Peril of the cut-price paramedics

Care assistants with just a few weeks’ training sent on 999 calls

CUT-PRICE ambulance staff with only a few weeks’ training are being sent on thousands of 999 calls, a investigation reveals.

Seven out of the ten ambulance services say they routinely dispatch crews of two care assistants to incidents without a qualified paramedic.

Figures obtained from four organisations show they went out to 47,000 incidents last year including heart attacks, strokes and cardiac arrests. The total figure is likely to be much higher as three organisations did not provide statistics.

The ambulance service is desperately overstretched and just yesterday, a son revealed how he had travelled for four hours to reach his injured mother and still beat paramedics. Mark Clements, 48, caught a bus, two Tube services and two trains to race 180 miles from London to Exmouth in Devon on Saturday. An ambulance turned up an hour later meaning 77-year-old Margaret, who had broken her hip, endured an agonising wait of seven hours.

Care assistants – also known as emergency care assistants (ECAs) – are normally paired up with paramedics to support them while they provide care. But increasingly they are being sent out in pairs or on their own as ambulance services struggle to respond to a rise in calls.

NHS bosses said it was more important for critically- ill patients to be treated as quickly as possible, and not necessarily by a paramedic. Some ambulance trusts insisted that when ECAs were dispatched to lifethreatening incidents, paramedics would always be sent on later once they had finished with other patients. Three trusts – London, the West Midlands and Yorkshire – said they never sent ECAs out on their own.

The Mail used Freedom of Information laws to ask the ten ambulance trusts how often ECAs had been sent to 999 calls, without paramedics. Four trusts were able to provide figures which showed they were dispatched to 46,836 incidents in 2017/18, up from 30,670 calls in 2016/17. Of the call- outs they attended last year, 13,736 were classed ‘category 2’ including heart attacks and strokes. Another 2,328 were the most serious ‘category 1’ calls, which are usually cardiac arrests where a patient’s heart has stopped.

Three other trusts said ECAs were sent on their own but could not provide figures.

ECAs earn up to £19,000 a year compared to paramedics who are on up to £30,000 a year rising to £36,000 if they learn additional skills. They are quicker to train and do a course lasting between four and 12 weeks, consisting of medical skills and driving an ambulance. Paramedics, on the other hand, complete a threeyear degree.

Dr John Lister, of London Health Emergency, which campaigns against NHS cuts, said ECAs were a ‘cheap way of staffing the ambulance service’. ‘If I needed treatment I would like to be cared for by a paramedic rather than someone who has done an eight-week course,’ he said.

Martin Flaherty, of the Association of Ambulance Chief Executives, said ECAs were a ‘vital’ part of the ambulance workforce. He said they would never be sent to the most seriously ill patients as sole responders. ‘They will only be sent when they are likely to get there faster than a paramedic to start the life-saving process until a paramedic is able to get to the scene.’

Meanwhile, it emerged that the ambulance trust that left Margaret Clements waiting for seven hours following her fall knew it was failing elderly patients. Internal documents identified a ‘trend’ in the number of ‘long lies following falls’ at least ten months before she was left stricken at home.

The long waits are believed to be the result of a decision by bosses at South Western Ambulance Service Foundation Trust to focus on the most life-threatening and serious cases.

Official figures show the Trust is the second worst in the country at responding to category 4 calls, which include falls such as those suffered by Mrs Clements.

It left patients waiting an average of one hour, four minutes.

Yesterday Mr Clements said his mother was ‘doing much better’ as she continued to recover in hospital in Exeter. She had been able to sit up and had also tried walking, he added.

A JOURNEY TO SHAME 999 SERVICE Yesterday’s Mail