The Bucket Overfloweth

The ambulance service is experiencing a constantly high level of calls via the 999 system on a daily basis (except it would seem on the days of action by the Junior Doctors) and we only have a finite number of crews and vehicles. 

This situation is similar to the “stress bucket” model which is referred to in acute mental health services; the water pours into the bucket (calls coming in via 999) until the water overflows (the calls back up) with undesired consequences.  The recognised solution is for the “bucket” to be fitted with a stress relieving tap through which the water level can be reduced to prevent over flow taking place.

With regard to the high volume of calls coming in

 via the 999 system, it would appear that “assigning calls to resources” may take the part of the tap, but inevitably the  mountain of incoming calls, continues to increase, the water level continues to rise, as does the stress and pressures on our call takers and dispatchers…. So what should we do about it?

 

“Get a plumber” I hear you say, or “get a bigger bucket”. If we were gifted a larger bucket (more ambulances and qualified clinicians) then it could have a marked positive affect, but does not appear to be likely. So what about the size of the incoming waterfall ( the 999 calls)?

When considering the amount of water flowing into the bucket, we need to consider the source; is it a limited supply that is dripping into the bucket or is it a mains supply of unlimited quantities? The latter appears to be the case with our incoming 999 calls, so we need to take stock of our situation with regard to the source of our 999 calls.

Remember, there was no apparent surge during the Junior Doctors days of action, so there must be means out there to divert the waterfall (incoming 999 calls) and by that I don’t mean directing the callers to a nom emergency line to triage the calls because that has the potential to have serious impact on time critical patients.

For those of us that saw life prior to the nineties, there was a Government Department with sole task of providing public announcements for radio, television and cinema. Most famous where the advice to holiday makers towing caravans, reminding them to check their mirrors and to pull over so that workers could get past and reach their work on time; another one was the elderly couple sat having a picnic on the cliff tops, looking out to sea they observed a sailor waving at them. “Hey up, Petunia” he says to his wife “Do we know that guy waving at us?”… in fact it was a distress wave and the advice was to dial 999 and ask for the Coastguard.

 

 

The department is no longer there, but the need still remains for members of the public to reminded about some of the everyday  needs and irritations which they could help relieving, and by that I mean we need to commence educating the public about their personal healthcare, having the basic medication and first aid items in their homes, making proper use of their GP surgeries, reinforcing the training of First Aiders so that they have a better understanding of what is a first aid issue and what is a 999 ambulance incident. The same applies to Care Homes, Residential Homes and places of public entertainment.

A similar approach could reap benefits if we targeted GP surgeries and enlightened them about cycle responders, RRVs and ambulances; what they are capable of doing, but most importantly, what impact it has on the ambulance service when they make an inappropriate call which diverts the resource away from a patient that actually DOES need immediate medical assessment and treatment by our clinicians.

We are NOT a Taxi service, but listening to our clinicians it would appear that a high percentage of the public are of the impression that in fact we ARE a Taxi service, at their beck and call 24/7; so until we stop acting like a Taxi firm, until we educate the public, they will continue to make inappropriate use of us, the waterfall will continue and the bucket will continue to overflow.

 

Jeff Pittman

East of England Ambulance Unison 20106

Branch Health & Safety Officer