What I learned from my night shift with the East of England Ambulance Service
PUBLISHED: 09:56 16 April 2017 | UPDATED: 14:31 16 April 2017
Ambulance prepared and stocked up, it was a matter of seconds before the first job came in - a woman with chest pains, GEMMA MITCHELL writes.
It was 6.45pm, and senior paramedic Lee Eastall and senior emergency medical technician Kev Hope turned on the blue lights and dashed to the Ipswich property, with myself in tow as I joined them on their 12-hour Thursday night shift.
The patient, who is known to the East of England Ambulance Service, is alcohol-dependent and banned from seeing the GP because she has caused problems in the past.
When Kev tracked her down, he was not met with a polite greeting.
It took an hour to coax the patient into going to A&E at Ipswich Hospital, but when we arrived there were no beds available, meaning people were waiting on trollies in the corridor.
“We can spend quite a long time queuing in A&E,” Kev said.
The handover of a patient from an ambulance to A&E staff should take no longer than 15 minutes. If it takes more than half an hour, the hospital trust is liable for a fine from its Clinical Commissioning Group (CCG).
Once the handover is complete, the ambulance crew then has 15 minutes to clean the vehicle and be available to respond to the next 999 call. If this breaches half an hour, the ambulance trust could also be fined.
In February this year alone, the East of England Ambulance Service lost more than 547 hours due to a delayed patient handover at Ipswich Hospital’s A&E.
In this case, just over 30 minutes passed before the woman was seen, which meant the hospital trust incurred a penalty. However, before the woman was assessed she decided to leave, or self-discharge.
“It’s really frustrating,” Kev said. “You just have to grit your teeth and get on, but it can be very hard sometimes.”
While they were dealing with this incident, Lee and Kev were unable to respond to a number of ‘general broadcasts’ which came through on their radios. It meant someone was in serious need of an ambulance but there were none available, so the control room sent out a message to all paramedics on duty.
I learnt that this experience is commonplace for night crew paramedics. Alcohol and drugs take up a vast amount of their time, pulling them out of action for providing care to others who may critically need it.
While on shift we met senior paramedic Emma Jackson-Cornford. She had just returned from a job at Unit 17 nightclub in Cardinal Park, where a woman was reported to be having a seizure. A rapid response vehicle and two police officers also attended.
The patient, in her early 20s, was taken to hospital but within 10 minutes had self-discharged and left in a taxi with her friends. It was her thirteenth visit to hospital this year for overdoses or alcohol-related problems.
“I hate to think how much it costs in resources to get her here,” Emma said. “This is why we need an SOS bus in Ipswich because we can take them there to sleep it off and that would save A&E a huge amount of resources. It would save us time and the police time.”
Earlier that night, Emma had been diverted while en route to an 80-year-old who had been on the floor for two hours following a fall to attend a heroin overdose on a bus.
“People don’t recognise waking up in hospital as a bad thing, it’s almost seen as kudos,” she said. “There’s no reprimand for it.”
In many cases involving substance misuse, mental ill health plays a role. Lee said better out-of-hours crisis care would help ease some of the pressure on the ambulance service and A&E.
The NHS 111 non-emergency line has also put added strain on those on the front line, I was told, as call handlers are often over-cautious and send ambulances to those who don’t need one.
Lee said: “We are here for genuine emergencies and if we are called for minor things that doesn’t enable us to deal with people who are the most unwell and the most needy.”
Yet what struck me most from my shift with Lee and Kev was the level of care, compassion and respect shown to every single patient we saw that night.
No job was rushed. A 95-year-old man who fell over was given the same service as a man who was beaten with a hammer at his flat.
“One of the things that is good about this job is you see the whole variety of life and social spectrum,” Lee said. “We go into people’s home and are given their trust - it’s a privilege.”
Kev added: “You just want to make a difference, and you get to meet some really nice people along the way.”