New 999 System Cuts Wasted Ambulance Journeys

A controversial pilot scheme in which an ambulance response is put on hold while 999 call handlers judge the urgency of the problem is to be rolled out further, Sky News has learnt.

Tests of the system carried out in London and southwest England have proved so successful that NHS England will announce shortly that other ambulance services will be asked to take part.

Under the Dispatch on Disposition scheme, call handlers are given an extra two minutes to triage patients with serious but not life-threatening problems - and assess whether they need a blue-light response.

Health unions warned in January, when the pilot was announced, that it could lead to dangerous delays in responding to emergencies.

But figures seen by Sky News suggest the system reduces blue-light responses by almost a quarter without added risk to patients.

Since starting the system in February, South Western Ambulance Service (SWAS) has been dispatching 4,000 fewer emergency vehicles every week.

Neil Le Chevalier, director of operations, said: "It allows us to prioritise. It releases emergency ambulances to patients who actually need one."

Under the scheme, life-threatening calls still get an immediate response, with the aim of reaching the scene within eight minutes.

But other calls are now triaged over the phone with a series of medical questions in a maximum of two minutes.

Those rated as less serious are given advice over the phone by a clinician or sent an ambulance with a lower priority.

Mr Le Chevalier said the extra time allowed call handlers to gauge whether somebody reporting chest pain is suffering a heart attack or indigestion.

"There are lots of other reasons why people get chest pain other than they are going to collapse and die. That's why we must make sure," he said.

"With the rise in demand we are very stretched. We saw a 10% rise last year and a 6% rise this year.

"What this trial allows us to do is (ensure) appropriate resources are sent, so we have available ambulances to send to those in most need."

In the 23 weeks since starting the pilot, SWAS received 398,423 emergency calls.

Of those, 56,049 - 24,323 more than the same period last year - were dealt with just over the phone.

And 74,310 were sent an ambulance with a reduced priority.

In all, the service has made 98,633 fewer blue-light journeys since the start of the trial.

"We err on the side of safety," said Mr Le Chevalier.

"During this trial we have had no adverse incidents, no safety issues.

"When you triage a call there is always that concern, but our system is risk averse."

Ambulance services missed government response targets for 11 months in a row over the last year, though performance is now improving.

Health union UNISON conceded that the system has been a success so far, but warned it must not be used as a fig leaf for a shortage of paramedics.

"We would want any enhancement of this trial to continue with a proper evaluation," said UNISON national officer Alan Lofthouse.

"But we also want to make sure that it's not a mask for cuts within the system - in other words they're still replacing the ambulance staff that are still desperately needed to attend the emergencies."

NHS England is currently reviewing the structure of emergency and urgent care services.

It is due to unveil a further eight "vanguard" pilots, including an expansion of the specialist trauma network of hospitals.