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When you call for an ambulance, you generally want it now. To you, it’s an emergency and an emergency requires an immediate response.
Often the immediate need for an ambulance treatment is not met, there can be several reasons for this. On some occasions the call handler incorrectly assesses the nature of the call and the call is allocated a lower ranking for response time, on many occasions, there are insufficient available units to respond to the call. On occasions, the treatment that can be provided to the patient may be determined by the skill and experience of the responding ambulance crew. Some of these delays would be considered to be negligent.
Our Team can offer free initial advice as to whether you have a case in relation to poor ambulance care.
Cases involving poor ambulance care generally include the following :
Upon a call being connected the dispatching process commences with a Pre-Triage Sieve (PTS) conducted by reference to the Dispatch on Disposition flowchart. The purpose of this is for the emergency medical dispatcher (EMD), who receives the initial call, to identify as quickly as possible whether the call can immediately be identified as meriting a Category 1 response. This PTS function is thus limited to the prompt identification of obviously life-threatening illness or injury.
Three questions are initially asked. The first of these questions, “Is the patient breathing” will, if answered in the negative, result in the EMD presenting the call to Dispatch for allocation as a Category 1 response. The second question is “Is the patient conscious”, but regardless of how that is answered, it is only if the third question “Does their breathing sound noisy” is answered in the affirmative, that this results in the call being presented by the EMD to Dispatch at that point for allocation as a Category 1 response.
On occasions how a question is answered by the caller may impact the response. Sadly, a caller’s response to what is carefully worded specific questions is not always as clear as a “yes” or “no”. Any answer interpreted as a “don’t know” will not result in a dispatch request being put through at that point.
Assuming the call is not identified as Category 1 on the initial PTS, there is a further opportunity for an emergency (as opposed to urgent) dispatch to be requested if the next open question “What is the problem” produces a response that the EMD interprets as one of a number of specified problems which include choking and drowning listed in a Nature of Call list or if the caller uses one of a range of keywords or phrases which are listed in alphabetical order for the EMD to scan.
If the initial questions do not illicit a Category 1 response, the EMD will move to a triage process as contained in the Advance Medical Priority Dispatch System (AMPDS) which is a computer-based set of progressive screens, where the EMD is led through a succession of questions which will lead to a categorisation of the call. An initially lower categorisation can and sometimes is re-categorised to a higher level of priority if additional information is gleaned which merits that, with the EMD having the ability to refer to a clinician for advice and guidance based on the information elicited. This gives rise to the possibility of exploring whether a call, not categorised as Category 1 from the Dispatch on Disposition process, should nonetheless have been recategorised in the light of additional information. To argue this will likely require expert evidence as to why the clinician considering the information ought to have realised that the call in fact related to a life-threatening situation as opposed to one that was only urgent or of even lower priority.
Assuming that a Category 1 dispatch is requested, as a caller one would hope that the ambulance would be dispatched and en route to the scene immediately. Sadly, commonly this is not the case. In recent times a particular problem has arisen relating to the availability of resources. We are all familiar with hearing in the news about ambulances, occupied with patients transported to hospital from the community waiting, sometimes for many hours, to handover, their patients to staff in A&E. Until such time as that crew is clear from their previous job that resource is unavailable for dispatch.
On occasions, this can result in no resource being available to dispatch or there being a need to choose or prioritise one Category 1 over another Category 1. It is suggested that any delay that results from this situation is very unlikely to result in a finding of breach of duty. This delay, consequent upon the inadequacy of resources, is likely to be regarded as unavoidable. It will only be if resourcing can, in and of itself, be objectively demonstrated to be insufficient to enable the Trust to meet its obligations to exercise reasonable skill and care that this could potentially result in a finding of breach of duty. An example may be where the number of ambulances in service is patently insufficient to properly serve a population, perhaps lower than had previously been operated. It is suggested that such situations will be vanishingly small in number.
Assuming that an ambulance is then available and is dispatched, operation performance standards require a specific response to be achieved. There will be many variations in response times, for example, the location of the patient, the availability of ambulance crews and units, road delays etc. Where a delay has potentially resulted in a fatality there is likely to be enquiry within an inquest setting, where the Coroner may be interested in missed opportunities and preventing future deaths
Cases involving ambulance treatment are complex. We have handled many cases involving ambulance treatment.
Browell Smith & Co have an experienced clinical negligence team who can assess all of the evidence relative to the way in which your treatment was handled. Our assessment may include obtaining the telephone call recording to 999, examining call logs and response times, evaluation of events from the initial call handling to the treatment provided at the scene and delivery to Hospitals A and E.
We are able to provide representation at Inquests when required. Our experienced team will be able to guide you through the process at all times. We are able to provide representation at Inquests when required. Get in touch with our team of Medical Negligence Solicitors today to find out how we can help you.
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