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Opinion

Wales’ new ambulance strategy is cruel and distressing for patients and those dialling 999

By Mark Mansfield
Health Minister Jeremy Miles

Emily Price

Call handler: “Ambulance, is the patient breathing?”

It’s early on a school day and my worst fears have happened before my eyes. My 11-year-old daughter has collapsed in front of me.

B had been fine all morning, we had breakfast together and chatted about the news stories I was planning to write up that day - she loves hearing about the latest drama in Welsh politics.

Then as she put on her coat to leave for school, her face suddenly dropped, she stumbled forward, fell and started clutching her stomach.

Her face was burning up as she gritted her teeth, she couldn’t answer any of my questions as she gasped out in pain. She couldn’t even get through a sentence without crying out for help.

My heart was pounding in my chest. I had never been so frightened in all my life.

As I stammered out my address and explained what had happened to the 999 call handler, I was suddenly put on hold.

Astonished, the merry hold music began to eerily mix with the sounds of B sobbing as she continued to clutch at her hip and stomach.

Minutes ticked by before the call handler came back on the line and asked if B was hot or cold to touch?
“She’s hot,” I said. “Boiling hot and crying out and I don’t know why.”

I realised the call handler was going through the motions of the Welsh Government’s new ambulance framework which categorises how serious a call is.

Health Minister Jeremy Miles announced the new response model in July. He claimed it would improve outcomes for patients with serious conditions.

Paramedic

The call handler was cutting out the middle man of a trained paramedic by asking me to carry out certain checks on B.

I started to become frustrated as the call handler put me on hold again. I realised that for some reason my call had already been deemed non-urgent.

I write news for a living - I’m well aware that unfortunately there are foolish people out there who dial 999 for non-life threatening illnesses like chipping a tooth or an ingrown toenail.

But I had dialled 999 because my child had gone from being perfectly well to hitting the ground in front of me and screaming in agony.

I’m not a doctor. But I knew that a burst appendix, gallstones or stomach ulcers were all serious conditions that required urgent medical attention.

I couldn’t believe the lack of urgency in the call handler’s tone. The lack of advice. She came back on the line before putting me on hold again. B started curling up as a wave of pain hit.

Then. The line went dead. I stared at the phone in my hand my heart hammering in my chest. It was like one of those bad dreams where you need to be somewhere but can’t quite make it.

I held on to B’s hand and tried to focus. Should I move her when I didn’t know what was wrong with her? The phone started to ring and I answered it. The call handler casually said she’d been cut off.
Then, she placed me on hold again.

Music played in my ear for a third time. I started to realise help wasn’t going to come.

I began working out in my head if I could move B myself and get her to a doctor quickly without an ambulance.

Driving license

I’m epileptic and not allowed a driving licence. The nearest hospital was a train and a bus ride away. My doctor’s surgery was two bus rides after all the local surgeries in the surrounding villages were closed and merged into one health centre miles away.

I clutched the phone and ran to the front door ready to shout to my neighbour for help. I looked out on the street and saw his car was gone. He’d already left for work.

The call handler came back on the line.

“Hi sorry for the delay. I’ve spoken to a doctor and you need to get your daughter to A&E urgently. You cannot wait. It’s very important you go now.”

“Yes I know,” I said, “that’s why I called 999. I don’t know what to do. She can’t walk. I don’t know how I can move her alone.”

Then to my astonishment the call handler told me to physically pick up my 11 year old daughter who is nearly as tall as me and carry her to A&E.

Chatty

As B cried out in pain, the call handler bizarrely began to reel off chatty pleasantries about how she hoped I got her sorted at the hospital.

I hung up the call mid script without saying goodbye. I was on my own.

The phone showed I had been on the line - much of it on hold - for almost half an hour. I’d wasted time.

I rang my husband who was at work and several miles away. I told him to come quick, that B had collapsed. That I’d called for an ambulance half hour ago but help wasn’t going to come.

I tried to help my daughter up. I’d heard stories of how people can gain sudden strength in moments of extreme stress. Although I could just about lift B, she screamed and writhed in agony every time I moved her. After what felt like an age, my husband burst through the door. He grabbed B in his arms and carried her to the car. The drive to the hospital was about 40 minutes and my daughter’s cries became weaker and weaker as we drove.

As my husband carried her to the entrance she looked ashen. Then B began to vomit uncontrollably. Whatever was happening to her was getting worse by the minute. She was as pale as a ghost and still weakly clutching at her waist and hip. I ran ahead to the desk and we were raced to the paediatric department.

Nurses sprang into action. They said all her symptoms pointed to appendicitis. A life threatening infection that required surgery fast.

I told them I’d called 999 but that they wouldn’t send an ambulance and I’d had to wait for a lift.

Some of the medical staff raised their eyebrows.

A team a surgeons rushed in, taking bloods and feeling my daughter’s tummy. Three doctors stood with their heads together discussing next steps whilst my husband and I stood by watching our worst nightmares unfold.

My daughter was sent for an ultrasound scan where to our horror the sonographer found a 13cm mass attached to her ovaries. Not appendicitis. Something else. A growth larger than a grapefruit taking over her insides.

MRI

B would have to be transferred to a more senior team of surgeons. I felt sick to my stomach as doctors explained that the growth was too dense to be a cyst and more likely be a tumour. An MRI would help them to determine what kind.

I cried into a surgeon’s shoulder as she explained that B would need to be transferred to oncology at another hospital. Radiation has been mentioned as well as biopsies and surgeries. All words parents don’t want to hear.

It was clear that my daughter was seriously ill when she collapsed on Friday morning. And yet, she wasn’t entitled to an ambulance.

Calling 999 is not a casual thing for anyone to do. Callers do it in their darkest moments, in the grip of fear for loved ones or even strangers on the street who need urgent medical help.

People dialling 999 don’t need upbeat hold music whilst they watch their children cry out for help. They need urgent action from a trained paramedic.

Distressing

The Welsh Government’s new ambulance performance framework is cruel and distressing for families and good Samaritans who dial 999 to save people in desperate need of help.

The new response strategy puts too much responsibility on the person calling 999 to do the job of a trained professional. It wastes time and prolongs unnecessary pain.

My daughter’s sudden collapse and our call to 999 has left us both traumatised. What’s worse is that the experience has taught B that if she is in severe pain and needs urgent help - there’s no point calling 999.

I blame ministers in the Senedd for that.

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27 comments

Evan Aled Bayton

The ambulance service has failed because the hospitals have backed up. It is obvious why but no one seems motivated to alter it. The service is too small for the population it serves.

Reply
Thomas

The headcount and budget of the NHS are the highest they have ever been. Yet the service it delivers is the worst it has ever been.

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Amir

Probably because there are so many vacant posts for doctors and dentists in the NHS.

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Davie

What's happened to demand? Doubling a budget isn't enough if demand has tripled, for example.

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Davie

And hospitals are backed up waiting to discharge into social care. Social care beds are much cheaper than hospital beds.

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David Richards

While extremely distressing for callers it is perhaps fitting that the Welsh labour Government’s new 'ambulance performance framework' is a utter disaster - because welsh labour's stewardship of the nhs in Wales for the last 25 years has been a utter disaster! We have the worst waiting lists in the uk - 38000 people are dying annually on welsh waiting lists - and had the worst ambulance response times for years. And like Emily i had the misfortune of trying to summon a Welsh ambulance recently but it seems the victim of the attack id just witnessed - a woman who'd been assaulted (and molested) by more than one male - wasnt, in the handlers view, a 'medical priority' so no timescale could be given for when - or even if - a ambulance would be despatched. I would complain to my local health board but they (like every health board in Wales) are stuffed with labour party appointees who can be relied upon to defend their party chums from criticisms of the way it is wrecking the health service in Wales. Thankfully however the chickens are coming home to roost for labour in Wales and - on account of its disastrous management of the Welsh among other things - the party rightly faces annhilation at the Senedd election in May

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Ernie The Smallholder

That is the problem when the health boards are stuffed with appointees from centralised political structures. The Labour party (whether Welsh Labour, or otherwise) are controlled from the centre and it is the same for the conservative party, Those parties have top-down structure. Reform UK is even worse as Reform policy is made by a limited company controlled by 2 shareholders. Plaid Cymru is decentralised as it is a natural Welsh party. The Green Party is federalised by nation, with independent policy making decisions within its structures. The Liberal Democrats have decentralised federal policy making structures which are independent for each of the nations and region.

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Tucker

So you'd prefer the reform privatised health care model instead?

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smae

That is terrifying. "I've spoken to a doctor"... tf. Sadly I've had the same or similar treatment. When my mother had a suspected heart attack "Oh the ambulance will be with you soon" "When?" "Oh in about 8hrs or so". I could not believe what I was hearing. I'd read about such cases in the news before, but usually what I read in the newspaper and my own experience often tends to be completely different. Yet anyone can see the problems with the ambulance service. In England (North East), if you call the emergency services, they are there within the hour. Especially if the words "collapse", "unable to communicate", "agony" and similar phrases are uttered. My own experience was that they turned up in 15 minutes (we had to call them out twice). (Also the coastguard are amazing, who knew they did land stuff, team of volunteers but wow, more professionalism than the ambulance service in Wales). There is something seriously wrong in Wales. However, I'm not exactly sure how Wales could do better with the restrictive funding and higher demands, especially when being robbed blind to help England pay for its infrastructure costs.

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Mab Meirion

Miles has no right through qualification to be in that job...enough solicitor politicians...

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Mab Meirion

Plaid do you have a plan for NHS Cymru, or will it drag on in crisis until Farage sells it off... 6 months to save the day...

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Thomas

'until Farage sells it off'? Utter nonsense. Even if he wanted to sell it, who in their right minds would want to buy such an overweight, bureaucratic, inefficient, uncaring organisation?

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OZZY666 DAVEY

EXACTLY, J. MILES WILL HAVE SOME EXPLAINING TO DO AFTER I PUT IN A FORMAL COMPLAINT ABOUT THE EXTREMELY BADLY RUN ROYAL GLAMORGAN HOSPITAL & IT'S C.E.O PAUL MEARS. THE CONCERN TEAM & PALS OPERATIVES ARE NOT FIT FOR PURPOSE, END OF❗️

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Amir

I am so sorry and distressed to read about your personal experience, Emily. You write and the pain is so evident. Our governments are letting the NHS die through cuts and cuts and they are not fighting for crown estates to be devolved which would give Wales a lot more funds.

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Thomas

Cuts? What cuts? The budget is the highest it has ever been!

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Smae

So is demand.

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Merch o'r Cwm

I know this piece is about the deficiencies of the Welsh Ambulance Service - and like other commentators, I've had a similar experience whereby we found an obviously intoxicated but badly injured man laying at the roadside and were told to take him to hospital ourselves - but I hope that Emily's daughter is receiving the treatment she needs and that the prognosis is a positive one. What an awful experience all round.

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Elaine Ley

Get this on the Welsh news

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Raf16369

My mother passed away at home in January after waiting 20 hours for an ambulance tjat never came. If I could have got her to A&E I would have done but this was an impossible task as it took 3 people to get her from the bathroom to her bed (a distance of no more than 10 feet). I complained about the service received and after waiting 6 months for a response (after involving the Ombudsman) the Ambulance Trust apologised but found not real issue with the (lack of) service provided.

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jimmy

Inept crisis management that only serves to compound the crisis.

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Tracey

The Welsh Government need to build Recrupriation hospitals, Council Care Homes so that patients can be discharged from Acute Hospitals when well enough but not well enough to go home, then it would free up beds which means that space can free up in A&E for ambulance crews to offload their patients to enable them to go out to the next emergency, simple! The problem is that the recrupriation hospitals we used years ago were closed down as the government refused to spend the money to maintain them, so we need new built. It's not the fault of the Ambulance Service at all when they are stuck outside A&E for up to 48 hours at a time! I'm an ex-nurse, saw this happening on a daily basis and hated it. It causes such low morale in the work place which is quite depressing for Nurses and Doctors. Recruiting Nurses and Doctors is at an all time low due to the expense of the training, the risks of certain hospitals closing down and the stress of a huge workload! We need to have First Aid taught in Schools as it was years ago, this will encourage some to become interested in care, nursing and becoming medics, it all starts here! Nurse training should be a job, with pay increasing when each level of training is reached, one day a week inhouse academic work not have to pay for your training! This is the only way that they can guarantee having sufficient recruitment of nursing staff! It should be free to train doctors too as they are all a necessity to a public service. All this would answer the crisis of our NHS and provide a sufficient and fit for purpose NHS. Welsh Government should stop giving money abroad, such as the £20 million to 3rd world countries to plant trees (probably not used by their government to plant trees, but to be used by corrupt money grabbers), this could have built one recrupriation hospital! Plus the purchases of Farms and land that are used for music festivals etc! Such a huge waste! So the Welsh Government need to sit down and discuss a good way forward with the input of other parties to get this right not bully and run other parties down they should all work together! It's not Rocket Science!!

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Paul

When I first joined the ambulance service in the early 2000’s we would respond to calls and if they were ‘assistance’ calls (eg stuck in the bath or fallen out of bed) we could sort the situation out and had the autonomy to decide if the pt was ok and will be in a safe place eg with family who could keep an eye out in case pt deteriorated. The crew could then be off on another call. These days crews have to undertake a number of tests to check that the patient has not got other issues eg. heart problems or breathing problems, even though the cause might be as simple as slipping off the side of the bed. All of this paperwork is now the most important part of the call easily adding an hour onto what could be a quick call. This paperwork is now checked by supervisors who are paid extra to ensure that paperwork is done correctly just in case a complaint is made and someone is to be held to account. This blame culture is something that is never discussed as a cause for delays but is nevertheless a major reason for everything taking longer. We really need to have a cultural change in our system to reduce the ‘where there’s a blame there’s a claim’ culture.

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Matthew

There's not enough money to spend on making our public services run well and our politicians are desperately trying to make the service work while workers effectively have one hand tied behind their back. But billionaire wealth in the UK and globally doubled in the last five years. It'll only get worse if we don't act now and only support parties who want to bring in wealth taxes. Otherwise in 10 years we'll fondly remember the days when even when they were bad, at least we had public services.

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Davie

We can only tackle billionaire (and soon trillionaire) wealth globally. That's why these folks are working hard to dismantle global alliances like funding the Leave campaign.

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K E

The past service wasn't much better. I went to the coroners investigation into the death of a mutual friend, and an investigation found the ambulance service system wasn't fit for purpose. It sounded like they would have pushed further on it, but this new system had already been rolled out at the time of the coroners report. As a result, despite being listed as urgent, their call was skipped over and an ambulance took much longer to arrive. They couldn't rule that it had a part the death, but it was chilling to hear that 999 kept trying to call their phone and got no response.

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Stephen

I had a stroke in April wife phoned 999 it took 12 hours for the ambulance to come the nhs in Wales is disgusting I could have died

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Replying to Amir Cancel

I am so sorry and distressed to read about your personal experience, Emily. You write and the pain is so evident. Our governments are letting the NHS die through cuts and cuts and they are not fighting for crown estates to be devolved w...

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