999 ambo shambles
Study finds serious failures in call system to pick out Covid patients
A 999 call system which was designed to pick out Covid patients has been slammed by former senior paramedics and labelled “poor”.
Shock research has found call handlers at the Scottish Ambulance Service (SAS) got it wrong in 94 per cent of suspected coronavirus cases between April and August 2020.
The study – led by ex-SAS consultant paramedic turned academic Dr David Fitzpatr ick – found wor rying increases in the numbers of patients “non-conveyed” to hospital.
“Non- conveyance” is a term that applies to when a patient calls 999 but for a variety of reasons – they decide against it , improve by the time paramedics arrive or are assessed as not needing one – they never make the trip to hospital in an ambulance.
And it said there was a high death rate among those who didn’t get in them.
The study looked at the use of Protocol 36 – where call handlers quiz callers on Covid-related symptoms. The system was developed in 2003 after the outbreak of Sars. Worried SAS bosses updated it for coronavirus.
But Dr Fitzpatrick and his team of researchers at Stirling University found it added to the burden on call-centre staff and didn’t work.
His damning report, which looked at 214,000 999 calls made over five months, labelled Protocol 36 “poor”.
It said call handlers identified 7305 patients they believed could be Covidpositive during calls using Protocol 36. But, out of them, just 438 later tested positive in hospital. Over 2000 were negative and the rest weren’t even tested.
The researchers warned the system should be updated and said Protocol 36 had a “very poor ability” for picking out Covid cases.
It warned: “Ambulance Control Centres remain under considerable pressure and any additional questions during triage place further workload on the system.
“While additional protocols may introduce a benefit to patients, our results indicate that Protocol 36 has little utility and, therefore, would benefit from further refinement.”
But the study was equally worrying for the 206,000 callers not suspected of suffering from Covid. Over 60,000 were not taken by ambulance to hospital.
At a rate of nearly 30 per cent, researchers said it was “considerably higher” than normal. In 2019, SAS reported 20 per cent of 999 calls resulted in non-conveyance.
The study said the non-Covid cases who weren’t taken to hospital had a high death rate. Nearly 10 per cent of them were dead within 30 days. That was a far higher rate than just six per cent of patients who died within 30 days of leaving hospital over the same period. It said more research was needed to examine the death rate among those who were non-conveyed.
Scottish Labour’s Jackie Baillie said: “This is a deeply worrying development. We know the pandemic has badly affected services but it is clear SNP mismanagement has thrown the ambulance service into crisis.”
Scot t i sh Conser vat ive Dr Sandesh Gulhane said: “These f igures are deeply concerning. They highlight the extraordinary pressure our ambulance crews were under and the incredibly diff icult decisions they had to make at the height of the pandemic.”
The SAS said: “The study focuses on the period at the start of the pandemic before LFT and PCR tests were prevalent and where only a hospitalbased test could conf irm Covidpositive patients. This was a time when public anxiety about the risk of contracting Covid by being taken to hospital was at its peak.
“In those small number of cases where a decision was taken that a patient remained at home, the study shows they were of low clinical risk. Additional safety measures were put in place, such as 24/ 7 access to specialists. The standard of care remained high through the pandemic, with 30-day survival rates for seriously unwell patients at their highest level.”