponse times for mil­lions

Daily Mail - - Front Page - By So­phie Bor­land Health Ed­i­tor

VIC­TIMS of sus­pected heart at­tacks and strokes will have to wait ten min­utes longer for an am­bu­lance.

In a ma­jor over­haul of the 999 ser­vice, the eight-minute re­sponse tar­get is to be scrapped. Suf­fer­ers will now typ­i­cally have to wait 18 min­utes for help.

In some cases the de­lay could be as long as 40 min­utes. This is be­cause sus­pected heart at­tacks and strokes will no longer be clas­si­fied as life-threat­en­ing.

NHS bosses say the re­forms will save lives and en­sure pa­tients get the right treat­ment.

The ex­ist­ing sys­tem is also open to abuse, with am­bu­lance trusts us­ing cars and mo­tor­cy­cles to hit re­sponse time tar­gets even though the ve­hi­cles can­not carry pa­tients to hospi­tal.

The shake-up has alarmed cam­paign­ers be­cause swift treat­ment is crit­i­cal in both heart at­tack and stroke cases.

‘None of this seems very re­as­sur­ing at all for pa­tients,’ said Joyce Robins of Pa­tient Con­cern. ‘It seems more like they are re­ar­rang­ing the deckchairs on the Ti­tanic. It is hard to see the ben­e­fit for pa­tients, when many are be­ing

told they may have to wait longer if they have had a heart at­tack or stroke.’

Half of 999 calls are cur­rently classed as life-threat­en­ing – re­quir­ing a re­sponse within eight min­utes.

The cat­e­gory ranges from car­diac ar­rests – where the heart has ac­tu­ally stopped beat­ing – to breath­ing dif­fi­cul­ties, traf­fic ac­ci­dents, sus­pected heart at­tacks and strokes. How­ever, un­der the new sys­tem, only 8 per cent of calls, in­clud­ing car­diac ar­rests, will be classed in this top tier. An am­bu­lance should ar­rive within seven min­utes.

Sus­pected heart at­tacks and strokes will fall into the next cat­e­gory, with am­bu­lances tak­ing an av­er­age of 18 min­utes. The way the tar­gets are be­ing mea­sured is also chang­ing – mean­ing some pa­tients could wait a lot longer.

Am­bu­lance trusts will also have to en­sure that 90 per cent of ur­gent pa­tients are sent a re­sponse within 40 min­utes. The re­main­ing 10 per cent will be al­lowed to wait longer.

Emer­gency op­er­a­tors will be given an ex­tra three min­utes – four in to­tal – to as­sess the sever­ity of the call be­fore send­ing help.

The new sys­tem has been pi­loted in three of the coun- try’s ten am­bu­lance trusts and will be rolled out na­tion­ally in time for win­ter. Although med­i­cal ex­perts and MPs are broadly sup­port­ive of the changes, it will do lit­tle to solve the huge prob­lems fac­ing the am­bu­lance ser­vice.

Trusts took a record ten mil­lion calls in 2016/17 and this to­tal is go­ing up by 5 per cent a year. The rise is be­ing driven by the grow­ing and age­ing pop­u­la­tion and the fact that pa­tients are find­ing it so dif­fi­cult to get hold of a GP.

There is also a short­age of paramedics, and one in 14 posts is va­cant.

Re­searchers be­lieve the changes will save up to 250 lives a year. Pro­fes­sor Keith Wil­lett, NHS Eng­land’s di­rec­tor of acute care, said: ‘You might wait a bit longer, but what you’ll get is the thing you need. We can achieve a faster re­sponse to those who are the sick­est and those with im­me­di­ately life-threat­en­ing con­di­tions.’

But Jonathan Ash­worth, Labour’s health spokesman, said: ‘The truth is that the Tories’ un­der­fund­ing and mis- man­age­ment of the NHS has pushed am­bu­lance ser­vices to the brink and left record num­bers of pa­tients suf­fer­ing and in dis­com­fort. The pub­lic will want to know that a new series of stan­dards is truly based on the best clin­i­cal ev­i­dence.’ Nor­man Lamb, Lib Dem health spokesman, said: ‘I wel­come these new stan­dards, but it is cru­cial the im­pact is mon­i­tored closely – in­clud­ing what hap­pens in ru­ral ar­eas, which have of­ten lost out un­der the cur­rent tar­get regime.’

In France, cur­rent per­for­mance on emer­gency calls is ar­rival at the scene within ten min­utes for 80 per cent of re­sponses.

In New York, there is a com­pul­sory ten-minute re­sponse time for all emer­gency calls. This tar­get rises to up to 15 min­utes in Cal­i­for­nia.

In the Nether­lands, emer­gency am­bu­lances must ar­rive within 15 min­utes.

Car­diac ar­rests are im­me­di­ately life-threat­en­ing. Heart at­tacks are less se­ri­ous, although pa­tients may die later with­out treat­ment.


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