Ambulance

Is it time to rethink the ambulance service?

By: Ben Gowland CEO NHS Nene Clinical Commissioning Group @ccginsider
Published: Monday, November 3, 2014 - 09:09 GMT Jump to Comments

Taking more responsibility for our own health while the NHS strives for integrated local services demands collaboration between first responders and Ambulance services

The closest I have been to death was a few years ago when I was playing golf in France.  I remember the day vividly.  It was a bright, sunny Sunday morning, but the weather was very much in contrast to the way the three of us were feeling, as we struggled to recover from two nights over-indulging in the local red wine.

After the usual frenetic battle to get to the course on time (missed alarm call, rapid check out, the impossible task of finding a golf course in a foreign country armed with only an out of date map and a signal lack of helpful signposting), we finally arrived at the first tee.  But we needn’t have rushed, as the queue was three groups deep, and it was the best part of half an hour before we were on our way.  Our frustration grew.

Even when we got going the pace didn’t pick up.  We had to wait to play every shot, which meant we also got to watch the group in front.  There were two men and a woman, all of whom were French.  The second hole was a par three.  One of the men and the woman hit reasonable tee shots; the second man hit two tee shots into the deep rough, and rather than play a third just picked up his tee and trudged towards the green.  I know the feeling.

When we got to the third tee, the group ahead had already teed off and were in the fairway waiting to play their next shot.  Then all of a sudden one of the men fell to the ground.  He didn’t get up.  We just stood there, staring, not sure what was going on.  Our trance was broken when all of a sudden the woman started haring towards us, screaming in French at the top of her voice.

As she came towards us, I asked if any of us knew CPR.  None of us did.  We weren’t even sure what it stood for (this was before we had the ‘Staying Alive’ adverts, so we didn’t even have that to guide us!).  However, one of my group did speak reasonable French, so we agreed he would ring for an ambulance and then ring the clubhouse for the defibrillator, whilst we would see what we could do to help.

When we got there we couldn’t find a pulse, but given none of us had ever looked for one before it didn’t mean he didn’t have one.  We tried the breath and pushing the chest but the man’s body kept making noises and we panicked that we were making it worse.  We decided the best thing to do was to try and find someone who did know CPR, and sprinted round the course like madmen trying to find someone.  Eventually I found a couple who could help and they took over.

In what seemed like an age later, and what in reality was at least half an hour, the paramedics arrived.  They arrived via golf cart, and it was quite a sight: three paramedics hanging off the cart with another running alongside, all in full uniform, like superheroes coming to save the day. 

But unfortunately it was too late.  Maybe competent help at the outset would have helped him, but by the time the paramedics arrived there was nothing they could do. 

It is easy to look back and try and apportion blame: blame to myself for not learning CPR, blame to the golf club for not having a defibrillator, blame to the French ambulance service for taking so long to respond to such an important call.  But in the end blame doesn’t help.  I think what is important is to try and take the learning and understand what we can do differently.

Recently I came across a Ted Talk by Eli Beer.  He speaks of how he took an experience not dissimilar to mine and set up a community rapid response service in Jerusalem to support the ambulance service.  They take thousands of volunteers who fill the critical gap between the ambulance call and their arrival.  They save people that otherwise would not be saved.  The response time is three minutes.

And it is not a one off.  They have recently started in Panama and Brazil.  It could be set up anywhere.  As he says, ‘We all want to be heroes.  We just need a good idea, motivation and lots of chutzpah, and we could save millions of people that otherwise would not be saved’.

I wish I could have done more to help on that golf course, and I wish a service had been in place that could have responded more quickly.  As our ambulance services struggle to meet their response times, is it time for us in this country to look at this approach, and to turn our aspirations of local integration into something that tangibly saves lives?

Eli Beer TED Talk

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