Friday, 1 January 2010


I couldn't leave this auspicious (suspicious?) date, without at least disturbing your day for a short while, so first, allow me to wish you a happy, healthy, successful and prosperous New Year. And if by prosperous it means that you win a huge amount on the lottery, then please remember who your friends are.
In the days leading up to the end of the year, the London Ambulance Service has been doing one of the things it does best. Counting numbers. Specifically, a very large number. One Million to be precise.
That was the magic number we hit at just after 3am on the last day of the year. One million calls dealt with in a single year. It's a significant rise on the year before, and the year before that, and the ... well, you get the picture. The thing is, I'm not so sure that it's a number to be proud of.
There are no more ambulances out there than there were a year ago.
No more man- (or woman-) hours. There are boasts that there have been hundreds of new recruits, but there have been probably an equal number of people leaving. The front line staff, as well as those in control, are being pushed ever harder to meet targets that are at best dubious and ill-conceived, and at worst downright dangerous. Patient care targets are nothing compared to the national time-based targets set by the government, and this is where we have the danger of falling flat on our faces.
Patients don't want to see just an FRU outside, single-staffed, with no ability to convey a sick patient. They want to see it backed up quickly by an ambulance. More than that, they want those staffing the FRU and the ambulance to be at the top of their game. Well-informed, well-trained, professional staff will do a great deal more for not only our patients, but our image too. Demoralised, despondent and harassed staff will do the opposite.
Partly, the blame needs to be placed on the fact that we are, in a way, victims of our own success. We are too good sometimes. We provide too much for too little, and do not do enough in the way of public education. We provide paramedics with extra training who now do the house-calls that used to be done by GPs. We provide ambulances especially geared for non-life threatening calls. We still attend calls that any level-headed person would look at with disbelief. Stubbed toes, broken finger-nails, a three-week runny nose, and many more of the same ilk. We even provide transport, every weekend of the year, so that the public can drink as much alcohol as possible, take the booze bus, and not face up to their social responsibility. Or their cab fare.
This year, I'd like to see the trend reversed. I'd like to see fewer calls. Not because I'm lazy, but because I think that the priorities need rethinking.
I think we need to educate ourselves and the public. I think we need to concentrate on what's important, and not necessarily what's arbitrary.
I think we need to worry more about serving those who really need us, and ensure that we are always prepared for them.
I think we need to go back to the days where ambulances are waiting for calls, and not calls waiting for ambulances.
I love my job. I am passionate and idealistic about it, probably to a fault. I'm one of those crazy people who actually loves getting up in the morning and going to work (ok, ok, so I work nights and go to bed in the mornings). If I have more than two or three days off, I start getting withdrawal symptoms. I'm inspired by my job, my colleagues, even my patients. I know, it's worrying, but this is why I want to see positive changes.
We all have our New Year's resolutions. The Service's should include more public education, higher expectation of their staff, whilst maintaining high levels of morale. It's a tricky balance.
My resolutions are little changed from last year. Always be ready to learn something new every single day. I owe it to my career, to myself, to the Service. Most of all, I owe it to my patients. I hope I can stick to it, and I hope, whether you're a colleague, a manager, or a patient, that you can help me do that. I promise to return the favour.
Happy New Year to you all.


slmiller72 said...

Happy New Year to you, Ben.

I would like to say your latest post reflects my thoughts exactly.In essence, I really couldn't have put it better myself :)

However, I would just like to add that as old fashioned as this sounds - Happy staff are more productive in terms of targets. Happy staff are nicer people to be around thus making the patients feel more at ease rather than being faced with de motivated, de moralised and indeed downtrodden staff.With apathy comes mistakes.

I have to disagree with your suggestion that the Service's New Year's resolutions should be higher expectation of their staff.They already have this. Their resolution should be to cherish and nurture those that have a genuine passion for their job, a true desire to do their best for the patient. It is those people who should be rewarded.To be told when they are doing a good job rather than reprimanded for every minor fault.

The service, when under severe pressure, has learnt to say no to a variety of callers requesting/demanding an ambulance. I would like to see this implemented as one of their New Year's Resolutions when the service is running normally, not just because we are stretched to breaking point.

Thanks for an insightful blog as always Ben. It's working with colleagues like you that makes the job good. It's also reassuring to know i'm not the only one who actually looks forward to going to work!!!!

Fee said...

Happy New Year.

I promise, in turn, to continue to strive to NOT call an ambulance unless there is no other option. I will deal with my childrens' ailments the same way my mother dealt with mine (with common sense, paracetamol and Milk of Magnesia!). I will consult my GP or practice nurse as necessary, and will continue to regard dialling 999 as the absolute last resort when trained help is required along with a quick trip to hospital.

I'd like to see the 999 services release yet more figures - shock people with the sheer volume of unnecessary calls you receive. Publicise the abuse of the system - and I'd also like to see the guilty parties named and shamed (although that's never going to happen, I can wish!).

Harris said...

Well said. Not sure why the powers that be seem so chuffed at hitting the million mark and it sets a worrying precedent. Agree that more public education is necessary; some of the calls we get in EOC just beggar belief and it's doubly frustrating to then see that a crew has actually been sent out.

Ben Yatzbaz said...

Thanks all again for commenting!
SLM - I don't see anything wrong with maintaining high expectations - but agree that there's a right and productive way of going about it...
Fee - just for you - a kind of naming and shaming. Have a look at . The police obviously do it - you're right - maybe we should too...
Harris - glad to hear that you guys up in EOC are equally as frustrated as we are!