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Vanessa Reeve

The Digital Revolution versus Quality of Care

Ambulance

The Institute of Engineering and Technology has published a report called “Contacting Emergency Services in the Digital Age” stating that emergency services need think differently to take into account the increased use of text messages and social media to communicate, rather than people making phone calls.  The report proposes that radical changes should be made to 999 call services to allow people to send text messages, or file reports via a specific app when they find themselves in an emergency situation.  This information would then be sent through an automatic software system where it would be scanned and processed, with user information and mobile device location being provided via GPS coordinates to the call handlers.  It is thought that this will help to develop pace and momentum in the response to urgent calls allowing emergency services to respond quicker, as well as allowing people different routes of access.

This all sounds very nice in principle, but how will this actually work in practice for the Ambulance Service in particular?

Currently when you dial 999 and ask for the Ambulance Service you will be put through to an ambulance control centre where the relevant details will be taken by a qualified call centre team.  These details are taken to help determine the level and type of response required and so my first concern is therefore whether a text or an app will be capable of providing all of the relevant details to enable the most appropriate decision to be made by the control centre staff. What happens if the lack of detail results in the wrong decision being made? Or even worse what if the GPS coordinates from the mobile device are wrong and the ambulance ends up being sent to the wrong location?

Furthermore, the control centre staff are trained professionals who are there to ensure the most appropriate ambulance service resource is provided or dispatched, to provide instructions about immediate life support until the paramedic crew arrives and to provide reassurance to the person on the other end of the phone.  Additionally, in certain circumstances Triage Nurses within the control centre will take over calls that meet certain criteria in order to assess people who have non-life-threatening conditions to decide on appropriate care referral. This includes advising people to go and see their local GP, out-of-hours service, community nurse, mental health services or providing advice on self-care for the condition. This ‘triage’ of non-life-threatening calls is an important part of the ambulance service as it ensures that paramedic teams and fast response vehicles are only sent to treat those people who require immediate specialist intervention and/or conveyance to an acute hospital.

This personal interaction with the Emergency Medical Dispatchers and Triage Nurses would potentially not be able happen with the proposed change in the digital 999 provision. I believe this is a vital part of the service that ambulance control centres provide and as such I am a little bit nervous about how the introduction of technology in this way could help deliver a more effective service that has better health outcomes for people requiring urgent care.

If we are intent on introducing technology to the emergency services maybe an alternative would be an app that is pre-installed on all smart phones that enables a direct video link to ambulance control centres where Emergency Medical Dispatchers and Triage Nurses can see as well as hear what is going on. This will potentially help them react to the situation quicker and ensure that the right response is given; whether it be a referral to a GP, community nurse or social worker, some self-care advice, a paramedic to treat them on the scene, or a conveyance to an appropriate place for treatment.

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