Helpline makes 'wasted 999 calls'

Share this article

AMBULANCES are being sent on thousands of wasted 999 calls every year in Scotland by ‘over cautious’ NHS telephone staff, a report suggests.

Around half of the 10,000 emergency calls generated each year by the NHS 24 phone service could have been dealt with by simply giving advice or seeing a GP, claim ambulance chiefs.

They are warning that genuine emergencies could take longer to attend as a result of the time-wasting calls generated by NHS 24.

The specially trained nurses who staff NHS 24, a round-the-clock advice line which is being rolled out across Scotland after its launch in Grampian last year, can request an emergency ambulance if a caller’s description of their symptoms appears to merit one.

The Scottish Ambulance Service has now studied the records of 250 patients who had an ambulance sent out to them after such a request.

It said its "preliminary" findings were that about a quarter could have been dealt with adequately by visiting a GP, and another quarter could simply have been given advice over the phone.

About 6,750 emergency ambulances have been requested by NHS 24 in the eight months from April 1 this year to date, which represents 3,375 unnecessary ambulance 999 journeys. Ambulance staff do not query NHS 24 requests on the grounds that the phoneline service is capable of making the right decision.

Talks are now expected between the two organisations to identify the cause of the problem.

Ambulance staff, who refused to be named, told Scotland on Sunday they believed NHS 24 operators erred on the side of caution too often, particularly with respiratory symptoms and patients who might have a broken ankle or wrist.

In theory their training, and the computer programme they use, should allow them to differentiate between a chronic respiratory condition which is not an emergency, and a genuinely life-threatening breathing problem. Foot and hand injuries are also supposed to be assessed in a similar way.

SAS director of operations Phil Spence said: "We’ve looked at the calls [from NHS 24] and we believe that a quarter could be dealt with by them and should not come to the ambulance service, and another quarter should have been seen by a GP."

The ambulance service has not yet assessed what impact the situation has had on its ability to respond to genuine emergencies, and stressed that its findings were a "rough analysis at the moment" which had not yet been assessed jointly with NHS 24.

However, when asked what the effect of the problem was, Spence said: "There is a correlation between demand and performance. Any increase in demand is bound to have an effect. You can’t be in two places at once."

He added: "We are working extremely closely with NHS 24 to ensure all calls are dealt with as appropriately as possible."

The problem follows a string of other complaints about NHS 24, which has so far cost the taxpayer 75m.

The service, which employs 816 staff to cover Grampian, Moray, Glasgow, Highland, Ayrshire and Arran, Fife, and Dumfries and Galloway, is due to be rolled out across Scotland by the end of next year.

It was introduced to take pressure off GPs, casualty departments and the ambulance service. But three months after its introduction in Grampian last May, GPs in the region found there were just as many home visits by doctors, as many out-of-hours consultations at health centres, and the same number of visits to A&E.

It has also been blamed for removing much-needed nursing staff from hospitals by offering them better pay and conditions.

Margaret Davidson, chief executive of the Scotland Patients’ Association, said: "We warned them this would happen before they introduced it: that they mustn’t go calling out ambulances all over the place willy-nilly. Otherwise if the ambulance service gets an emergency elsewhere they may not be able to go to it. The system has backfired."

David Davidson, Tory health spokesman in the Scottish parliament, called for the watchdog body Audit Scotland to examine NHS 24’s performance.

"It is currently failing," he said. "We are seeing no decline in people turning up in accident and emergency, and now we have evidence ambulance callouts are going up.

"If an unnecessary callout means, say, a 15-minute journey out and another 15 minutes back, with perhaps 15 minutes’ appraisal of a patient, how many lives could be saved during that time at real emergencies?"

Davidson predicted the problems would get worse when a new contract for Scotland’s family doctors is introduced. That is scheduled for April next year, unless wrangling in the Scottish parliament delays it.

A key component of the deal is the ability for GPs to opt out of providing out-of-hours cover. Health boards will be expected to provide alternative cover but critics fear that will not be possible everywhere, further increasing pressure on NHS 24.

A spokeswoman for NHS 24 said: "I’m very surprised to hear this. We are showing consistently good levels of appropriateness in referrals to all our partners, who include GPs, A&E departments, and the ambulance service."