999 plan ‘puts lives at risk’
Tuesday 28th October 2008, 8:00PM GMT.
New guidelines which could see patients taken to hospital by ambulance without a paramedic on board could put people’s lives at risk, it was claimed today.
Bosses at the West Midlands Ambulance Service, which covers Shropshire, want to allow two emergency care assistants – whose role is to assist paramedics and ambulance technicians at the scene of incidents – to man an ambulance to take a patient to hospital.
The ambulance service today defended the stance – claiming it had been requested by staff and would keep paramedics in rural Shropshire – and said ECA crews would only be used for minor incidents.
But union officials and Shropshire campaigner Steve Jetley attacked the proposals.
The guidelines say a clinician at the scene must carry out a full patient assessment and if there is no “reasonable” indication the patient will require support from a technician or paramedic en-route to hospital a two-person ECA crew can be used.
But Mr Jetley and Unison said assistants could not take responsibility for patients and could not provide a full range of treatment.
They have been taught basic life support, fracture and wound management and low flow oxygen administration and can initially deal with life threatening conditions such as chest pain, fits and head injuries.
However, the document says if a patient being taken to hospital by a double ECA crew deteriorates, they should inform operators and a decision made whether to take the patient to the nearest clinician or to hospital.
Mr Jetley said: “It’s putting lives at risk.”
Ray Salmon, regional organiser for Unison, advised staff not to hand patient care to ECA crews. He said: “If patients do not require input from a trained clinician en-route to hospital, the question has to be asked, do they need an ambulance?”
Murray MacGregor, spokesman for West Midlands Ambulance Service, said: “There are a few occasions when it is clinically appropriate to have a double ECA crew to take a patient into hospital, such as a deep gash on a hand.
“It means we can keep highly trained paramedics in rural Shropshire.”
By John Kirk
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Surely, its black and white, if the bosses who quoted “It means we can keep highly trained paramedics in rural Shropshire.” train the emergency care assistants to become paramedics. But I forgot these bosses want their bonuses and big pay packets, so they have to save money, so its the ambulance service again.
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So the ambulance service get a call saying that a senior politician or a member of the royal family needs an ambulance – who do they send out?
OK, we all know the answer…….so who works for who?
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its happening all over the country.its madness.first aiders on emrgency vehicles.it needs stopping now, it is just a way to get bums on seats and to save money as they are lower paid than qualified clinicians. they cannot make a clinical decision and back up in the form of a rapid response paramedic is not always available. this puts both patients and care assistants in vey awkward and possibly life threatening positions. public see green uniforms and expect the person to be a paramedic, not a first aider barely qualified up to a first responder level.its an easy way to hit government statistics but is a dfilution of the ambulance seervice, we are not in a classroom with a teaching assistant or in a hospital with lots of doctors and nurses around to support us we are going to seriously ill people and thats the differance
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Maybe if the ambulance service wasn’t being used as a taxi service for drunks they could afford to pay for paramedics to perform their duties. I was disgusted to find an ambulance dropping a local drunk off outside my house at 1.30 am on Sunday morning (it wasn’t my husband!). Any other patients have to call for a taxi to get home but obviously this alcoholic is well known to them and is given a special service because he spends all his money on alcohol so can’t afford a taxi home.
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It isnt just drunks who abuse the service, for a long time polls have claimed that a good 60% of ambulance ” emergencies/calls ” do not require an ambulance and can either wait to see a gp or they can make their own way to hospital. And with recent changes to the way ambulance services are judged as succeeding or failing and funded by the new response times this is what you get, but as Tech above has commented this is not the way forward.
But as usual it will need the death of someone to occur before people realise.
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ECAs are NOT there to provide any sort of patient care, only to assist clinicians ie. driving and manual handling. They are not trained or paid to work unsupervised. Most of the staff in WMAS are disgusted by the managements disregard for patient care and will not have anything to do with this dangerous move that’s merely designed to save money. Staff have not asked for it, that is a lie. What staff want are ambulances staffed with adequately trained clinicians, not care assistants with two weeks ‘awareness training’.
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I can understand ‘Ellesmere Residents” disquiet. 2 points:
1. How do you KNOW that on *this* occasion the man was drunk?
2. Also, a drunk person who is unconscious is STILL an unconscious person unfortunately. And therefore one who does not necessarily have control of their own airway and breathing. Therefore – clinically – such patients becomes a priority case for the Ambulance Service.
3. If the man has been treated in hospital and then the hospital requests transport home, the Ambulance Service frequently has to oblige. And not just the West Midlands Ambulance Service. It happens all over the UK.
4, Its possible that everyone with a mobile phone kept ringing 999 for this person (assuming he was drunk, and lying at the side of the road somewhere).Believe me – it happens. Sometimes – if theres no serious problem – its better just to take them home and get them off the street. Of course, if you’d rather they took the patient to RSH (…and so tie up an ambulance crew – and hospital staff – for even longer…)
Intoxicated patients are a major problem and a serious drain on resources. All Ambulance staff would admit that. But simplistic comments are no help unfortunately and I doubt this man was given ‘special treatment’.
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The bosses say “We can keep highly trained paramedics in rural shropshire”. What nonsense. Firstly what good is a paramedic in rural Shropshire on his/her own without an ambulance with a trained crew available to back him/her up.
Secondly – if double ECA crews would only be used to carry ‘minor injuries such as a cut hand’ then why is the patient going to hospital in an ambulance in the first place? Get a Taxi or in the worst case scenario one of the ECA’s could drive the patient to hospital in the Paramedics car whilst the paramedic stayed with the ambulance where he/she can do some good.
Thirdly, What happens when an ambulance staffed by two ECA on its way to, or back from, a ‘minor injury’ happens across a serious road accident or other REAL emergency? How will they explain to someone that despite having all the kit and drugs all they can do is administer a bit of first aid? How on earth will they tell the relatives that they can’t even take the injured or dying patient to hospital?
Once again WMAS shows that the only thing it cares about is meeting the Government’s meaningless targets so it can win worthless awards even at the expense of proving adequate care to Shropshire residents.
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If two ECA’s are left on an A&E vehicle they will ultimately be sent to class A life threatening jobs in order to hit the governments 8 minute response time. It’s at this point that lives are put at risk. The use & employment of ECa’s is putting extra strain on EMT’s & paramedics also, meaning they have to assume all the responsibility for all the patients all shift. Your healthcare is at risk. Write a letter to your local or national MP.
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oh god here we go again, yes its the same dribble and stupid comments that is happening in staffordshire,yes its all down to money,firstly let me say no double eca crews will be working together as the boses have already said,as for not having a paramedic on an ambulance if a member of the public called for an ambulance what are the chances of having 2 techs,or a para/tech, and if you get 2 techs then a (cpo)paramedic in a car will turn up,this is just a case pf some paras and techs wanting an easy life and only doing half a days work for their £25-35,000 a year,an eca is a cheaper alternative than having 2 paras on 1 vehicle which is not cost efective ,the 2 paras could be split up to cover other areas so the patient gets better care and gets the treatment they deserve, dont pretend you care about the patient first because you dont its your workload, eca,s are here to stay so get used to it, no amount of moaning and whinning and pathetic rumours started by unison are going to change things, without the eca,s the service would not have the cash to put so many vehicles on the road,eca,s are not putting anymore stress or strain on paras/techs and no lives are being put at risk its just childish and pathetic lies started by unison and some of their not so bright members are letting it snowball out of hand, as a paramedic of 18 years iam more than happy to work with an eca, and lets not forget there are qualified para/techs out there who put lives at risk,
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Mr Evans,
I can only assume that you haven’t read the statement from the ‘bosses’ which says that double ECAs will be working together – so perhaps you’d better get used to that.
Indeed an ECA is a cheaper alternative that a Para and/or a Tech (exactly my point) – so is a Community responder – so, in fact, is a completely unqualified first aider – but would you want one manning an ambulance attending YOUR child?
You say that by using ECAs the two Paras could be split up to cover other areas. Fine – except lets assume you are a patient having a massive MI. What use is a Para in a car and no means of getting you to hospital? Paras in cars are a means of meeting government targets in arrival times – not a means of delivering patient care.
Additionally, you claim that working with an ECA puts no more strain on a Para or Tech than working with another qualified person. Get real. If you are having to watch a ‘beginner’ then are not concentrating on the patient. What you need is someone who knows exactly what they are doing and can work unsupervised.
I appreciate that you have been a paramedic for 18 years. I’m aware that when you probably started that crews were little more than ambulance drivers- but that is not the case anymore even if you haven’t gone with the times.
If I, or any member of my family needed an ambulance I would want one of the professionals who are concerned by this dangerous practice to attend – not an ECA or and certainly not you if you think it is acceptable,
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