"My partner is having a heart attack."
"We don't have the capability to respond to that within the eight
minutes (or whatever) the politicians have decreed. Would some time
between 4 and 5pm next Tuesday be OK? And between us girls, if we don't
get there in three minutes, they are as good as dead anyway. Does your partner have a funeral plan?"
On 25/01/2024 15:52, Roland Perry wrote:
"My partner is having a heart attack."
"We don't have the capability to respond to that within the eight
minutes (or whatever) the politicians have decreed. Would some time
between 4 and 5pm next Tuesday be OK? And between us girls, if we
don't get there in three minutes, they are as good as dead anyway.
Does your partner have a funeral plan?"
IME you get very good instructions on giving CPR right up until the
ambulance crew tell the operator they have arrived, which was only a
few minutes later.
In message <-NSdncC7d6ErGi_4nZ2dnZeNn_ednZ2d@giganews.com>, at 16:14:44
on Thu, 25 Jan 2024, Colin Bignell <cpb@bignellREMOVETHIS.me.uk> remarked:
On 25/01/2024 15:52, Roland Perry wrote:
"My partner is having a heart attack."
 "We don't have the capability to respond to that within the eight
minutes (or whatever) the politicians have decreed. Would some time
between 4 and 5pm next Tuesday be OK? And between us girls, if we
don't get there in three minutes, they are as good as dead anyway.
Does your partner have a funeral plan?"
IME you get very good instructions on giving CPR right up until the
ambulance crew tell the operator they have arrived, which was only a
few minutes later.
Where we live in rural Cambs the nearest Ambulance station is 15 minutes drive away, and typically I think they send one from Cambridge which is
40 minutes away.
My A&E nurse always asks of a patient who has just arrived after CPR
"How many ribs are broken", and if it's not at least three then CPR was mainly a placebo.
On 26/01/2024 10:27, Roland Perry wrote:
Where we live in rural Cambs the nearest Ambulance station is 15 minutes
drive away, and typically I think they send one from Cambridge which is
40 minutes away.
There are two ambulance stations about 15 minutes away from me. However,
for every ambulance station in this area there are three ambulance
response centres, where they park ambulances to put them closer to where
they are likely to be needed. The closest one to me is about three
minutes away.
On Fri, 26 Jan 2024 11:42:58 +0000, Colin Bignell <cpb@bignellREMOVETHIS.me.uk> wrote:
On 26/01/2024 10:27, Roland Perry wrote:
Where we live in rural Cambs the nearest Ambulance station is 15 minutes >>> drive away, and typically I think they send one from Cambridge which is
40 minutes away.
There are two ambulance stations about 15 minutes away from me. However,
for every ambulance station in this area there are three ambulance
response centres, where they park ambulances to put them closer to where
they are likely to be needed. The closest one to me is about three
minutes away.
Ambulances aren't, typically, dispatched from ambulance stations anyway (other than for the first call of a crew's shift or the first call after they've gone back to the station for a break). It's always the nearest free ambulance which is sent, and in most cases that's either one which has just finished a "treat at scene" incident which doesn't require taking the
patient to hospital, or one which has just dropped off a patient at a hospital. That's why they're more likely to be coming from the nearest big city, because that's also where the nearest A&E is and therefore where an ambulance is most likely to become free after completing a job.
In some cases, particularly city centres on a Friday night or major highways at rush hour, an ambulance will be sent to park up in a convenient spot near to where a call is most likely to come from, in anticipation of the calls that the service is likely to get. And if an ambulance does become free without having another call to go to immediately, they will typically be
sent to wait in an area where the next call is likely to come from, rather than staying where they are or going back to the station. In some of those situations they do, as you say, even have dedicated locations specifically for that purpose. But rural areas and small towns tend not to benefit from that kind of predictive scheduling, and even where it is practical it's not always possible if there are no ambulances free to just sit and wait.
More generally, a lot of people misunderstand the function of an ambulance station. The location of the station isn't for the benefit of patients, it's for the benefit of the service, and in particular for the benefit of the crews - it's somewhere to park ambulances that are not currently crewed (eg, overnight), somewhere to store equipment and supplies, and somewhere for the crews to go for a break and to do their paperwork. It's handy for the crews to have that broadly central to the area they serve, but the location isn't mission critical to the service because it's not the location that most ambulances will start a call from.
A few years ago, there was a big furore where I live because the ambulance service decided to close the ambulance station in town. Cue angry letters to local newspapers and much wailing and gnashing of teeth on social media.
Some people got themselves elected to the council on a platform of
preventing the closure. A campaign group crowdfunded a judicial review of
the ambulance service's decision. The review failed. The newly elected councillors did not prevent the closure. I used an FOI request to obtain the call logs for the postcode area covering the town for the period leading up to and after the closure. And there was absolutely no difference to typical response times.
What does affect response times, a lot, is the inability of A&E departments to process all incoming patients in a timely manner. If ambulances are
having to queue up to deliver patients, or are being used as temporary patient accommodation on hospital premises, then they are taking a lot
longer to become free and therefore the chances of there being a free ambulance close to a call is significantly reduced. But that's beyond the ambulance service's control, and not something they can fix by moving ambulance stations around.
Mark
On Fri, 26 Jan 2024 11:42:58 +0000, Colin Bignell ><cpb@bignellREMOVETHIS.me.uk> wrote:
On 26/01/2024 10:27, Roland Perry wrote:
Where we live in rural Cambs the nearest Ambulance station is 15 minutes >>> drive away, and typically I think they send one from Cambridge which is
40 minutes away.
There are two ambulance stations about 15 minutes away from me. However, >>for every ambulance station in this area there are three ambulance
response centres, where they park ambulances to put them closer to where >>they are likely to be needed. The closest one to me is about three
minutes away.
Ambulances aren't, typically, dispatched from ambulance stations anyway >(other than for the first call of a crew's shift or the first call after >they've gone back to the station for a break). It's always the nearest free >ambulance which is sent, and in most cases that's either one which has just >finished a "treat at scene" incident which doesn't require taking the
patient to hospital, or one which has just dropped off a patient at a >hospital. That's why they're more likely to be coming from the nearest big >city, because that's also where the nearest A&E is and therefore where an >ambulance is most likely to become free after completing a job.
In some cases, particularly city centres on a Friday night or major highways >at rush hour, an ambulance will be sent to park up in a convenient spot near >to where a call is most likely to come from, in anticipation of the calls >that the service is likely to get. And if an ambulance does become free >without having another call to go to immediately, they will typically be
sent to wait in an area where the next call is likely to come from, rather >than staying where they are or going back to the station. In some of those >situations they do, as you say, even have dedicated locations specifically >for that purpose. But rural areas and small towns tend not to benefit from >that kind of predictive scheduling, and even where it is practical it's not >always possible if there are no ambulances free to just sit and wait.
More generally, a lot of people misunderstand the function of an ambulance >station. The location of the station isn't for the benefit of patients, it's >for the benefit of the service, and in particular for the benefit of the >crews - it's somewhere to park ambulances that are not currently crewed (eg, >overnight), somewhere to store equipment and supplies,
and somewhere for the
crews to go for a break and to do their paperwork. It's handy for the crews >to have that broadly central to the area they serve, but the location isn't >mission critical to the service because it's not the location that most >ambulances will start a call from.
A few years ago, there was a big furore where I live because the ambulance >service decided to close the ambulance station in town. Cue angry letters to >local newspapers and much wailing and gnashing of teeth on social media.
Some people got themselves elected to the council on a platform of
preventing the closure. A campaign group crowdfunded a judicial review of
the ambulance service's decision. The review failed. The newly elected >councillors did not prevent the closure. I used an FOI request to obtain the >call logs for the postcode area covering the town for the period leading up >to and after the closure. And there was absolutely no difference to typical >response times.
What does affect response times, a lot, is the inability of A&E departments >to process all incoming patients in a timely manner. If ambulances are
having to queue up to deliver patients, or are being used as temporary >patient accommodation on hospital premises, then they are taking a lot
longer to become free and therefore the chances of there being a free >ambulance close to a call is significantly reduced. But that's beyond the >ambulance service's control, and not something they can fix by moving >ambulance stations around.
On 26/01/2024 10:27, Roland Perry wrote:
In message <-NSdncC7d6ErGi_4nZ2dnZeNn_ednZ2d@giganews.com>, at
16:14:44 on Thu, 25 Jan 2024, Colin Bignell
<cpb@bignellREMOVETHIS.me.uk> remarked:
On 25/01/2024 15:52, Roland Perry wrote:
"My partner is having a heart attack."
"We don't have the capability to respond to that within the eight >>>>minutes (or whatever) the politicians have decreed. Would some time >>>>between 4 and 5pm next Tuesday be OK? And between us girls, if we >>>>don't get there in three minutes, they are as good as dead anyway. >>>>Does your partner have a funeral plan?"
IME you get very good instructions on giving CPR right up until the >>>ambulance crew tell the operator they have arrived, which was only a
few minutes later.
Where we live in rural Cambs the nearest Ambulance station is 15
minutes drive away, and typically I think they send one from
Cambridge which is 40 minutes away.
There are two ambulance stations about 15 minutes away from me.
However, for every ambulance station in this area there are three
ambulance response centres, where they park ambulances to put them
closer to where they are likely to be needed. The closest one to me is
about three minutes away.
In message <p7b7ri1r6k0tokkna04dqnb2j4u15pifum@4ax.com>, at 13:42:06 on
Fri, 26 Jan 2024, Mark Goodge <usenet@listmail.good-stuff.co.uk>
remarked:
What does affect response times, a lot, is the inability of A&E departments >>to process all incoming patients in a timely manner. If ambulances are >>having to queue up to deliver patients, or are being used as temporary >>patient accommodation on hospital premises, then they are taking a lot >>longer to become free and therefore the chances of there being a free >>ambulance close to a call is significantly reduced. But that's beyond the >>ambulance service's control, and not something they can fix by moving >>ambulance stations around.
The ambulances service can't control it on a day to day basis, but ought
to have the capacity to lobby for some change to the situation to
alleviate this.
One big City the answer was to insist the A&E department
accepted all arrivals, but that just means you have patients on beds in >corridors, which for some reason creates even more bad-press.
On Sat, 27 Jan 2024 15:18:34 +0000, Roland Perry <roland@perry.uk> wrote:
In message <p7b7ri1r6k0tokkna04dqnb2j4u15pifum@4ax.com>, at 13:42:06 on >>Fri, 26 Jan 2024, Mark Goodge <usenet@listmail.good-stuff.co.uk>
remarked:
What does affect response times, a lot, is the inability of A&E departments >>>to process all incoming patients in a timely manner. If ambulances are >>>having to queue up to deliver patients, or are being used as temporary >>>patient accommodation on hospital premises, then they are taking a lot >>>longer to become free and therefore the chances of there being a free >>>ambulance close to a call is significantly reduced. But that's beyond the >>>ambulance service's control, and not something they can fix by moving >>>ambulance stations around.
The ambulances service can't control it on a day to day basis, but ought
to have the capacity to lobby for some change to the situation to
alleviate this.
Behind the scenes, they lobby a lot. But it doesn't tend to get made public, >because it's perceived to be bad PR for one part of the NHS to be
criticising another.
One big City the answer was to insist the A&E department
accepted all arrivals, but that just means you have patients on beds in >>corridors, which for some reason creates even more bad-press.
In the ambulance, a patient will have paramedics on hand watching over them >at all times.
And the paramedics in turn will have all their equipment on hand.
Neither is true in a corridor. So, not unsurprisingly, patients are
more likely to die in corridors than they are in an ambulance.
If they can't go straight into a treatment room,
then the ambulance is the best place for them to wait. But that then
ties up the ambulance and prevents it attending a different emergency.
There isn't an easy solution to this. The hospital's mortality rate will go >up if it has to accept more patients than it can process. The ambulance >service's response time will go up if it can't hand over patients promptly. >It's generally accepted that the latter is the less bad option, because not >all ambulance call-outs are to life-threatening incidents, whereas any >admission by the ambulance service to A&E is, almost by definition, >life-threatening (or, at least, potentially life-changing).
But, on the other hand, a larger number of people are affected by slow >ambulance response times than are affected by overloaded A&E
departments.
Wrong wrong wrong, again again again. A big part of the problem is that
if people have called 999 to get an ambulance and it's eventually turned
up (figures of 11hrs were quoted over New Year) many (most?) trusts have
a policy that if the patient doesn't rescind the so-called emergency
when they arrive, they MUST take them to hospital.
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